Acute Psychosis Associated With Phenibut Ingestion

Acosta, Eric; Munguti, Cyrus

doi:10.17161/kjm.vol14.15550

Cited by 2 publications

(7 citation statements)

References 7 publications

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“…2 Elevations of creatine kinase (>800 U/L) and rhabdomyolysis have also been reported. [32][33][34][35] 5 In this same study, 22 of these patients (56.4%) required admission to an intensive care unit (ICU). 5 Although this study reported a lone death, the prevalence of patients requiring intubation and ICU admission was notable.…”

Section: Intoxicationmentioning

confidence: 84%

“…9,11,17,33,47,52,[62][63][64][65] In many of these cases, the exact dose taken by the patient is unknown and therefore not reported or is reported in a nonspecific manner (ie, "the patient took a tablespoon of phenibut powder"). 34,35,[66][67][68][69][70][71][72][73][74] Few reports of acute phenibut toxicity have included data on plasma phenibut concentration. 17 A 20-yearold female was noted to have a phenibut plasma concentration of 29.7 μg/mL approximately 11 hours after taking 25 g of phenibut the previous day in 3 separate doses.…”

Section: Intoxicationmentioning

confidence: 99%

“…Signs and Symptoms Commonly Associated with Phenibut Toxicity and Withdrawal2,5,6,11,[30][31][32][33][34][35] …”

mentioning

confidence: 99%

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Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Penzak,

Bulloch

2024

The Journal of Clinical Pharma

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Abstractβ‐Phenyl‐γ‐aminobutyric acid (phenibut) is an analog of the inhibitory neurotransmitter γ‐aminobutyric acid (GABA) that was first synthesized in Russia in the early 1960s. It is marketed as a nootropic (smart drug) to improve cognitive performance, and to treat generalized and social anxiety, insomnia, and alcohol withdrawal. The use of phenibut is legal in the USA and it is widely available online without a prescription. Increased public awareness of phenibut has led to a growing number of reports of acute intoxication and withdrawal. In this review, we describe the pharmacology of phenibut, the presentation and management of acute intoxication, and regulatory issues, placing particular emphasis on the treatment of acute withdrawal, for which there are no comparative studies. Among 29 cases of phenibut withdrawal, patients were successfully treated with baclofen, benzodiazepines, and phenobarbital, as individual agents or in various combinations. Ancillary medications included antipsychotics, dexmedetomidine, gabapentin, and pregabalin. After stabilization, a number of patients did well on baclofen tapers, whereas others were weaned off benzodiazepines or phenobarbital. Phenobarbital may be preferred over baclofen, or used as an added agent, in patients at risk for seizures. As long as phenibut remains legal, cases of phenibut intoxication and withdrawal are likely to increase. As urine or plasma drug screening for phenibut is not widely available, it is vital that clinicians obtain a detailed medication history in patients presenting to the emergency department with nonspecific symptoms that may represent phenibut intoxication or withdrawal. Further, clinicians may wish to consult an addiction specialist or toxicologist in these situations.

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Section: Intoxicationmentioning

confidence: 84%

Section: Intoxicationmentioning

confidence: 99%

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Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Penzak,

Bulloch

2024

The Journal of Clinical Pharma

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“…The most commonly reported acute intoxication symptoms associated with phenibut include tachycardia, hypertension, insomnia, anxiety, agitation, and hallucinations. There have been 27 adverse events related to phenibut reported in the CAERS database including hospitalization and other life threatening medical events 24,95,104 …”

Section: Resultsmentioning

confidence: 99%

“…There have been 27 adverse events related to phenibut reported in the CAERS database including hospitalization and other life threatening medical events. 24,95,104 Most of the research focused on phenibut was conducted in the former Soviet Union. One study of swimmers with disadaptation syndrome evaluated 4 weeks administration of phenibut at 250 mg, aminalon at 250 mg, and picamilon at 100 mg daily.…”

Section: Phenibutmentioning

confidence: 99%

Unauthorized ingredients in “nootropic” dietary supplements: A review of the history, pharmacology, prevalence, international regulations, and potential as doping agents

Jędrejko,

Catlin,

Stewart

et al. 2023

Drug Testing and Analysis

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The first nootropic prohibited in sport was fonturacetam (4-phenylpiracetam, carphedon) in 1998. Presented here 25 years later is a broad-scale consideration of the history, pharmacology, prevalence, regulations, and doping potential of nootropics viewed through a lens of 50 selected dietary supplements (DS) marketed as "cognitive enhancement," "brain health," "brain boosters," or "nootropics," with a focus on unauthorized ingredients. Nootropic DS have risen to prominence over the last decade often as multicomponent formulations of bioactive ingredients presenting compelling pharmacological questions and potential public health concerns. Many popular nootropics are unauthorized food or DS ingredients according to the European Commission including huperzine A, yohimbine, and dimethylaminoethanol; unapproved pharmaceuticals like phenibut or emoxypine (mexidol); previously registered drugs like meclofenoxate or reserpine; EU authorized pharmaceuticals like piracetam or vinpocetine; infamous doping agents like methylhexaneamine or dimethylbutylamine; and other investigational substances and peptides. Several are authorized DS ingredients in the United States resulting in significant global variability as to what qualifies as a legal nootropic. Prohibited stimulants or ß2-agonists commonly used in "pre-workout," "weight loss," or "thermogenic" DS such as octodrine, hordenine, or higenamine are often stacked with nootropic substances. While stimulants and ß2-agonists are defined as doping agents by the World Anti-Doping Agency (WADA), many nootropics are not, although some may qualify as non-approved substances or related substances under catch-all language in the WADA Prohibited List. Synergistic combinations, excessive dosing, or recently researched pharmacology may justify listing certain nootropics as doping agents or warrant additional attention in future regulations.

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Acute Psychosis Associated With Phenibut Ingestion

Cited by 2 publications

References 7 publications

Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Unauthorized ingredients in “nootropic” dietary supplements: A review of the history, pharmacology, prevalence, international regulations, and potential as doping agents

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