Phenibut Use in a Patient Prescribed Gabapentinoids

Tamarelli, Carrie; Hosanagar, Avinash

doi:10.1093/pm/pnaa205

Cited by 3 publications

(6 citation statements)

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“…One study reported that a patient developed withdrawals after only 10 days of use 26 . Multiple studies highlighted how their subjects took phenibut multiple times throughout the day to achieve mind-altering effects, address their cravings, and manage their withdrawals 10,27,28 . Caution about the addictive potential of phenibut and specifically against the daily dosing of phenibut to avoid withdrawal symptoms and dependence is found in many online communities made of those that use this substance.…”

Section: Discussionmentioning

confidence: 99%

“…26 Multiple studies highlighted how their subjects took phenibut multiple times throughout the day to achieve mind-altering effects, address their cravings, and manage their withdrawals. 10,27,28 Caution about the addictive potential of phenibut and specifically against the daily dosing of phenibut to avoid withdrawal symptoms and dependence is found in many online communities made of those that use this substance. These online communities highlight warnings about phenibut and direct those who are using it and have concerns about withdrawal or dependence to support communities and contain many stories of those struggling with problematic phenibut use.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

et al. 2023

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Objectives: This systematic review aimed to identify published articles that evaluated all phenibut toxicity and withdrawal cases to understand better their clinical presentations and treatments. Methods: A comprehensive literature search was conducted using Medline (Ovid), Embase (Ovid), and Cochrane Library databases to capture all published cases on the presentations and management of phenibut toxicity or withdrawal. Results: Sixty-two cases from 36 studies on presentation and management of phenibut toxicity or phenibut withdrawal were identified. Of all subjects, 80.7% were male. The average age was 30.9 years (SD, 13.2 years; range, 0-71 years). A total of 86.8% reported obtaining phenibut online, and 63.2% reported concomitant substance use with other addictive agents; benzodiazepines and alcohol were the most combined drugs. The average length of hospital stay was 5.0 days (n = 25; SD, 5.4 days; range, 1-25 days) for phenibut toxicity and 7.7 days (n = 20; SD, 7.8 days; range, 0-30 days) for phenibut withdrawals. The most common symptoms reported during phenibut toxicity were altered mental status, somnolence, psychosis, and movement disorders. Of the phenibut toxicity cases, 48.7% required intubation. Benzodiazepines and antipsychotics were most used to treat phenibut toxicity. For phenibut withdrawal cases, 95.7% reported daily use. The most common symptoms reported during phenibut withdrawals were anxiety, irritability or agitation, insomnia, and psychosis. Sixteen (69.6%) of phenibut withdrawal cases required multiple medications for treatment. Benzodiazepines, baclofen, atypical antipsychotics, gabapentanoids, and barbiturates were commonly used to treat phenibut withdrawals. Conclusions: The seriousness of presentations, combined with the assortments of medications used for both syndromes, reflects the potential dangers of phenibut use and the need for systematized treatment protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

et al. 2023

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“…Lorazepam (n = 13), with repeated doses up to 16 mg/day acutely (1 patient was maintained on 10 mg/day) and diazepam (n = 7), with repeated doses up to 50 mg/day acutely, were the 2 most commonly administered benzodiazepines; others include chlordiazepoxide (n = 2), clonazepam (n = 2), oxazepam (n = 1), delorazepam (n = 1), midazolam (n = 1), and nitrazepam (n = 1). 32,[36][37][38][39][40][41][42][45][46][47][48][51][52][53][54][55][56][57][58][59][60]62 Benzodiazepines were typically used in the first 24 hours to treat symptoms of anxiety and insomnia. In 4 cases benzodiazepines were used as monotherapy.…”

Section: Benzodiazepinesmentioning

confidence: 99%

“…Pregabalin dose and duration was NR in 1 case. In the other case pregabalin was administered 125 mg TID (duration NR) 57,60 Sparse data suggest that pregabalin may be useful in treating alcohol withdrawal. 86,87 It is unclear whether pregabalin may have a role in treating phenibut withdrawal.…”

Section: Benzodiazepinesmentioning

confidence: 99%

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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“…While several eastern European states allow its medical use [7] it is mostly considered a New Psychoactive Substance (NPS) in the western world [8] . Although there is an abundance of studies on the abuse potential of Phenibut [9–13] only one CSD communication by P. Y. Zavalij gives any information on its structural properties, or more specifically on those of the HCl salt form [14] . Contemplating the possible stigma around NPS or psychoactive substances in general could be an explanation for the diminutive interest.…”

Section: Introductionmentioning

confidence: 99%

Crystal Structure and Thermal Properties of Phenibut, Phenibut H₂O and Phenibut HCl: a Case for Phase Stability Based on Structural Considerations

Komisarek¹,

Pallaske²,

Vasylyeva³

2021

Zeitschrift anorg allge chemie

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Phenibut is an anxiolytic drug approved for medical use in many eastern European states. With the exception of the HCl Salt of Phenibut no crystal structure related research has been conducted on this substance. Herein, the crystal structures of Phenibut and Phenibut⋅H2O are presented, including crystal packing analysis based on interaction energy calculations. IR spectra are shown alongside powder diffraction data and thermogravimetric analysis to characterize and compare structural as well as thermal properties of the examined Phenibut forms. Single crystal diffraction is used in conjunction with Crystal Explorer based Hirshfeld analysis to carefully identify the bonding interaction properties in each compound. Finally, a case is made regarding stability of the compared crystalline phases based on the conducted structural analyses and the quantification of the molecular interaction energies.

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Phenibut Use in a Patient Prescribed Gabapentinoids

Cited by 3 publications

References 10 publications

Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Crystal Structure and Thermal Properties of Phenibut, Phenibut H₂O and Phenibut HCl: a Case for Phase Stability Based on Structural Considerations

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Phenibut Use in a Patient Prescribed Gabapentinoids

Cited by 3 publications

References 10 publications

Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

Clinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review

Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal

Crystal Structure and Thermal Properties of Phenibut, Phenibut H2O and Phenibut HCl: a Case for Phase Stability Based on Structural Considerations

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Product

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Crystal Structure and Thermal Properties of Phenibut, Phenibut H₂O and Phenibut HCl: a Case for Phase Stability Based on Structural Considerations