Acute phenibut withdrawal: A comprehensive literature review and illustrative case report

Authors

  • Matthew I. Hardman Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
  • Juraj Sprung Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
  • Toby N. Weingarten Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA http://orcid.org/0000-0002-8405-1328

DOI:

https://doi.org/10.17305/bjbms.2018.4008

Keywords:

Phenibut, abstinence syndrome, psychomotor agitation, serotonin syndrome, neuroleptic malignant syndrome, GABA

Abstract

Phenibut is a glutamic acid derivative with activity on the γ-aminobutyric acid (GABA)B, A, and B-phenethylamine receptors. It is prescribed in former Communist Bloc countries for anxiolysis and related psychiatric disorders. It can be easily obtained in Western countries and is thought to have abuse potential. Abrupt discontinuation has been reported to precipitate an abstinence syndrome. A review of the literature identified 22 reported cases, many of which were notable for severe psychomotor agitation and requirements for aggressive pharmacologic treatment. Neurologic and autonomic signs and symptoms may mimic serotonin or neuroleptic malignant syndrome. Patients were typically younger and had coexisting substance abuse disorders to other drugs. Also presented is a case of a 23-year-old male with an acute phenibut abstinence syndrome. This patient exhibited severe psychomotor agitation requiring physical restraints, dexmedetomidine, lorazepam, haloperidol, diphenhydramine, cyproheptadine, melatonin, olanzapine, and baclofen for symptom control.

Author Biographies

  • Matthew I. Hardman, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

    Department of Anesthesiology and Perioperative Medicine

  • Juraj Sprung, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

    Department of Anesthesiology and Perioperative Medicine

  • Toby N. Weingarten, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

    Department of Anesthesiology and Perioperative Medicine

Acute phenibut withdrawal: A comprehensive literature review and illustrative case report

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Published

20-05-2019

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Reviews

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How to Cite

1.
Acute phenibut withdrawal: A comprehensive literature review and illustrative case report. Biomol Biomed [Internet]. 2019 May 20 [cited 2024 Feb. 25];19(2):125-9. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/4008