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

  • 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
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.

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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
Published
2019-05-20
How to Cite
1.
Hardman MI, Sprung J, Weingarten TN. Acute phenibut withdrawal: A comprehensive literature review and illustrative case report. Bosn J of Basic Med Sci [Internet]. 2019May20 [cited 2019Oct.19];19(2):125-9. Available from: https://bjbms.org/ojs/index.php/bjbms/article/view/4008
Section
Reviews

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