A Systematic Review of Phenibut Withdrawals

Abstract

Phenibut is an anxiolytic agent that was originally used as a treatment for anxiety, depression, post-traumatic stress disorder (PTSD), and insomnia. It is a gamma-aminobutyric acid (GABA) mimetic, which stimulates GABA receptors in the brain. This increases the inhibitory effects of GABA leading to a greater chance of a sedative response and risk for abuse. It is not currently registered in Western countries but is easily accessible online as a supplement. This is a systematic review of case reports of phenibut patients with withdrawal symptoms published in the PubMed database between January 2010 and October 2023. Following the inclusion criteria application, 15 articles were included. Descriptive statistics were used to analyze the results. The average age of patients with phenibut withdrawals was 31.8 years (SD=12.66 years), and 13 cases (87%) were males. The average dosage was 13.6 g/day (SD=8 g), ranging from 1.5 to 28.5 g/day. Nine cases (60%) presented at an emergency department, and three cases (17%) were presented at a clinic setting facility. The most common history of patients who took phenibut was alcohol or drug abuse (73%). A history of anxiety and depression (60%) was also seen in the majority of patient presentations. Phenibut is never prescribed in the United States, and there are no official guidelines for phenibut use. Educating all physicians about the potentially harmful supplements available to patients and their biological mechanisms is essential. This review highlights the importance of collecting a thorough patient history, including supplements, to help prevent phenibut misuse and subsequent withdrawals.