Chronic Phenibut Use: Symptoms, Severe Withdrawal, and Recovery.

INTRODUCTION

Phenibut is a psychoactive drug with GABA agonism. It remains unregulated and easily attainable in the United States, where it has become a novel drug of abuse.

CASE PRESENTATION

We present the case of a 34-year-old man who used phenibut consistently for 3 years. After 6 months of use, he developed signs of dependence and failed outpatient detoxification. While taking high doses, he experienced parasomnia-like symptoms and periods of dysexecutive function. After abrupt cessation, he developed severe withdrawal symptoms, was hospitalized, and required intubation. His condition improved after 1 week of treatment. After recovery and discharge, he remains stable utilizing an extended taper of acamprosate and baclofen.

DISCUSSION

Phenibut is not detected on urine drug screen and withdrawal symptoms are nonspecific. Optimal treatment of withdrawal remains unknown. Baclofen and phenobarbital have been successful for treatment of dependence.

CONCLUSION

Clinicians should be aware of phenibut abuse and the potential for dependence and withdrawal.