Weleff Jeremy, Kovacevich Alexsandra, Burson Jesse, Nero Neil, Anand Akhil
From the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (JW); Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH (JW, AK, AA); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN (JB); Education Institute, Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, OH (NN); Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH (AA).
J Addict Med. 2023;17(4):407-417. doi: 10.1097/ADM.0000000000001141. Epub 2023 Feb 3.
This systematic review aimed to identify published articles that evaluated all phenibut toxicity and withdrawal cases to understand better their clinical presentations and treatments.
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.
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.
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.
本系统评价旨在识别已发表的评估所有苯乙胺毒性和戒断病例的文章，以更好地了解其临床表现和治疗方法。
使用Medline（Ovid）、Embase（Ovid）和Cochrane图书馆数据库进行全面的文献检索，以获取所有已发表的关于苯乙胺毒性或戒断的表现及管理的病例。
共识别出36项关于苯乙胺毒性或苯乙胺戒断的表现及管理研究中的62例病例。所有受试者中，80.7%为男性。平均年龄为30.9岁（标准差为13.2岁；范围为0至71岁）。共有86.8%的人报告通过网络获取苯乙胺，63.2%的人报告同时使用其他成瘾性物质；苯二氮卓类药物和酒精是最常合并使用的药物。苯乙胺毒性患者的平均住院时间为5.0天（n = 25；标准差为5.4天；范围为1至25天），苯乙胺戒断患者的平均住院时间为7.7天（n = 20；标准差为7.8天；范围为0至30天）。苯乙胺毒性期间报告的最常见症状为精神状态改变、嗜睡、精神病和运动障碍。在苯乙胺毒性病例中，48.7%需要插管。苯二氮卓类药物和抗精神病药物最常用于治疗苯乙胺毒性。对于苯乙胺戒断病例，95.7%报告为每日使用。苯乙胺戒断期间报告的最常见症状为焦虑、易怒或激动、失眠和精神病。16例（69.6%）苯乙胺戒断病例需要多种药物治疗。苯二氮卓类药物、巴氯芬、非典型抗精神病药物、加巴喷丁类药物和巴比妥类药物常用于治疗苯乙胺戒断。
临床表现的严重性，以及用于这两种综合征的药物种类，反映了使用苯乙胺的潜在危险以及制定系统化治疗方案的必要性。
