Is Phenibut safe?
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Safety of Phenibut: A Comprehensive Review
Introduction to Phenibut Safety Concerns
Phenibut, a nootropic and anxiolytic drug, has garnered significant attention due to its dual nature as both a therapeutic agent and a substance of abuse. Originally developed in Russia, it is used for its calming effects and cognitive enhancement. However, its safety profile is under scrutiny, especially with its increasing availability online and reports of misuse.
Therapeutic Use and Clinical Trials
Phenibut is primarily used for its anxiolytic and antinociceptive properties, acting on the GABAB receptor and voltage-dependent calcium channels1. Clinical trials involving 583 patients have shown that when used at therapeutic doses (0.25-2 g/day), phenibut is generally safe and well-tolerated, with minor adverse effects such as somnolence reported in only 5.66% of patients1. This suggests that under controlled conditions, phenibut can be a safe medication.
Risks of Dependence and Intoxication
Despite its therapeutic potential, phenibut has a high risk of dependence and intoxication, particularly when purchased online. Case reports highlight severe symptoms such as cardiovascular effects, insomnia, anxiety, agitation, hallucinations, and altered mental status, often linked to doses much higher than recommended (0.5-100 g/day)1 2 3. The discrepancy between clinical trial data and real-world misuse underscores the dangers of unsupervised phenibut use.
Withdrawal and Addiction
Phenibut withdrawal can be severe, with symptoms including delirium, hallucinations, seizures, and psychosis8 9. Withdrawal management often requires hospitalization and the use of multiple medications, such as benzodiazepines and baclofen, to mitigate symptoms8 9. The potential for addiction and the complexity of withdrawal treatment highlight the need for careful monitoring and regulation of phenibut use.
Online Availability and Misuse
The ease of purchasing phenibut online has contributed to its misuse. Reports indicate that individuals often use phenibut for recreational purposes, to manage anxiety or insomnia, or as a substitute for other drugs like benzodiazepines5 7. This unregulated access increases the risk of adverse effects and complicates the management of phenibut-related health issues.
Case Reports and Toxicity
Numerous case reports have documented severe phenibut toxicity, including altered mental status, psychosis, and movement disorders, often requiring intensive medical intervention4 6 10. In some instances, phenibut use has been linked to fatalities, further emphasizing the potential dangers associated with its misuse10.
Conclusion
While phenibut can be safe and effective when used under medical supervision at therapeutic doses, its potential for abuse, dependence, and severe withdrawal symptoms poses significant risks. The unregulated online availability of phenibut exacerbates these dangers, making it imperative for healthcare providers to be vigilant and for regulatory bodies to consider stricter controls. Public health messaging and education about the risks of phenibut are crucial to mitigate its misuse and associated health complications.
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Most relevant research papers on this topic
Safety and Tolerability of the Anxiolytic and Nootropic Drug Phenibut: A Systematic Review of Clinical Trials and Case Reports
Phenibut is a safe and well-tolerated drug at therapeutic doses, with minor adverse effects, but questions remain about its quality and its potential role in dependence and intoxication.
Systematic ReviewPhenibut, the appearance of another potentially dangerous product in the United States.
Phenibut, a novel substance with potential toxicity and abuse potential, has been found in the United States, potentially contributing to internet-purchased synthetic cannabinoids and cathinones.
Case Report[Phenibut: harmless dietary supplement or dangerous drug?]
Phenibut, a freely available online dietary supplement, has potent and potentially harmful psychotropic effects, leading to addiction and withdrawal in users.
Case ReportA Case of Phenibut Directed Detoxification Leading to Toxicity During the COVID-19 Pandemic
Phenibut use for self-directed detoxification during the COVID-19 pandemic can lead to toxic effects and disrupt addiction treatment plans.
Case ReportReasons for use and experiences of using phenibut, a mixed methods analysis of online reports
Phenibut use may have benefits for some people, but it also carries risks of adverse effects, withdrawal, and addiction.
Observational StudyPhenibut (β-Phenyl-γ-Aminobutyric Acid): an Easily Obtainable “Dietary Supplement” With Propensities for Physical Dependence and Addiction
Phenibut, marketed as a "dietary supplement," is a potent psychoactive substance with potential for physical dependence, withdrawal, and addiction, and its marketing as a "dietary supplement" is inaccurate and misleading.
Literature ReviewPhenibut (4-amino-3-phenyl-butyric acid): Availability, prevalence of use, desired effects and acute toxicity.
Phenibut is readily available in the UK from internet sites selling NPS, with desired and adverse effects similar to other gamma-aminobutyric acid receptor agonists.
Observational StudyClinical Presentations and Treatment of Phenibut Toxicity and Withdrawal: A Systematic Literature Review
Phenibut toxicity and withdrawal are serious conditions requiring systematized treatment protocols, with benzodiazepines and antipsychotics being the most common treatments.
Systematic ReviewA systematic review of phenibut withdrawal focusing on complications, therapeutic approaches, and single substance versus polysubstance withdrawal
Phenibut withdrawal can cause severe symptoms, and treatment strategies vary widely, with benzodiazepine being the most common and baclofen being used as a second drug.
Systematic ReviewPhenibut, a GABAB Agonist, Detected in a Fatality.
Phenibut, a GABAB agonist, was detected in the blood and urine of a 26-year-old male found dead at home with containers on scene.
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