ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
Author/Year
Phenibut Dose & duration of use
Baclofen Starting Dose (mg/day)
Baclofen Max Dose (mg/day)
Duration of Baclofen Therapy
Baclofen Taper Strategy
Patient Age (Years) & Sex
Co-ingestionsDelayed DecompensationMulti-Model Treatment Utilization (including baclofen)
Length of stay
ICU Admission
IntubationSeizure
Time from last dose to withdrawal symptoms
2
Joshi 2017
8-10 g/day plus ~16 g/day the week prior to admission; unknown duration of use
10 mg TID; titrated to 30 mg TID over 2 days
90 mg/day>10 weeks
10 mg per week
32; MaleTestosterone and nandrolone injected 6 weeks prior to admissionAgitation, aggression, worsening mental statusAntipsychotics, olanzapine, diazepam, ramelteon, lorazepam
At least 9 days (full length not reported)
000
3
Hardman 2019
4 g every 6 hours (16 g daily); unknown duration of use
Unknown (not reported)
Unknown (not reported)
As needed
Unknown (not reported)
23; MaleSSRI, PHBTremulousness, insomnia, nausea, vomiting, anxiety, psychomotor agitationLorazepam, dexmedetomidine, cyproheptadine, gabapentin, haloperidol, melatonin, olanzapine
At least 9 days (full length not reported)
100
4
Coenen 2019
11-12 g TID (max of 34.5 g/day) for 2 years
25 mg 4 times daily with 5 mg prn if withdrawal
100 mg/day plus 5 mg/day additional if needed
1 year+
10 mg every 2 days (~50% per week)
25; MaleDiazepam, pregabalin
Sadness, irritability, insomnia, psychomotor agitation, anxiety, tension, flulike symptoms (headache, myalgia)
Olanzapine, diazepam, pregabalin6 weeks
Unknown (not reported)
Unknown (not reported)
0
5
Ahuja 20181100-300 mg every few days for several months; increased quantity but exact dose unknown5 mg TID for 2 days15 mg/day1 week5 mg 3 times/day for 2 days, then 5 mg twice/day for 1 day, then 5 mg in the morning and 2.5 mg in the evening for 1 day, then 2.5 mg twice/day, and, finally, 2.5 mg once/day21; MaleAlcoholNoChlordiazepoxide5 days000
6
7
Sethi 20211200-500 mg for a few months. Increased to 1-1.5 g/day for 1 year5 mg TID for 2 days15 mg/day6 days5 mg 3 times/day for 2 days, then 5 mg twice/day for 1 day, then 5 mg in the morning and 2.5 mg in the evening for 1 day, then 2.5 mg twice/day, and, finally, 2.5 mg once/day26; MaleUnknown (not reported)Unknown (not reported)ClonazepamUnknown (not reported)Unknown (not reported)Unknown (not reported)0
8
9
Samokhvalov 2013
8 g/day for 10 months
15 mg/day for 1 week.
60 mg/day24 weeks
Cross tapered phenibut dose from 8 g daily to 1 g daily and baclofen from 0 mg to 60 mg over 7 weeks, then tapered baclofen to 0 mg over 13 weeks
35; MaleKratomAggression, irritationCitalopram
Unknown (not reported)
000
10
McCabe 2019
1 g/day; duration unknown
10 mg every 8h; increased to 20 mg every 8h on day 360 mg/day25 daysTapered over 12 days27; MaleNoneSevere agitation, tachycardia hyperthermia, rigidity, myoclonusFentanyl, midazolam, valproic acid, phenobarbital, hydromorphone, gabapentin, olanzapine, dexmedetomidine, clonidine and methadoneAt least 13 days (full length of stay not reported)110
11
12
13
20-30 g/day 2 months prior to ED admission
14
15
Ingested 30 g day of admission
16
17
Thalambedu 2020
200 g; unknown duration of use
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
42; MaleMethadoneUnknown (not reported)Unknown (not reported)
Unknown (not reported)
110
18
Gilbert 202034 g/day
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
34; Male
Acetaminophen, caffeine, diphenhydramine, escitalopram, hydroxyzine, lorazepam (UDS on hospital day #3; initial UDS unable to be obtained)
Altered mental status, tremors, ankle clonus, tachycardia, agitation, diaphoresis, respiratory distress, tonic-clonic activity, incontinence
Haloperidol, lorazepam, Benadryl, dexmedetomidine
Unknown (not reported)
1
Unknown (not reported)
1
19
Case from this article
25-30 g/day10 mg TID120 mg/day
Unknown (lost to follow up)
Unknown (lost to follow up)
31; MaleNoSeizure, hallucination, tremorsLorazepam, phenobarbital, clonidine, and gabapentin101
20
Zheng 2019
4-5 g/day for 1 month
NoneNoneNoneNone23; MaleAlcohol, marijuanaUnknown (not reported)Benzodiazepines, bupropion, quetiapine, gabapentin
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
0
21
VabDreese 2022
1g/day to 8-12g/day over 6 months; continued to use phenibut while receiving outpatient tx --> increased use to 28.5g/day over 3 years
5 mg TID as initial outpatient tx; 10 mg dose x1 inpatient tx
60 mg/day
>4 months (exact not reported)
20 mg TID x1 month, then 15 mg TID x 3 months, then 10 mg TID (based on lack of reported withdrawal sx at follow up appointments)
34; Male
baclofen, gabapetin, benzodiazepines, methamphetamines, amphetamines
agitation, sweating, hallucinations, confusion
Gabapentin, risperidone, lorazepam, olanzapine, haloperidol, diazepam, midazolam, dexmedetomidine, propofol, phenobarbital taper, acamprosate (outpatient)
11 days110
22
Peterkin 2022
"several teaspoons" 2 days prior to presentation, another unknown dose 24 hours prior to presentation
NoneNoneNoneNone38; FemaleFentanyl IV, clonazepam, gabapentin, diphenhydramineUnknown (not reported)Ketamine, dexmedetomidine, propofol, remifentanil, antipsychotics, methadone, diazepam
9 days (left AMA)
000
23
O'Connel 2014
3 g/day x4 days
NoneNoneNoneNone25; MaleNoneNoneNone (patient refused treatment outside of home venlafaxine and mirtazapine)
Unknown (not reported)
000
24
Magsalin 2010
1g/day x10 days; stopped x2 days and noticed withdrawal sx --> started phenibut self-taper (0.5 g/day x4 days)
NoneNoneNoneNone21; MalenoneUnknown (not reported)None
Unknown (not reported)
000
25
Wong 2015
2 g daily x1.5 months; 30 g prior to admission
NoneNoneNoneNone43; MaleNoneUnknown (not reported)Midazolam
Unknown (not reported)
110
26
Downes 2015
25 g dose x1 day of admission
NoneNoneNoneNone20; FemaleNoneUnknown (not reported)Venlafaxine
Unknown (not reported)
000
27
Downes 2015
Unknown (not reported)
NoneNoneNoneNone38; MaleAlcohol, THCUnknown (not reported)Droperidol, ketamine, morphine, midazolam
Unknown (not reported)
110
28
Esteves 2019Unknown
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
25; MaleUnknown (not reported)Unknown (not reported)Unknown (not reported)
At least 11 days (full length of stay not reported)
111
29
Goldfine 2019
10 g/day x2 months; stopped using phenibut 5 days PTA
5 mg TID15 mg/day8 days
5 mg TID x72 hours with decreasing benzodiazepine requirements; then tapered baclofen over 5 days
34; MaleUnknown (not reported)Unknown (not reported)Lorazepam, dexmedetomidine
Unknown (not reported)
000
30
Hodgman 2019
5 g/day x 2 months (prior ICU admission for phenibut withdrawal of unknown dose)
15 mg TID45 mg/day28 days
tapered over 4 weeks; decr by 5 mg/day every 4 days
19; MaleUnknown (not reported)Unknown (not reported)Unknown (not reported)3 days000
31
Odujebe 2008
750-1000 mg/day for "months"; discontinued 3 days prior to presentation
NoneNoneNoneNone40; MaleUnknown (not reported)Unknown (not reported)lorazepam
at least 4 days (full length of stay not reported)
Unknown (not reported)
10
32
RF JT 2021
25-30 g/day x6 months
10 mg dose x2 over 8 hours in ED; 10 mg TID --> pt represented to ED after seizure, discharged on 40 mg TID
120 mg/day
Unknown (not reported)
decr daily dose by 5 mg each week
31; MaleUnknown (not reported)seizure, nausea, tremors, hallucinationslorazepam, phenobarbital5 days001"Shortly"
33
ROD 2018
2 g/day x12 months; reduced dose in week prior to presentation
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
47; MaleEtOH, bupropion, duloxetine, gabapentin, kratomUnknown (not reported)lorazepam, chlordiazepoxide, phenobarbital
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
0
34
Srihari 2020
2-3 g/day x 1 week
130 mg initially while inpatient, discharged on 40 mg BID outpatient
130 mg17 days
taper over 15 days
24; MaleNoneUnknown (not reported)lorazepam, phenobarbital2 days000
35
Wolters 2019
34 g/day; duration of use unknown
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
34; Male
tachycardia, diaphoresis, agitation, respiratory distress, tonic-clonic seizure
acetaminophen, caffeine, diphenhydramine, escitalopram, hydroxyzine, lorazepamhaloperidol, lorazepam, diphenhydramine, dexmedetomidine8 days101
36
Hodgman 2019unknownN/AN/AN/AN/A18; MaleUnknown (not reported)Unknown (not reported)Dexmedetomidine and benzodiazpines
Unknown (not reported)
1
Unknown (not reported)
Unknown (not reported)
Unknown (not reported)
37
Lai 201910 g/day5 mg TID15 mg/day8 days
Unknown (not reported)
34; MaleUnknown (not reported)worsening agitation from time of presentationDexmedetomidine and lorazepam
Unknown (not reported)
Unknown (not reported)
00
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
Hardman MI, Sprung J, Weingarten TN. Acute phenibut withdrawal: a comprehensive literature review and illustrative case report. Bosn J Basic Med Sci. 2019;19(2):125-129. doi:10.17305/bjbms.2018.4008
53
2
Joshi YB, Friend SF, Jimenez B, Steiger LR. Dissociative intoxication and prolonged withdrawal associated with phenibut: a case report. J Clin Psychopharmacol. 2017;37(4):478-480. doi:10.1097/JCP.0000000000000731
54
3
Ahuja T, Mgbako O, Katzman C, Grossman A. Phenibut (β-Phenyl-γ-aminobutyric Acid) dependence and management of withdrawal: emerging nootropics of abuse. Case Rep Psychiatry. Published online April 30, 2018. doi:10.1155/2018/9864285
55
4
Samokhvalov AV, Paton-Gay CL, Balchand K, Rehm J. Phenibut dependence. BMJ Case Rep. Published online February 6, 2013. doi:10.1136/bcr-2012-008381
56
5
McCabe DJ, Bangh SA, Arens AM, Cole JB. Phenibut exposures and clinical effects reported to a regional poison center. Am J Emerg Med. 2019;37(11):2066-2071. doi:10.1016/j.ajem.2019.02.044
57
6
VanDreese B, Holland A, Murray A. Chronic phenibut use: symptoms, severe withdrawal, and recovery. WMJ. 2022;121(1):E1-E4.
58
7
Peterkin AF, Abraham R, Harris MT. A case of phenibut directed detoxification leading to toxicity during the COVID-19 pandemic. J Addict Med. Published online February 4, 2022. doi:10.1097/ADM.0000000000000966
59
8
Wong A, Little M, Caldicott D, Easton C, Andres D, Greene SL. Analytically confirmed recreational use of phenibut (β-phenyl-γ-aminobutyric acid) bought over the internet. Clin Toxicol (Phila). 2015;53(7):783-784. doi:10.3109/15563650.2015.1059944
60
9
Downes MA, Berling IL, Mostafa A, Grice J, Roberts MS, Isbister GK. Acute behavioural disturbance associated with phenibut purchased via an internet supplier. Clin Toxicol (Phila). 2015;53(7):636-638. doi:10.3109/15563650.2015.1059945
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100