The Uncontrolled Compound Phenibut May Be Toxic at Higher Doses
By Rob Goodier
NEW YORK - A supplement called phenibut that is unregulated in the United States and Europe may be toxic at higher doses, a new case study suggests.
The patient was found unconscious after taking 3g daily of the compound for four days.
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"The drug is a sedative/hypnotic and we would expect it to act in overdose like that similar to other drugs in that class such as benzodiazepines and barbiturates," said Dr. Aaron Schneir, a toxicologist at the University of California, San Diego who helped manage the case.
"The management of an overdose would be supportive, as it would be with other drugs in this class, so even if was not known at the time what the person had used (it) the management would be straightforward," Dr. Schneir told Reuters Health by email.
Phenibut is short for beta-phenyl-gamma-aminobutyric acid HCL. It is a neuropsychotropic drug sold in Russia as an anxiolytic and it is thought to have nootropic effects that sharpen and enhance the mind. It is sold as an unregulated supplement or vitamin in the United States and Europe.
In a paper online March 19 in the American Journal of Medicine, the authors say the subject of their study slowly regained consciousness over the course of seven hours in the emergency room. At admission his blood pressure was 110/50, his pulse was 69 bpm, and he averaged 14 respirations/min. An ECG, CT brain scan and chest radiograph were normal. Laboratory tests were mostly normal.
A follow-up phone call one week later revealed no further effects and the patient said he had quit using phenibut.
The report might be the first to suggest a toxic effect of the drug, but it joins a scant number of other case studies reporting dependence and withdrawal symptoms that can include psychosis and hallucinations. Internet forums and information sites report other adverse effects including suicidal thoughts and insomnia.
"With regard to withdrawal from the drug - we would expect it to be similar to withdrawal from other sedative hypnotic drugs," Dr. Schneir says.
GHB, the infamous date-rape drug, and baclofen are both in phenibut's class and known to cause severe withdrawal. Baclofen is also implicated in poisoning.
"It is fascinating that phenibut is only one chloride atom different (from baclofen). We just do not have enough information at this point to characterize if the manifestations of phenibut toxicity and withdrawal will be unique," Dr. Schneir says.
SOURCE: https://bit.ly/1hibPa4
Am J Med 2014.
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