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CASE REPORT
Phenibut dependence
  1. Andriy V Samokhvalov1,2,
  2. C Lindsay Paton-Gay1,2,
  3. Kam Balchand1,2,
  4. Jürgen Rehm1,2,3,4
  1. 1Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  2. 2Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
  3. 3Dalla Lana School of Public Health, Toronto, Ontario, Canada
  4. 4Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany
  1. Correspondence to Dr Andriy V Samokhvalov, avsamokhvalov{at}yahoo.ca

Summary

Phenibut is a γ-aminobutyric acid (GABA) agonist designed and used as an anxiolytic in Russia. In Western countries, phenibut is not a registered medication but is available through online stores as a supplement. We present a case of a patient who used phenibut to self-medicate anxiety, insomnia and cravings for alcohol. While phenibut was helpful initially, the patient developed dependence including tolerance, significant withdrawal symptoms within 3–4 h of last use and failure to fulfil his roles at work and at home. He finally sought medical assistance in our addictions clinic. We have gradually, over the course of 9 weeks, substituted phenibut with baclofen, which has similar pharmacological properties, and then successfully tapered the patient off baclofen. This required approximately 10 mg of baclofen for each gram of phenibut.

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