What structurally similar GABA-B agonist has been shown to successfully treat patients with dependence on the dietary supplement phenibut (β-Phenyl-ϒ- amino-butyric acid)?
Baclofen
Phenibut is a primarily a GABA-B receptor agonist. It is prescribed in Russia as an anxiolytic and can be purchased online as a dietary supplement. There is going concern for its abuse potential. Regular users develop dependence and discontinuation results in withdrawal symptoms similar to alcohol. The chemical structure of phenibut is similar to that of baclofen. Two case reports have successfully used a baclofen taper to treat dependence on phenibut and prevent relapse.
1. Coenen, N.C.B, Dijkstra, B.A.G, Batalla, A, & Schellekens, A.F.A. (2019). Detoxification of a patient with comorbid dependence on phenibut and benzodiazepines by tapering with Baclofen: Case report. Journal of Clinical Psychopharmacology, 39(5), 511-514.
2. Samokhvalov, Andriy V, Paton-Gay, C Lindsay, Balchand, Kam, & Rehm, Jürgen. (2013). Phenibut dependence. BMJ Case Reports, 2013(Feb06 1), Bcr2012008381.
Submitted by: Emily Kershner, MD on behalf of The Medical Toxicology Fellowship, Virginia Commonwealth University