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Monday, August 17, 2020

Phenibut Withdrawal Symptoms, Timeline & Treatment

Phenibut Withdrawal Symptoms, Timeline & Treatment Addiction Coping and Recovery Overcoming Addiction Print How Long Does Withdrawal From Phenibut Last? By Corinne O’Keefe Osborn linkedin Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology. Learn about our editorial policy Corinne O’Keefe Osborn Updated on August 07, 2019 Verywell / Gary Ferster More in Addiction Coping and Recovery Overcoming Addiction Methods and Support Personal Stories Alcohol Use Addictive Behaviors Drug Use Nicotine Use In This Article Table of Contents Expand Overview Signs & Symptoms Coping & Relief Warnings Long-Term Treatment Resources View All Back To Top Phenibut (ß-phenyl-?-aminobutyric acid) is a psychoactive medication developed in Russia during the nineteen-sixties. It was, and remains, approved there to treat a variety of disorders, including insomnia, anxiety, and depression. Because phenibut was never approved by the FDA, it remains unavailable here as a prescription medication. Although it is still unknown to most Americans, phenibut use has grown in recent years due to its widespread availability on the internet. Phenibut can now be easily purchased online as a “dietary supplement.” Phenibut is used and abused for a variety of purposes. As a central nervous system depressant, it can relieve anxiety and induce euphoria. This makes it an appealing alternative to people struggling with alcohol or opioid dependence. It is less sedating than some other anti-anxiety medications because it also contains stimulating and nootropic properties. Nootropics, also known as smart drugs, help to increase focus. Due to these combined effects, phenibut is often used to reduce social anxiety, become more sociable, and get work or studying done. Unfortunately, phenibut tolerance can develop within weeks of occasional use. This leads people to take higher and higher doses, increasing the likelihood of a difficult withdrawal experience.   Overview Phenibut is a synthetic, designer drug, but its chemical structure is very similar to that of a naturally occurring amino acid known as GABA. Because GABA and other amino acids are proteins, according to the FDA, GABA is technically a “food” and not a drug. It is through this loophole that phenibut, a GABA lookalike, can be legally bought and sold in the U.S.?? People often assume that legal nutritional supplements are safer than illegal drugs, even when taken daily in large doses. Unfortunately, this is not the case. There are many risks to taking unregulated nutritional supplements like phenibut, and chief among them is the potential for dependence and withdrawal. Reports have begun surfacing of phenibut withdrawal symptoms so severe that people require hospitalization.?? These symptoms are usually both physical and psychological. Symptoms can include severe anxiety and agitation along with tremors, nausea, and vomiting. There have been reports of serious psychotic symptoms such as auditory and visual hallucinations, delusions, and paranoia.?? Withdrawal symptoms may appear anywhere from several hours to several days after your last dose. Symptoms may be combined with an intense desire to use more phenibut. If you experience intense cravings, then your phenibut abuse may have evolved into an addiction.   Signs Symptoms Phenibut withdrawal is different for everyone. Some people take large daily doses for a year but don’t experience withdrawal, or see only mild effects. Other people take moderate doses two to three times a week for a few months and end up suffering severe symptoms when they try to stop. Still, others take high doses for only a few consecutive days and end up in the hospital. Doctors and researchers in this part of the world have little understanding of phenibut withdrawal. It is not easily recognized in clinical settings and there are no standard treatment protocols. What little we do know about phenibut withdrawal syndrome comes from case reports published in medical journals and self-reported descriptions in online forums. Phenibut withdrawal can begin in as little as three to four hours after your last dose. Acute symptoms can last for several days and are sometimes followed by a period of protracted withdrawal lasting weeks or months.?? The physical symptoms can be very distressing, but it is usually the psychological symptoms that drive people to seek medical attention. Psychological hallucinations delusions dissociation suicidal thoughts anxiety depression panic attacks Physical tremors muscle rigidity sweating nausea vomiting fast heart rate seizures fatigue There have been several reported cases of extreme psychotic symptoms stemming from phenibut intoxication and withdrawal. People have come to the emergency room after experiencing visual and auditory hallucinations.?? One person described seeing dragons, flashes of color, and disturbing sexual images.?? Others have described a sense of dissociation or a feeling of unreality. Delusions, psychosis, and suicidal thoughts or acts have also been reported.?? Many people experience extreme agitation and anxiety. In several of the reported cases of intoxication and withdrawal, both physical and chemical restraints were necessary for the safety of both the patient and medical staff. Three patients required IV sedation so intense that they needed breathing tubes.?? While these examples are worst-case scenario, milder psychological symptoms are not uncommon. In online message boards, many people describe feeling like they are “going insane” or “stuck in hell.” People describe panic attacks, depression, suicidal thoughts, and severe insomnia. Physical symptoms like tremors, muscle rigidity, and sweating all contribute to intense insomnia. Some people even experience “brain zaps” when they try to sleep.  Depression and fatigue cause problems for many people, who find it difficult to fulfill their normal responsibility at home, work, or school. Depression and rebound anxiety may continue for several weeks after the acute symptoms of withdrawal resolve.   How Do You Know If Youre Having Hallucinations? Coping Relief First of all, if you experience hallucinations, suicidal thoughts, or extreme agitation, seek emergency medical attention right away. Phenibut withdrawal can be severe, so many people opt for medication-assisted detox. While there is no standard treatment protocol, there are several medications that can help treat your acute symptoms and increase your chances of quitting phenibut successfully. Trying to treat your withdrawal symptoms at home with prescription drugs or supplements is not a good idea. Treating phenibut withdrawal is difficult and people respond differently to the medications available. Medications that work for some people may make your symptoms worse. Inpatient treatment at your local emergency room or detox clinic ensures access to a variety of prescription medications. Medications that have been used to treat severe acute symptoms of phenibut withdrawal in inpatient settings include the following sedatives and anti-psychotics:?? Dexmedetomidine PhenobarbitalPropofolHaloperidolBenzodiazepines   For people without severe psychological symptoms like hallucinations, delirium, or agitation, the following prescription medications may be taken at home. It is important to work with a doctor to gradually taper these medications. BaclofenGabapentinBenzodiazepines (diazepam, lorazepam, others)ClonidinePregabalinPhenobarbitalZolpidem, Benadryl, or other sleep medsAnti-depressants In anecdotal reports, most people respond to either a baclofen or gabapentin taper. These two medications are structurally similar to phenibut, so they act as a substitute to prevent withdrawal. However, you may need to reduce your phenibut dose before you make the switch.     In one case study of an individual taking high doses of phenibut, doctors found that 8 to 10mg of baclofen could be substituted for one gram of phenibut.?? Their treatment protocol involved reducing daily phenibut intake by about 0.5 to 3g each week. For example, 8g daily during week one, 5g daily during week three, and down to 1g by week six. During this taper, doctors simultaneously prescribed gradually larger doses of baclofen, peaking at 60mg during week six, then tapering down.?? This was one of the only reported case studies that included a phenibut taper, but according to anecdotal reports, a gradual taper is one of the most common self-directed withdrawal treatments. The members of the subreddit r/quittingphenibut recommend reducing your dose by about 10-100mg per day. During your taper, the short-term use of benzodiazepines and sleep meds can help you manage acute anxiety and insomnia. Go to a primary care doctor or psychiatrist for help. They can help you develop a plan.   Discussions in online forums also include a variety of supplements that may help ease withdrawal in some people. Frequently mentioned supplements include: L-theanineMagnesiumKavaAshwagandha Warnings Phenibut withdrawal can be very dangerous. More dangerous than most other withdrawal syndromes. Attempting to quit cold turkey very bad idea and could increase your risk of seizures, insomnia, and psychosis.  Your best bet is to make a plan to quit phenibut. Inpatient detox is hands down the safest way to quit. At an inpatient detox facility, hospital, or addiction clinic, you will be met with a team of specialists who can help get you through withdrawal with the least amount of discomfort possible. Many insurance plans cover detox and addiction treatment. If you can’t or won’t do inpatient treatment, then at least see a doctor before you quit. That way you are prepared with a tapering plan and prescription medications to treat your symptoms. Arrange to take the first three or four days off of work. Make sure you have someone to help monitor you for signs of danger and assist with at-home responsibilities like childcare.   Be prepared to meet with some resistance at the hospital or doctor’s office. Most doctors in the U.S. have very little experience with phenibut dependence and withdrawal. Even addiction specialists may be unaware of the severity of phenibut withdrawal. You may need to educate your doctor about phenibut, so make sure to have an article or case report keyed up on your phone. Even better, print one out. Long-Term Treatment Many people with phenibut dependence require a long-term treatment plan. Long-term addiction treatment focuses on preventing relapse. Relapses are common among phenibut users who may go months without the drug then decide they are “ready” to handle it again in small doses, or for occasional use only. This type of thinking typically leads straight back to dependence and addiction. Your long-term treatment plan will need to address any current or prior dependence on other drugs or alcohol. If you started using phenibut to help you quit drinking, then quitting phenibut increases your risk of relapsing with alcohol. Research shows that people addicted to drugs require at least three months of treatment to quit successfully. If you have a co-occurring alcohol use disorder, treatment will be an ongoing process that you will have to deal with for many years to come, especially during times of high stress.?? There is another group of people who may require more specialized care. If you began using phenibut to treat anxiety, depression, or post-traumatic stress disorder, these symptoms are likely to reemerge after withdrawal. It is imperative that you seek treatment for these underlying disorders. Otherwise, you are at risk of relapsing with phenibut or other non-therapeutic drugs.   Evidence-based treatments for single or multi-substance abuse include varying combinations of behavioral therapy and medications.?? The same is true for people with co-occurring substance abuse and mental health issues. Behavioral therapy can take several forms. You may work with a therapist, psychologist, or a prescribing psychiatrist. Many people benefit from residential treatment programs, which provide an opportunity to stay in a healing environment for several weeks after your withdrawal. Other people prefer to seek treatment on an outpatient basis. Often supplementing behavioral therapy with peer-based support groups like Narcotics Anonymous or Alcoholics Anonymous. Resources Phenibut dependence is not widely understood or recognized, but that doesn’t mean it isn’t real. Check out this message board full of people going through the same thing as you: r/quittingphenibut. When you are ready to get serious about quitting, start by making an appointment with your primary care doctor, psychiatrist, or local health clinic. Your doctor can help refer you to the best place for treatment. Look for someplace that accepts your insurance. To find a doctor who specializes in addiction treatment, use this searchable directory from the Substance Abuse and Mental Health Services Administration (SAMHSA). You can also call SAMHSA’s national helpline at 1-800-662-HELP (4357).   A Word From Verywell When you first sought out phenibut, you were not looking to pick up another addiction. Maybe you used to help you get off alcohol, kratom, or benzos. Maybe you have severe anxiety. Whatever your reasons, expect those issues to arise again during and after your phenibut withdrawal. It is going to be hard, and symptoms may linger for weeks, but you will get through it. Once the brain fog is lifted, and the vicious withdrawal cycles are over, you will be free to live your life. How Long Should You Expect Withdrawal Symptoms to Last?

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