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.” It is less sedating than some other anti-anxiety medications because it also has stimulating properties at low dosages, and is a purported nootropic. 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. 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.
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. 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. The physical symptoms can be very distressing, but it is usually the psychological symptoms that drive people to seek medical attention. 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. For more mental health resources, see our National Helpline Database. 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.
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. Medications that work for some people may make your symptoms worse. Inpatient treatment in a hospital 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 medical settings include the following sedatives and anti-psychotics:
PhenobarbitalPropofolHaloperidolBenzodiazepines
For people without severe psychiatric symptoms like hallucinations, delirium, or agitation, or medical issues, the following prescription medications may be taken at home. It is important to work with a doctor to actively manage and gradually taper these medications.
Baclofen Gabapentin Benzodiazepines (diazepam, lorazepam, others) Clonidine Pregabalin Zolpidem, Benadryl, or other sleep meds Anti-depressants
Discussions in online forums also include a variety of supplements that may help ease withdrawal in some people. Frequently mentioned supplements include:
L-theanineMagnesiumKavaAshwagandha
Use of all supplements should be discussed with your doctor.
Warnings
Phenibut withdrawal can be potentially very dangerous. Attempting to quit cold turkey could be a very bad idea and could increase your risk of seizures, insomnia, and psychosis. 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. 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. If you have a co-occurring alcohol use or other substance use disorders, 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. 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 fog has lifted and the withdrawals are over, with the right kind of support, you will be free to live your life.
