Phenibut Withdrawal, Tapering, and Detox
Since the 1960s, phenibut has been used to treat people in the Soviet Union for various conditions. Although it hasn’t been approved by agencies in western countries, it remains a common medication in Russia and can be purchased online anywhere as a supplement. The medication is sometimes used by astronauts for its calming effects and ability to improve mental clarity. Often called a “smart pill”, phenibut may be used by executives and students in an effort to improve focus and productivity. Increasing brainpower is something that has long been sought via drugs, says the Montreal Gazette. Phenibut is also taken to relieve depression, anxiety, and post-traumatic stress disorder.
In November 2013, New York State Office of Alcoholism and Substance Abuse Services issued a report with a “Phenibut Warning” following near fatal overdoses in upstate New York. The report highlights the availability of Phenibut HCL, a white powder, sour in taste, that is soluble in alcohol or plain water. According to the report, the effects begin in 60-90 minutes and last 4-10 hours. It is also inexpensive. A gram of phenibut ranges from 30 cents to $1; people using it typically take anywhere from 500 milligrams to 4 grams.
This supplement has not been approved by the Food and Drug Administration in the US.
The problem with phenibut is people rapidly develop a tolerance to it. Dosages must be increased to maintain the desired effects. Over the long-term, this increases the risk of unwanted side effects. Stopping use is then difficult, and withdrawal symptoms can be quite severe. People often get used to the calming and analgesic effects of the drug. Those who take it feel relaxed, slightly uninhibited, and a general sense of wellbeing. High doses can lead to intoxication. A person might get a headache, be nauseous, or vomit. To understand why it’s so hard to quit right away, it helps to understand how the substance work. As a chemical that is structured similarly to the neurotransmitter GABA, or gamma-aminobutyric acid, phenibut binds to GABA sites in the brain. This has sedative effects. It’s also possible the effects of alcohol, narcotic drugs, and tranquilizers can be enhanced; the combination increases the risk of an overdose on these substances.
According to Mental Health Daily, phenibut withdrawal symptoms are often more severe and unexpected than people realize. Some of the physical and psychological effects reported include:
- Anxiety: Most people who stop phenibut feel an increase in anxiety levels. This can be extreme for a person who takes high doses and/or has an underlying anxiety condition.
- Agitation: An individual may be very agitated for several days after stopping use. Sitting still may be hard, but this can be alleviated by exercising, walking, or meditating.
- Reduced appetite: Sometimes, a loss of appetite is reported due to anxiety, stress hormones, or slowed metabolism.
- Depression: Changes in GABA or dopamine can trigger downswings in mood. Those without co-existing depression should feel better in a few weeks.
- Cognitive deficits: Difficulty focusing and “brain fog” may last for a few weeks.
- Fatigue: Physical and mental tiredness are common during withdrawal.
- Dizziness: Lack of balance and vertigo can last a few days to up to a month.
- Depersonalization: People might not feel like themselves, which can spike anxiety.
- Visual and auditory hallucinations: These are rare but problematic for those who take high doses and stop abruptly.
- Heart palpitations: Changes in heart rhythm may occur during withdrawal.
- Insomnia: Neurotransmitter imbalances can affect wake-sleep transitions. Melatonin can help individuals fall and stay asleep.
- Nausea/vomiting: Nausea may last for a week while vomiting can be helped by tapering dosage levels slowly.
- Tremors: Phenibut withdrawal often involves feeling shaky, which tapering can help.
- Fear: People report becoming more sensitive to stimuli. Some have said chamomile tea helps.
How to Reduce Withdrawal Symptoms
In case studies, people who have used phenibut at high doses have recovered in up to 24 weeks. A BMJ Case Reports study followed a 35-year-old man who used phenibut to self-medicate for alcohol cravings, anxiety, and dysphoria. Combined with kratom, phenibut proved to help the man cope with withdrawal from alcohol and opioid drugs. However, withdrawal from phenibut was so severe, he experienced heightened anger, anxiety, and irritability, and returned to use.
Baclofen was used in this case and has been used for alcohol dependence. He was able to stop using kratom without being administered naloxone or buprenorphine, which are common drug addiction treatment medications. Stopping phenibut completely after 9 weeks, he was able to taper off baclofen for the next 12 weeks. Soon, his anxiety and depression could be managed with citalopram.
It is believed phenibut withdrawal can take up to 6 months to subside. Quitting cold turkey seems to be rather intense for most people. Thus, abruptly stopping use is not a recommended course of action. It also does not give the brain a chance to heal or adjust to changes in neurotransmitter levels. People used to particularly high doses can experience very serious implications. Overcoming withdrawal is more likely with strategies, such as:
Mental Health Daily suggest gradually tapering the amount one takes. The idea is to reduce one’s dosage by 10 percent every 2-4 weeks. Generally, the faster a person reduces the dose, the more likely the person is to experience more severe withdrawal symptoms. The pace can be adjusted, however. By tapering, the brain can adjust to changes in neurotransmission over time, eventually allowing the person to function normally while completely off the supplement.
While weaning can be an effective method of kicking the habit and avoiding withdrawal, substituting phenibut with another substance can be effective. Substitution medications can be used as part of medical detox programs. Some people use supplements to help discontinue use, including magnesium, melatonin, chamomile tea, taurine, or rhodiola rosea.
Known to enhance some withdrawal symptoms, stress can be reduced by a variety of means. Regular exercise, breathing practices, and other supplements can help to reduce stress, which can speed up recovery.
Since the withdrawal effects from phenibut are so severe in many people, medical detox may be recommended. Those who want to stop using phenibut can be monitored in a safe and comfortable environment. Baclofen is one drug that may be used in medical detox, as it may help to alleviate withdrawal symptoms.
Cognitive Behavioral Therapy (CBT): Individuals who use high doses of phenibut often cite the substance’s calming and psychoactive effects as reasons for use. Proper therapy can focus on their thought processes and stress management skills, to develop and support an attitude of abstinence. By doing so, individuals can concentrate on sobriety during the withdrawal period and address factors that encourage them to use the drug.
Treatment for underlying condition: Someone who began taking phenibut to get relief from other conditions will experience those symptoms after stopping use. Anxiety or depression medications, in addition to therapy, can be helpful for those who suffer from these co-occurring disorders.
What Affects Withdrawal?
Although withdrawal is generally an uncomfortable experience, there are factors impacting how one person responds compared to another. These Include:
- Short-term vs. long-term use: Withdrawal symptoms are generally more severe the longer a person has been taking phenibut. A person becomes more accustomed to the drug over time, which has been integrated with neurotransmission processes. Desensitization of neurotransmitters and receptors to the supplement may occur over time. Stopping after prolonged use, therefore, requires more adjustments to neurophysiology. Short-term users can generally stop with fewer and milder effects over a shorter time period.
- Dose: According to Mental Health Daily, people on a low dose of phenibut, or about 100-500 milligrams, are much less likely to have long-lasting significant effects. At doses of 1-3 grams, withdrawal can be very severe and even dangerous. These doses are higher than anyone would need for a therapeutic effect. Changes to neurophysiology at high doses can make withdrawal actually debilitating to the person.
- Individual variations: Multiple users can take the same amount, for the same time period, and stop simultaneously, but won’t necessarily all have the same symptoms. Personal factors include whether people take other drugs or supplements. Stress levels, diet, genetics, exercise, and sleep quality have an effect as well.
The severity of withdrawal from phenibut can vary based on individual differences, doses, and how long the drug was taken.