Phenibut Explained

Verifiedfields:verified
Watchedfields:verified
Verifiedrevid:464373947
Iupac Name:4-Amino-3-phenylbutanoic acid
Width:200px
Width2:200px
Tradename:Anvifen, Fenibut, Noofen, others[1]
Legal Au:S4
Legal Ca:Unscheduled
Legal Br:B1
Legal De:NPSG
Legal Us:Unapproved drug; use in dietary supplements, food, or medicine is unlawful.[2]
Legal Un:Unscheduled
Legal Status:RU

Rx-only

Routes Of Administration:Common: Oral
Uncommon: Rectal
Class:GABAB receptor agonist
Gabapentinoid
Bioavailability:≥63% (250 mg)
Metabolism:Liver (minimal)
Metabolites:Inactive
Elimination Half-Life:5.3 hours (250 mg)
Onset:Oral

2–4 hours
Rectal: 20–30 minutes

Duration Of Action:15–24 hours (1–3 g)
Excretion:Urine

63% (unchanged)

Cas Number:1078-21-3
Cas Supplemental:
3060-41-1 (hydrochloride)
Unii:T2M58D6LA8
Atc Prefix:N06
Atc Suffix:BX22
Pubchem:14113
Chemspiderid:13491
Chembl:315818
Kegg:D10509
Synonyms:Aminophenylbutyric acid; Fenibut; Fenigam; Phenigam; Phenybut; Phenygam; Phenylgamma; Phenigama; PHG; PhGABA; β-Phenyl-γ-aminobutyric acid; β-Phenyl-GABA[3]
C:10
H:13
N:1
O:2
Smiles:O=C(O)CC(c1ccccc1)CN
Stdinchi:1S/C10H13NO2/c11-7-9(6-10(12)13)8-4-2-1-3-5-8/h1-5,9H,6-7,11H2,(H,12,13)
Stdinchikey:DAFOCGYVTAOKAJ-UHFFFAOYSA-N
Melting Point:253

Phenibut, sold under the brand name Anvifen among others, is a central nervous system (CNS) depressant with anxiolytic effects, and is used to treat anxiety, insomnia, and for a variety of other indications.[4] It is usually taken orally (swallowed by mouth), but may be given intravenously.

Side effects of phenibut can include sedation, sleepiness, nausea, irritability, agitation, dizziness, euphoria, and sometimes headache, among others. Overdose of phenibut can produce marked central nervous system depression including unconsciousness. The medication is structurally related to the neurotransmitter γ-aminobutyric acid (GABA), and hence is a GABA analogue. Phenibut is thought to act as a GABAB receptor agonist, similarly to baclofen and γ-hydroxybutyrate (GHB). However, at low concentrations, phenibut mildly increases the concentration of dopamine in the brain, providing stimulatory effects in addition to the anxiolysis.[5]

Phenibut was developed in the Soviet Union and was introduced for medical use in the 1960s. Today, it is marketed for medical use in Russia, Ukraine, Belarus, Kazakhstan, and Latvia. The medication is not approved for clinical use in the United States and most of Europe, but it is sold on the Internet as a supplement and purported nootropic.[6] Phenibut has been used recreationally and can produce euphoria as well as addiction, dependence, and withdrawal. It is a controlled substance in Australia, and it has been suggested that its legal status should be reconsidered in Europe as well. In Germany, phenibut is not approved as a drug and, as a food supplement, is controlled under the German New Psychoactive Substances Act.[7]

In a 2023 assessment, the U.S. Food and Drug Administration (FDA) determined that phenibut does not meet the definition of a dietary ingredient, thereby making phenibut supplement products misbranded and illegal for marketing.[8] FDA warning letters had been issued to supplement manufacturers marketing phenibut products as adulterated.[9]

Medical uses

Phenibut is used in Russia, Ukraine, Belarus and Latvia as a pharmaceutical drug to treat anxiety and to improve sleep (e.g., in the treatment of insomnia). It is also used for various other indications, including the treatment of asthenia, depression, alcoholism, alcohol withdrawal syndrome, post-traumatic stress disorder, stuttering, tics, vestibular disorders, Ménière's disease, dizziness, for the prevention of motion sickness, and for the prevention of anxiety before or after surgical procedures or painful diagnostic tests.

Available forms

Phenibut is available as a medication in the form of 250 mg or 500 mg tablets for oral administration and as a solution at a concentration of 10 mg/mL for infusion.[10] In the US, dietary supplements labeled as containing phenibut have been found to contain zero to greater than 1,100 mg of phenibut per serving.

Contraindications

Contraindications of phenibut include:

Phenibut should not be combined with alcohol.

Side effects

Phenibut is generally well-tolerated. Possible side effects may include sedation, somnolence, nausea, irritability, agitation, anxiety, dizziness, headache, and allergic reactions such as skin rash and itching. At high doses, motor incoordination, loss of balance, and hangovers may occur. Due to its CNS depressant effects, people taking phenibut should refrain from potentially dangerous activities such as operating heavy machinery. With prolonged use of phenibut, particularly at high doses, the liver and blood should be monitored, due to risk of fatty liver disease and eosinophilia.

Overdose

In overdose, phenibut can cause severe drowsiness, nausea, vomiting, eosinophilia, lowered blood pressure, renal impairment, and, above 7 grams, fatty liver degeneration. There are no specific antidotes for phenibut overdose. Lethargy, somnolence, agitation, delirium, tonic–clonic seizures, reduced consciousness or unconsciousness, and unresponsiveness have been reported in recreational users who have overdosed. Management of phenibut overdose includes activated charcoal, gastric lavage, induction of vomiting, and symptom-based treatment. There have been three associated deaths which found Phenibut in the users system but only one of these cases single-handedly included Phenibut.[11]

Dependency and withdrawal

Tolerance to phenibut easily develops with repeated use leading to dependency. Withdrawal symptoms may occur upon discontinuation, and, in recreational users taking high doses, have been reported to include severe rebound anxiety, insomnia, anger, irritability, agitation, visual and auditory hallucinations, and acute psychosis. Baclofen has successfully been used for treatment of phenibut dependence.[12]

Interactions

Phenibut may mutually potentiate and extend the duration of the effects of other CNS depressants, including anxiolytics, antipsychotics, sedatives, opioids, anticonvulsants, and alcohol.

Pharmacology

Pharmacodynamics

+ GABA and analogues
at biological targets[13]
Compound GABAA
0.08 0.12
>100 >100
1.10 1.38
Phenibut 9.6 >100
1.70 >100
0.13 >100
0.13 >100
74.0 >100
Values are IC50 (μM) in rat brain.

Phenibut acts as a full agonist of the GABAB receptor, similarly to baclofen.[14] [15] It has between 30- and 68-fold lower affinity for the GABAB receptor than baclofen, and, in accordance, is used at far higher doses in comparison. (R)-Phenibut has more than 100-fold higher affinity for the GABAB receptor than does (S)-phenibut; hence, (R)-phenibut is the active enantiomer at the GABAB receptor.[16]

+
Phenibut and analogues
at biological targets[17]
Compound GABAB
Phenibut 177
  (R)-Phenibut 23 92
  (S)-Phenibut 39 >1,000
156 6
0.05 >1,000
Values are Ki (μM) in rat brain.

Phenibut also binds to and blocks α2δ subunit-containing VDCCs, similarly to gabapentin and pregabalin, and hence is a gabapentinoid.[18] Both (R)-phenibut and (S)-phenibut display this action with similar affinity (Ki = 23 and 39 μM, respectively).

It is often claimed on websites about nootropics and elsewhere on the internet that phenibut increases dopamine. Three papers published in Russian by Soviet scientists in 1979, 1986, and 1990 report that phenibut increases dopamine in the striatum of rats and in the mouse brain.[19] The mechanism underlying this putative effect is unclear.[19] Structurally, phenibut can also be considered a derivative of phenethylamine, and some research suggests that phenibut antagonizes the action of phenethylamine.[19]

Pharmacokinetics

Little information thus far has been published on the clinical pharmacokinetics of phenibut. The drug is reported to be well-absorbed. It distributes widely throughout the body and across the blood–brain barrier. Approximately 0.1% of an administered dose of phenibut reportedly penetrates into the brain, with this said to occur to a much greater extent in young people and the elderly. Following a single 250 mg dose in healthy volunteers, its elimination half-life was approximately 5.3 hours and the drug was largely (63%) excreted in the urine unchanged.

Some limited information has been described on the pharmacokinetics of phenibut in recreational users taking much higher doses (e.g., 1–3 grams) than typical clinical doses.[20] [21] In these individuals, the onset of action of phenibut has been reported to be 2 to 4 hours orally and 20 to 30 minutes rectally, the peak effects are described as occurring 4 to 6 hours following oral ingestion, and the total duration for the oral route has been reported to be 15 to 24 hours (or about 3 to 5 terminal half-lives).

Chemistry

Phenibut is a synthetic aromatic amino acid. It is a chiral molecule and thus has two potential configurations, as (R)- and (S)-enantiomers.

Structure and analogues

Phenibut is a derivative of the inhibitory neurotransmitter GABA. Hence, it is a GABA analogue. Phenibut is specifically the analogue of GABA with a phenyl ring substituted in at the β-position. As such, its chemical name is β-phenyl-γ-aminobutyric acid, which can be abbreviated as β-phenyl-GABA. The presence of the phenyl ring allows phenibut to cross the blood–brain barrier significantly, unlike GABA. Phenibut also contains the trace amine β-phenethylamine in its structure.

Phenibut is closely related to a variety of other GABA analogues including baclofen (β-(4-chlorophenyl)-GABA), 4-fluorophenibut (β-(4-fluorophenyl)-GABA), tolibut (β-(4-methylphenyl)-GABA), pregabalin ((S)-β-isobutyl-GABA), gabapentin (1-(aminomethyl)cyclohexane acetic acid), and GABOB (β-hydroxy-GABA). It has almost the same chemical structure as baclofen, differing from it only in having a hydrogen atom instead of a chlorine atom at the para position of the phenyl ring. Phenibut is also close in structure to pregabalin, which has an isobutyl group at the β position instead of phenibut's phenyl ring.

A glutamate-derivative analogue of phenibut is glufimet (dimethyl 3-phenylglutamate hydrochloride).[22]

Synthesis

A chemical synthesis of phenibut has been published.

History

Phenibut was synthesized at the A. I. Herzen Leningrad Pedagogical Institute (USSR) by Professor Vsevolod Perekalin's team and tested at the Institute of Experimental Medicine, USSR Academy of Medical Sciences. It was introduced into clinical use in Russia in the 1960s.

Society and culture

Other names

Alternate spellings include fenibut and phenybut. It is also sometimes referred to as aminophenylbutyric acid. The word phenibut is a contraction of the chemical name of the drug, β-phenyl-γ-aminobutyric acid. In early publications, phenibut was referred to as fenigam and phenigama.[23] The drug has not been assigned an .

Brand names

Phenibut is marketed in Russia, Ukraine, Belarus, and Latvia under the brand names Anvifen, Fenibut, Bifren, and Noofen (Russian: Анвифен, Фенибут, Бифрен and Ноофен, respectively).

Availability

Phenibut is approved in Russia, Ukraine, Belarus, and Latvia for medical use. It is not approved or available as a medication in other countries in the European Union, the United States, or Australia. In countries where phenibut is not a licensed pharmaceutical drug, it is sold online without a prescription as a "nutritional supplement". It is often used as a form of self-medication for social anxiety.

Recreational use

Phenibut is used recreationally due to its ability to produce euphoria, anxiolysis, and increased sociability, as well as remaining undetected in routine urinalysis. Because of its delayed onset of effects, first-time users often mistakenly take an additional dose of phenibut in the belief that the initial dose did not work. Recreational users usually take the drug orally; there are a few case reports of rectal administration and one report of insufflation, which was described as "very painful" and causing swollen nostrils.

Legal status

As of 2021, phenibut is a controlled substance in Australia,[20] France,[24] Hungary,[25] Italy,[26] Lithuania,[27] [28] and Germany[7] where, nevertheless, it is readily obtained online.[29]

In 2015, it was suggested that the legal status of phenibut in Europe should be reconsidered due to its recreational potential. In February 2018, the Australian Therapeutic Goods Administration declared it a prohibited (schedule 9) substance, citing health concerns due to withdrawal and overdose.[30] [31]

As of 14 November 2018, Hungary added phenibut and 10 other items to its New Psychoactive Substances ban list,[32] and, as of 26 August 2020, Italy added phenibut to its New Psychoactive Substances ban list.[26] As of 18 September 2020, France added phenibut to the controlled psychoactive substances list, prohibiting production, sale, storage, and use.[33]

In the United States, phenibut is an unapproved drug, but is often misleadingly marketed as a dietary supplement. It is readily available without a prescription.[34] [35]

In Alabama, phenibut was made a Schedule II substance at the state level in November 2021.[36]

See also

Notes and References

  1. Drobizhev MY, Fedotova AV, Kikta SV, Antohin EY . 2016 . Феномен аминофенилмасляной кислоты . Phenomenon of aminophenylbutyric acid . Russian . Russian Medical Journal . 2017 . 24 . 1657–1663 . 1382-4368 . 16 September 2017 . 16 September 2017 . https://web.archive.org/web/20170916053610/https://www.rmj.ru/articles/nevrologiya/Fenomen_aminofenilmaslyanoy_kisloty/ . live .
  2. Nutrition . Center for Food Safety and Applied . 2023-03-06 . Phenibut in Dietary Supplements . FDA . en . 23 May 2023 . 23 May 2023 . https://web.archive.org/web/20230523031247/https://www.fda.gov/food/dietary-supplement-ingredient-directory/phenibut-dietary-supplements . live .
  3. Book: Elks J . The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. 14 November 2014. Springer. 978-1-4757-2085-3. 69–.
  4. Lapin I . Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug . CNS Drug Reviews . 7 . 4 . 471–81 . 2001 . 11830761 . 6494145 . 10.1111/j.1527-3458.2001.tb00211.x .
  5. Lapin I . Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug . CNS Drug Reviews . 7 . 4 . 471–81 . 2006-06-07 . 11830761 . 6494145 . 10.1111/j.1527-3458.2001.tb00211.x .
  6. Cohen PA, Ellison RR, Travis JC, Gaufberg SV, Gerona R . Quantity of phenibut in dietary supplements before and after FDA warnings . Clinical Toxicology . 60 . 4 . 486–488 . April 2022 . 34550038 . 10.1080/15563650.2021.1973020 . 237594860 .
  7. Web site: Anlage NpSG - Einzelnorm . 2024-06-07 . www.gesetze-im-internet.de.
  8. Web site: Phenibut in Dietary Supplements . US Food and Drug Administration . 14 September 2024 . 12 July 2023.
  9. Web site: FDA Acts on Dietary Supplements Containing DMHA and Phenibut . US Food and Drug Administration . 14 September 2024 . 29 April 2019.
  10. Web site: Регистр лекарственных средств России ([Russian Medicines Register]) . Фенибут (Phenybutum) . Fenibut (Phenybutum) . Russian . 15 September 2017 . 3 March 2009 . https://web.archive.org/web/20090303232933/https://www.rlsnet.ru/tn_index_id_5320.htm . live .
  11. Graves JM, Dilley J, Kubsad S, Liebelt E . Notes from the Field: Phenibut Exposures Reported to Poison Centers - United States, 2009–2019 . en-us . MMWR. Morbidity and Mortality Weekly Report . 69 . 35 . 1227–1228 . September 2020 . 32881852 . 7470459 . 10.15585/mmwr.mm6935a5 . free .
  12. Samokhvalov AV, Paton-Gay CL, Balchand K, Rehm J . Phenibut dependence . BMJ Case Reports . 2013 . bcr2012008381 . February 2013 . 23391959 . 3604470 . 10.1136/bcr-2012-008381 .
  13. Bowery NG, Hill DR, Hudson AL . Characteristics of GABAB receptor binding sites on rat whole brain synaptic membranes . British Journal of Pharmacology . 78 . 1 . 191–206 . January 1983 . 6297646 . 2044790 . 10.1111/j.1476-5381.1983.tb09380.x .
  14. Book: GABAb Receptor Pharmacology: A Tribute to Norman Bowery: A Tribute to Norman Bowery. 21 September 2010. Academic Press. 978-0-12-378648-7. 25–.
  15. Dambrova M, Zvejniece L, Liepinsh E, Cirule H, Zharkova O, Veinberg G, Kalvinsh I . Comparative pharmacological activity of optical isomers of phenibut . European Journal of Pharmacology . 583 . 1 . 128–134 . March 2008 . 18275958 . 10.1016/j.ejphar.2008.01.015 .
  16. Allan RD, Bates MC, Drew CA, Duke RK, Hambley TW, Johnston GA, Mewett KN, Spence I . 6 . A new synthesis resolution and in vitro activities of (R)- and (S)-β-Phenyl-Gaba. Tetrahedron. 46. 7. 1990. 2511–2524. 0040-4020. 10.1016/S0040-4020(01)82032-9.
  17. Zvejniece L, Vavers E, Svalbe B, Veinberg G, Rizhanova K, Liepins V, Kalvinsh I, Dambrova M . 6 . R-phenibut binds to the α2-δ subunit of voltage-dependent calcium channels and exerts gabapentin-like anti-nociceptive effects . Pharmacology, Biochemistry, and Behavior . 137 . 23–9 . October 2015 . 26234470 . 10.1016/j.pbb.2015.07.014 . 42606053 .
  18. Vavers E, Zvejniece L, Svalbe B, Volska K, Makarova E, Liepinsh E, Rizhanova K, Liepins V, Dambrova M . 6 . The neuroprotective effects of R-phenibut after focal cerebral ischemia . Pharmacological Research . 113 . Pt B . 796–801 . November 2016 . 26621244 . 10.1016/j.phrs.2015.11.013 .
  19. Lapin . Izyaslav . Phenibut (β-Phenyl-GABA): A Tranquilizer and Nootropic Drug . CNS Drug Reviews . December 2001 . 7 . 4 . 471–481 . 10.1111/j.1527-3458.2001.tb00211.x. 11830761 . 6494145 .
  20. Owen DR, Wood DM, Archer JR, Dargan PI . Phenibut (4-amino-3-phenyl-butyric acid): Availability, prevalence of use, desired effects and acute toxicity . Drug and Alcohol Review . 35 . 5 . 591–6 . September 2016 . 26693960 . 10.1111/dar.12356 . free . 10044/1/30073 .
  21. Schifano F, Orsolini L, Duccio Papanti G, Corkery JM . Novel psychoactive substances of interest for psychiatry . World Psychiatry . 14 . 1 . 15–26 . February 2015 . 25655145 . 4329884 . 10.1002/wps.20174 .
  22. Perfilova VN, Popova TA, Prokofiev II, Mokrousov IS, Ostrovskii OV, Tyurenkov IN . Effect of Phenibut and Glufimet, a Novel Glutamic Acid Derivative, on Respiration of Heart and Brain Mitochondria from Animals Exposed to Stress against the Background of Inducible NO-Synthase Blockade . Bulletin of Experimental Biology and Medicine . 163 . 2 . 226–229 . June 2017 . 28726197 . 10.1007/s10517-017-3772-4 . 4907409 .
  23. Khaunina RA, Lapin IP . Fenibut, a new tranquilizer . Pharmaceutical Chemistry Journal . 10 . 12 . 1976 . 1703–1705 . 0091-150X . 10.1007/BF00760021 . 29071385.
  24. Par https://www.legifrance.gouv.fr/codes/article_lc/LEGIARTI000032106035/ La liste des substances psychotropes
  25. Web site: 39/2018. (XI. 8.) EMMI rendelet Az új pszichoaktív anyaggá minősített anyagokról vagy vegyületcsoportokról szóló 55/2014. (XII. 30.) EMMI rendelet módosításáról. 14 November 2018. 14 November 2018. https://web.archive.org/web/20181114141557/http://kozlonyok.hu/nkonline/MKPDF/hiteles/MK18170.pdf. live.
  26. Web site: Gazzetta Ufficiale 11/08/20 . Lorenzo Arbolino . 11 August 2020 . 27 August 2020 . 2 May 2024 . https://web.archive.org/web/20240502165522/https://www.gazzettaufficiale.it/eli/id/2020/08/21/20A04540/SG . live .
  27. Web site: RINKOS RIBOJIMO PRIEMONĖS FENIBUTUI!. ntakd.lrv.lt. lt. 2020-01-27. 6 October 2021. https://web.archive.org/web/20211006065759/https://ntakd.lrv.lt/lt/naujienos/rinkos-ribojimo-priemones-fenibutui. dead.
  28. Web site: V-1431 Dėl Lietuvos Respublikos sveikatos apsaugos ministro 2000 m. sausio 6 d. įsakymo Nr. 5 "Dėl Narko.... e-seimas.lrs.lt. lt. 2020-01-27. 27 January 2020. https://web.archive.org/web/20200127002637/https://e-seimas.lrs.lt/portal/legalAct/lt/TAD/9aff1ef11ce911eaadfcfdb735b57421%3Fjfwid%3D-bgd9aafbv. live.
  29. Bonnet U, Scherbaum N, Schaper A, Soyka M. Phenibut — an Illegal Food Supplement With Psychotropic Effects and Health Risks. 5 April 2024 . 10.3238/arztebl.m2024.0003. 121. 222–7. Deutsches Ärzteblatt International. 7 . 38377332 . en. 11539871.
  30. Web site: Australian Government Department of Health.. Administration Therapeutic Goods Administration. 3.3 Phenibut. 6 November 2017. en. 31 October 2017. 27 March 2020. https://web.archive.org/web/20200327065227/https://www.tga.gov.au/book-page/33-phenibut. live.
  31. News: Mass school overdose investigation focuses on banned Russian drug . ABC News . Australian Broadcasting Corporation . 22 February 2018 . 22 February 2018 . 22 February 2018 . https://web.archive.org/web/20180222023735/http://www.abc.net.au/news/2018-02-22/detectives-probe-if-drug-behind-school-overdose-bought-online/9471958 . live .
  32. Web site: EMMI Decree substances or groups of compounds classified as new psychoactive substances . Wolters Kluwer . 1 January 2015 . 5 August 2020 . 8 August 2020 . https://web.archive.org/web/20200808213352/https://net.jogtar.hu/jogszabaly?docid=A1400055.EMM . dead .
  33. Web site: Le phénibut interdit en France Le Généraliste . 28 April 2021 . 22 January 2021 . https://web.archive.org/web/20210122213622/https://www.legeneraliste.fr/actu-medicale/sante-publique/le-phenibut-interdit-en-france . live .
  34. Penzak SR, Bulloch M . Phenibut: Review and Pharmacologic Approaches to Treating Withdrawal . J Clin Pharmacol . 64 . 6 . 652–671 . June 2024 . 38339875 . 10.1002/jcph.2414 . Review.
  35. Jouney EA . Phenibut (β-Phenyl-γ-Aminobutyric Acid): an Easily Obtainable "Dietary Supplement" With Propensities for Physical Dependence and Addiction . Curr Psychiatry Rep . 21 . 4 . 23 . March 2019 . 30852710 . 10.1007/s11920-019-1009-0 .
  36. Web site: Controlled Substances List; Schedule II, page 70. 22 February 2024. Alabama State Board of Health. 13 September 2024 .