Outpatient Phenibut Taper Supported by Baclofen and Gabapentin

Phenibut (β-phenyl-γ-aminobutyric acid) is a non-regulated gamma-aminobutyric acid (GABA)ergic compound associated with dependence and a clinically significant withdrawal syndrome characterized by anxiety, insomnia, and autonomic symptoms. Evidence-based guidance for phenibut withdrawal management is limited. We describe a 27-year-old male with phenibut dependence who achieved cessation in an outpatient setting using a gradual phenibut taper supported by baclofen and adjunctive gabapentin. Phenibut was tapered from approximately 2.5 g/day to cessation over nine weeks. Baclofen and gabapentin were introduced as adjunctive agents during the taper and subsequently discontinued. The patient's scheduled left shoulder labral repair surgery served as a significant external motivator for cessation. This case illustrates the feasibility of a clinician-guided outpatient taper strategy incorporating pharmacologic support in a motivated patient, while highlighting important limitations related to attribution of treatment effects and follow-up.