METHODS: We present a case of phenibut intoxication and withdrawal delirium that provided diagnostic and management challenges because of a patient that was initially not forthcoming about his phenibut use which resulted in five presentations to the hospital including two admissions.
RESULTS: Initial differential including adrenergic, serotonergic or anticholinergic toxidrome based on clinical picture and history reported at that time, however phenibut use of 50 g daily was eventually revealed, an amount exceeding the highest reported cases in our review of the English literature.
CONCLUSIONS: High-dose phenibut intoxication and withdrawal can appear as dramatic and dangerous as high-dose sedative withdrawal, however given its specified receptor affinity and binding profile we found that a pharmacotherapeutic approach targeting GABA-B, GABA-A, and gabapentenoid receptors were effective in stabilizing this patient, eventually leading to the patient\'s full and sustained recovery.
方法:我们介绍了一例苯尼布中毒和戒断性谵妄的病例,该病例的诊断和管理方面存在挑战,因为一名患者最初不了解他的苯尼布使用情况,导致五次医院就诊,包括两次入院。
结果:初始差异,包括肾上腺素,根据当时报道的临床表现和病史,血清素能或抗胆碱能毒物,然而,最终发现每天使用50克,超过我们对英语文献的评论中报告的最高病例。
结论:大剂量镇静剂戒断与大剂量镇静剂戒断一样严重和危险,然而,鉴于其特定的受体亲和力和结合谱,我们发现靶向GABA-B的药物治疗方法,GABA-A,加巴酚丁素受体有效地稳定了这个病人,最终导致患者的全面和持续的康复。