Sedative-Hypnotic Agents That Impact Gamma-Aminobutyric Acid Receptors: Focus on Flunitrazepam, Gamma-Hydroxybutyric Acid, Phenibut, and Selank.
Level 5 - mechanism / opinion, no new human data
Narrative review of pharmacology, toxicity, and abuse potential without original human data
PubMed 34396551 · doi:10.1002/jcph.1922
What was done
This narrative review evaluated the pharmacology, clinical indications, illicit misuse, and toxicities of non-opioid GABA-modulating central nervous system depressants, specifically focusing on flunitrazepam, gamma-hydroxybutyric acid (GHB), phenibut, and selank.
What was found
The abstract reports no numerical values or effect sizes. Flunitrazepam is noted to have higher potency and greater type A GABA receptor affinity compared to most benzodiazepines and is preferentially used recreationally and in drug-facilitated sexual assault. GHB is sought for hypnotic, euphoric, and anabolic effects, and is also implicated in sexual assault. High doses or combinations with other sedatives produce respiratory depression, coma, and death, with chronic use causing withdrawal syndromes. Phenibut and selank are poorly studied Russian agents sold as dietary supplements in the United States, with poison control center calls regarding phenibut increasing substantially over the preceding 5 years.
Why it matters
This review highlights the acute toxicity, dependence risk, and public health concerns surrounding both prescription and unregulated GABA-active compounds sold over the counter.
Limits
The abstract describes a non-systematic narrative overview with no original empirical data, quantitative synthesis, or detailed methodology. No precise numbers regarding poison control exposures, adverse event rates, or pharmacodynamic parameters are provided.
Cited by
- context Selank promotes calming and enhances restorative deep delta brain waves during sleep.