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A cocktail of synthetic stimulants found in a dietary supplement associated with serious adverse events

Drug Test Anal. 2014 Jun;6(6):578-81. doi: 10.1002/dta.1664. Epub 2014 May 6.

Abstract

Food supplements are regularly found to contain pharmacologically active substances. Recently, the food supplement Dexaprine was removed from the Dutch market because it was associated with severe adverse events. Reports to the Dutch Poisons Information Center (DPIC) showed that ingestion of as little as half a tablet caused several cases of nausea, agitation, tachycardia, and palpitations and even one case of cardiac arrest. The remaining tablets of four patients were sent in by different healthcare professionals. Analysis by ultra-performance liquid chromatography quadrupole time of flight mass-spectrometry (UPLC-QTOF-MS) confirmed the presence of synephrine, oxilofrine, deterenol, yohimbine, caffeine, and theophylline. Two more compounds were found which were tentatively identified as β-methyl-β-phenylethylamines. This incident is only the next in a series of similar incidents involving dietary supplements with (undeclared) active substances that are either unsafe or have no known safety profile.

Keywords: Acacia Rigidula; Dexaprine; UPLC-QTOF; deterenol; isopropyloctopamine; severe adverse events; synephrine; β-methyl-β-phenylethylamine.

MeSH terms

  • Adult
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / analysis*
  • Central Nervous System Stimulants / chemistry
  • Chromatography, High Pressure Liquid / methods*
  • Dietary Supplements / adverse effects
  • Dietary Supplements / analysis*
  • Female
  • Humans
  • Male
  • Mass Spectrometry / methods*
  • Middle Aged
  • Netherlands
  • Tablets
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Tablets