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

Venhuis, Bastiaan J.; Keizers, Peter H. J.; Riel, Antoinette van; Kaste, D. de

doi:10.1002/dta.1664

Cited by 62 publications

(71 citation statements)

References 12 publications

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“…[37][38][39][40][41] In fact, a growing number of PEA-class substances, generally known to have substantial sympathomimetic, cardiovascular, pulmonary, and central nervous system (including, psychotic, convulsion, and addiction potential) properties, 5,10 are included in essentially unregulated so-called energy formulations, posing significant public health risks. [37][38][39][40][41] These findings warrant further studies to elucidate the pharmacological profile, and most importantly, the potential toxicity of these compounds.…”

Section: Discussionmentioning

confidence: 99%

Behavioral Effects of β-Phenylethylamine and Various Monomethylated and Monohalogenated Analogs in Mice Are Mediated by Catecholaminergic Mechanisms

Mosnaim

Hudzik

Wolf³

2015

American Journal of Therapeutics

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The effects of the administration [intraperitoneally, 15 and 75 mg/kg, except α-MePEA (amphetamine, AMPH) at 5 and 10 mg/kg] of β-phenylethylamine (PEA), its methylated (o-Me-, p-Me-, α-Me-, β-Me-, N-Me-, p-OMe-, N,N-di-Me-, and 3,4-diOH-N-Me-), para-halogenated (Br-, Cl-, F-, and I-), and other derivatives for example, p-OHPEA (p-tyramine), on Swiss male albino mice caged behavior fall into 3 broad categories. (1) N,N-diMe-, 3,4-diOH-N-Me-, and o-MePEA tend to reduce the behavioral activity, (2) p-OH and p-IPEA were without noticeable effects, and (3) the remaining compounds increased locomotor activity, produced hyperexcitability and fighting, jumping and vocalization, and convulsion in a graded manner (listed in increasing order p-OMe-, β-Me-, p-Cl-, p-Br-, p-F-, p-Me-, and N-MePEA, PEA itself and α-MePEA). The latter compound (amphetamine) being the most potent among them; equieffective but with lower potency were p-MePEA, N-MePEA, and PEA itself. The effects of PEAs upon group cage behavior were increased by pretreatment with pargyline (1.5 hours; 15 mg/kg) and decreased after reserpine or haloperidol [4 hours and/or 24 hours (2.5 and/or 2.5 mg/kg) and 1 hour (1 mg/kg), respectively], reaching full suppression with the double-dose regimen of reserpine and single dose of haloperidol. As expected, none of these substances by themselves were noticeable changed group mice activity or stereotypic behavior. The effects of test amines and catecholamine-modulating agents on stereotypy were assessed by rating the sequentially occurring behaviors: increased exploratory behavior with increased sniffing; occasional side-to-side head weaving; paw-licking and other grooming; gnawing, fighting and continuous side-to-side head weaving, and periodic episodes of "popcorn" behavior, during which all mice in the cage ran, jumped, and vocalized. In general, rank efficacy in eliciting stereotype aligned with rank efficacy in affecting group cage behavior. Our results show that a number of as yet little studied monomethylated and monohalogenated PEA analogs share a similar behavioral profile with PEA and AMPH. Behavioral changes observed appear to be, at least in part, mediated by catecholaminergic mechanism as they are modulated by drugs known to influence catecholamine activity. PEA analogs provide a large number of clinically useful drugs; whether further studies on these novel amines will lead to the rational design of newer, safer, and effective PEA-class drugs remains to be seen.

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Section: Discussionmentioning

confidence: 99%

Behavioral Effects of β-Phenylethylamine and Various Monomethylated and Monohalogenated Analogs in Mice Are Mediated by Catecholaminergic Mechanisms

Mosnaim

Hudzik

Wolf³

2015

American Journal of Therapeutics

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“…In addition, warning labels educating consumers that combining highly concentrated caffeine products with other stimulants, particularly when consumed in conjunction with physical activity, may also help prevent adverse effects such as cardiotoxicity [21,[24][25][26][27][28][39][40][41][42][43][44]. However, given the current lack of regulation of these products, appropriate labeling and product warnings may remain scarce.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers

et al. 2016

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Introduction Anhydrous caffeine, often sold on the Internet as a powdered caffeine product, is sold as "pure caffeine" to be used as an additive to beverages and has also been used as an ingredient in energy supplement products. Methods This is a retrospective multiple-poison center chart review of calls regarding powdered caffeine to poison centers covering Oregon, Alaska, Guam, Washington, and Utah between January 1, 2013 and June 30, 2015.Results There were 40 calls to three poison centers over 30 months for powdered caffeine exposure. The majority of patients were over age 19 (52.5 %; 21/40) and male (70 %; 28/ 40). Sixty percent (24/40) of the patients were symptomatic but only 10 % (4/40) required admission; 52.5 % (21/40) of the patient calls were for inadvertent overdose of powdered caffeine; one patient overdosed in a self-harm attempt. Discussion Powdered caffeine calls to three poison centers during a 30-month study period were rare, and severe caffeine toxicity due to exposure was found in few patients. The majority of symptoms were reported after an inadvertent powdered caffeine overdose. Conclusions An analysis of calls to three poison centers for powdered caffeine found that exposures were uncommon, but did result in toxicity, and highlighted that the lack of clear dosing instructions on product packaging may place patients at risk of inadvertent overdose.

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“…Media and marketing targeted to athletes commonly engage in “claimsmaking” for the supplement industry (Bailey, 2013). Supplements are especially of interest, as athletes use these products for enhancement purposes (Baume, Hellemans, & Saugy, 2007) while independent lab analyses of supplements regularly demonstrate a huge proportion to be contaminated with banned – and potentially risky – substances (Abbate et al, 2015; Cohen, Travis, & Venhuis, 2013; Venhuis, Keizers, Riel, & Kaste, 2014). …”

Section: Challengesmentioning

confidence: 99%

Challenges to promoting health for amateur athletes through anti-doping policy

Henning

2016

Drugs: Education, Prevention and Policy

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Anti-doping regulations are intended, at least in part, to promote the health of athletes. While most anti-doping efforts target elite and professional competitors, there have been recent moves by sport governing bodies to expand anti-doping testing to include amateur athletes. Drawing on previous critiques of anti-doping policies and illustrating cases, this article outlines five of the challenges to health promotion of applying the current detect and ban model to the amateur level of sport. I argue that the current approach is not effective and, in some ways, may undermine the goal of health promotion at the amateur level. In order to address these challenges, I propose alternative, health-centred strategies that focus on athlete empowerment and choice through critical awareness of a variety of substances, associated risks and rewards, and the role of expertise in decision-making.

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

Cited by 62 publications

References 12 publications

Behavioral Effects of β-Phenylethylamine and Various Monomethylated and Monohalogenated Analogs in Mice Are Mediated by Catecholaminergic Mechanisms

Behavioral Effects of β-Phenylethylamine and Various Monomethylated and Monohalogenated Analogs in Mice Are Mediated by Catecholaminergic Mechanisms

A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers

Challenges to promoting health for amateur athletes through anti-doping policy

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