Garcinia Cambogia-Induced Refractory Status Epilepticus

Abstract

Garcinia cambogia (G.cambogia) is a herbal dietary supplement for managing obesity. Several adverse effects of G.cambogia have been reported including serotonin syndrome and mania. We report a patient with refractory status epilepticus after taking G.cambogia. A 24-year-old woman was admitted with continuing seizures. Based on electroencephalography and neuroimaging findings, she was diagnosed as refractory status epilepticus attributed to G.cambogia-related encephalopathy. After cessation of the G.cambogia with administrating antiepileptic drugs, she fully recovered without seizure recurrence and neurological sequelae.

Protocol for the Scientific Opinion on the evaluation of the safety in use of hydroxycitric acid and plant preparations containing hydroxycitric acid

“…These case reports include various dietary supplements containing a mixture of compounds: Hydroxycut™, Topine® 10 Kalo®11, Exilis (Garcinia cambogia, Garcinia sylvestre,L-carnintine and chrome), "Garcinia cambogia pure", multi ingredient protein supplement with Garcinia cambogia (70%), SUPER ANANAS SLIM™: Garcinia cambogia (60%), Ananas comosus and Ilex paraguariensis, OBLESS™: Garcinia cambogia (72 mg of HCA) and other components: 1 capsule/day AndMagistral preparation of different herbsextracts), THERMO GIALLO™: Garcinia cambogia (200 mg HCA) and 2 capsules of chromium. Acute pancreatitis (Grigos et al, 2016;Bystrak et al, 2017;Iqbal et al, 2019) Case reports Three cases have been reported of acute pancreatitis secondary to the use of Garcinia gummi-gutta (L.) N.Robson, as dietary supplement (Grigos et al, 2016;Bystrak et al, 2017;Iqbal et al, 2019) Serotonine syndrome, hypomania (Roy et al, 2004) (Narasimha et al, 2013;Lopez et al, 2014;Beecheno et al, 2016;Hendrickson et al, 2016;Wong et al, 2016;Cotovio and Oliveira-Maia, 2017;Nguyen et al, 2019;Nam et al, 2022) Rat studies…”

“…The administration of HCA-SX (60% (-)-hydroxycitric acid in its free form, 1% in its lactone form, 10% calcium, 15% potassium, …) among Sprague-Dawley rats during 8 weeks induced an upregulation of genes encoding serotonin receptors (Roy et al, 2004) Case reports Nine cases related to the use of dietary supplement containing Garcinia gummigutta (L.) N.Robson extracts described serotonergic effects which may lead to mania or psychosis (Narasimha et al, 2013;Lopez et al, 2014;Hendrickson et al, 2016;Wong et al ,2017;Beecheno et al, 2017;Cotovio and Olivera-Maia, 2017;Nguyen et al, 2019;Nam et al, 2022). Reduction in glycaemia (Thazhath et al, 2016;Arefhosseini et al, 2022) Randomized controlled trials A randomized trial (Thazhath et al, 2016) including 12 healthy individuals reported that a small intestinal exposure to HCA (2800 mg of HCA dissolved in water) resulted in a modest reduction in glycaemia and stimulation of plasma glucosedependent insulinotropic polypeptide and glucagon, but no effect on plasma glucagon-like peptide-1 or insulin, or on glucose absorption.…”