Hemorrhagic Stroke Probably Caused by Exercise Combined With a Sports Supplement Containing β-Methylphenyl-ethylamine (BMPEA): A Case Report
Authors: Pieter A. Cohen, Rickard Zeijlon, Rachel Nardin, Peter H.J. Keizers, Bastiaan Venhuis
Journal: Annals of Internal Medicine (2015)

Letters16 June 2015Hemorrhagic Stroke Probably Caused by Exercise Combined With a Sports Supplement Containing β-Methylphenyl-ethylamine (BMPEA): A Case ReportPieter A. Cohen, MD, Rickard Zeijlon, MD, Rachel Nardin, MD, Peter H.J. Keizers, PhD, and Bastiaan Venhuis, PhDPieter A. Cohen, MDFrom Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands., Rickard Zeijlon, MDFrom Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands., Rachel Nardin, MDFrom Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands., Peter H.J. Keizers, PhDFrom Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands., and Bastiaan Venhuis, PhDFrom Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0106 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The U.S. Food and Drug Administration has warned consumers that an isomer of amphetamine, β-methylphenylethylamine (BMPEA), is found in many sports supplements (1). The health effects of this chemical in humans are unknown (2, 3).Objective: To report a case of hemorrhagic stroke probably caused by exercise combined with BMPEA.Case Report: A 53-year-old woman presented with 1 day of numbness and clumsiness in her left hand. She reported the sudden onset of symptoms 45 minutes after beginning a vigorous exercise routine that she had repeated several times weekly for a few years.On examination, she was afebrile, blood ...References1. U.S. Food and Drug Administration. BMPEA in dietary supplements. 24 April 2015. Accessed at www.fda.gov/food/dietarysupplements/qadietarysupplements/ucm443790.htm on 28 April 2015. Google Scholar2. Pawar RS, Grundel E, Fardin-Kia AR, Rader JI. Determination of selected biogenic amines in Acacia rigidula plant materials and dietary supplements using LC-MS/MS methods. J Pharm Biomed Anal. 2014;88:457-66. [PMID: 24176750] doi:10.1016/j.jpba.2013.09.012 CrossrefMedlineGoogle Scholar3. Cohen PA, Bloszies C, Yee C, Gerona R. An amphetamine isomer whose efficacy and safety in humans has never been studied, β-methylphenylethylamine (BMPEA), is found in multiple dietary supplements. Drug Test Anal. 2015. [PMID: 25847603] doi:10.1002/dta.1793 CrossrefMedlineGoogle Scholar4. Zeijlon R, Andersson B. Hjärnblödning efter intag av prestationshöjaren "Jacked Power." Frisk kvinna insjuknade under träning efter en enda dos. Läkartidningen. 2014;111:1782-4. [PMID: 25699325] MedlineGoogle Scholar5. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356:1255-9. [PMID: 11072960] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard Medical School, Boston, Massachusetts; Sahlgrenska University Hospital, Gothenburg, Sweden; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=L15-0106.This article was published online first at www.annals.org on 12 May 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByA content analysis of marketing on the packages of dietary supplements for weight loss and muscle buildingNine prohibited stimulants found in sports and weight loss supplements: deterenol, phenpromethamine (Vonedrine), oxilofrine, octodrine, beta-methylphenylethylamine (BMPEA), 1,3-dimethylamylamine (1,3-DMAA), 1,4-dimethylamylamine (1,4-DMAA), 1,3-dimethylbutylamine (1,3-DMBA) and higenamineHPLC-UV-QDa analysis of Citrus aurantium-labelled pre-workout supplements suggest only a minority contain the plant extractPRE-WORKOUT SUPPLEMENT INDUCED CARDIAC ISCHAEMIA IN A YOUNG FEMALEKratom Adulterated with Phenylethylamine and Associated Intracerebral Hemorrhage: Linking Toxicologists and Public Health Officials to Identify Dangerous AdulterantsThe Supplement Adulterant β -Methylphenethylamine Increases Blood Pressure by Acting at Peripheral Norepinephrine TransportersFora fuelling the discovery of fortified dietary supplements – An exploratory study directed at monitoring the internet for contaminated food supplements based on the reported effects of their usersFour experimental stimulants found in sports and weight loss supplements: 2-amino-6-methylheptane (octodrine), 1,4-dimethylamylamine (1,4-DMAA), 1,3-dimethylamylamine (1,3-DMAA) and 1,3-dimethylbutylamine (1,3-DMBA)Overview of regulation of dietary supplements in the USA and issues of adulteration with phenethylamines (PEAs)Banned and discouraged-use ingredients found in weight loss supplementsEmergency department visits and hospitalisations for adverse events related to dietary supplements are commonHistory full circle: 'Novel' sympathomimetics in supplementsProtecting military personnel from high risk dietary supplementsBreaking the gridlock: Regulation of dietary supplements in the United States 16 June 2015Volume 162, Issue 12Page: 879-880KeywordsAdverse reactionsAmphetaminesBlood pressureDrug administrationDrugsExerciseHemorrhageHemorrhagic strokeSports ePublished: 16 June 2015 Issue Published: 16 June 2015 CopyrightCopyright © 2015 by American College of Physicians. 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