Serotonin Toxicity Associated with Garcinia cambogia Over-the-counter Supplement

Abstract

Garcinia cambogia, also known as the Malabar tamarind, is a plant that is commonly used in India and Southeast Asia for its sour taste and as a food-bulking agent [1]. The plant contains hydroxycitric acid (HCA) and has recently become a popular ingredient in over-the-counter supplements designed for weight loss and weight management [2]. Most of these supplements contain from 20 to 60 % HCA. There is limited evidence that HCA may increase serotonin concentrations and thereby increase the risk of serotonin toxicity. HCA analogs increase serotonin concentrations within the brains of rats [1, 3], and randomized human studies have found elevations in free serum serotonin concentrations after the administration of HCA derivatives [4]. We report a case of suspected serotonin toxicity in the presence of therapeutic dosing of serotonin reuptake inhibitors (SSRIs) when combined with a nutritional supplement containing G. cambogia and hydroxycitric acid.