Abstract
Sibutramine is an amphetamine derivative that has been prescribed as an antidepressant and appetite suppressant. It was voluntarily removed from the U.S. market in 2010 following a clinical trial that showed an increased risk of stroke and myocardial infarction. It has been detected as a clandestine additive in some over-the-counter weight loss and herbal remedies available on the Internet and in retail stores. We describe two fatalities involving the non-prescribed use of sibutramine by women using over-the-counter, herbal, weight loss supplements. Physicians need to be aware of inadvertent ingestion of sibutramine by patients who take herbal remedies for weight loss. Medical examiners and coroners may consider further investigation of sudden deaths in people who are taking herbal remedies for weight loss even with a history of heart disease. Since routine toxicology screens may not detect sibutramine, the toxicology laboratory should be informed when sibutramine is suspected.
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