Abstract Details

Title Acute Stroke in Young Women Taking Phentermine

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 249

Objective

Background BACKGROUND: Qnexa (phentermine and topamax) was FDA-approved for weight loss in February, 2012. As the first weight-loss drug to be approved in 13 years, it has been regarded as a promising new treatment in the growing obesity epidemic, with subjects losing 10% of their body weight on average. As use of this medication becomes commonplace, it is imperative to recognize potential side effects, particularly for patients with underlying cerebrovascular risk factors. Phentermine was also a component of the diet drug Fen Phen, which was discovered to cause cardiac valvular fibrosis.

Design/Methods DESIGN/METHODS: We present two women with acute stroke, who were taking diet pills containing phentermine. We reviewed clinical charts and radiographic imaging, including MRI and fluroscein angiography.

Results RESULTS: Case 1 is a 31 year old female with hypertension who presented after acute onset of severe headache, nausea, vomiting and right upper extremity weakness shortly after taking phentermine. Imaging revealed a convexity subarachnoid hemorrhage in the bilateral frontoparietqal cortical sulci. Case 2 is a 41 year old woman with asthma and hyperlipidemia on phentermine who experienced acute onset of painless monocular vision loss and was found on fluroscein angiography to have a central retinal artery occlusion. No other etiology for stroke was found in either women except for their pre-existing, relatively well-controlled cerebrovascular risk factors and their intake of phentermine-containing diet pills.

Conclusions CONCLUSIONS: We present here two patients with mild underlying cerebrovascular risk factors who presented with acute stroke after taking diet pills containing phentermine. The public should be aware of the possible association between stroke and phentermine. More long-term outcomes research is necessary to understand the safety of phentermine-containing diet pills. Patients with cerebrovascular risk factors should be cautious about using Phentermine containing diet pills.

Authors/Disclosures
Laurel J. Cherian, MD, FAAN (Rush University Medical Center) PRESENTER	The institution of Dr. Cherian has received research support from NIH.
Shawna M. Cutting, MD, FAAN	The institution of Dr. Cutting has received research support from Genentech.
James Conners, MD (Rush University Medical Center)	The institution of Dr. Conners has received research support from nih.
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center)	Dr. Lee has nothing to disclose.
Sarah Song, MD, MPH, FAAN (Rush University Medical Center)	Dr. Song has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.

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