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Walter Reed Army Medical Center, Silver Spring, MD 20910, USA.
Following the 2004 ban of ephedra, which was linked to several cases of stroke and myocardial infarction, manufacturers have marketed "ephedra-free" weight loss products that include the active ingredient synephrine. Despite the lack of data on safety and efficacy, synephrine is touted by its promoters as a "safe" alternative to ephedra and is often combined with caffeine, as in the supplement Xenadrine-EFX. We report a case of left middle cerebral artery vasopasm and stroke in a young healthy patient in the setting of Xenadrine-EFX use.
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