Vasospasm and Stroke Attributable to Ephedra-Free Xenadrine: Case Report

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.