Possible association of ischemic stroke with phentermine.

BACKGROUND AND PURPOSE Some commonly used anorexiants, including methamphetamine and phenylpropanolamine, have been associated with stroke. Because phentermine is an anorexiant with a chemical structure similar to that of amphetamines, similar side effects might be expected. CASE DESCRIPTIONS Two patients using phentermine (one was also using phendimetrazine) developed ischemic cerebrovascular disease. One suffered a cerebral infarct with angiographic evidence of vasculopathy involving multiple vascular beds. The other patient developed headache and a hemisensory disturbance of 7 days' duration. CONCLUSIONS Phentermine, and possibly phendimetrazine, should be considered an anorexiant and sympathomimetic drug that can be associated with ischemic cerebrovascular disease.