title: Reversible cerebral vasoconstriction syndrome in a patient taking citalopram and Hydroxycut: a case report.
abstract: BACKGROUND
  Reversible cerebral vasoconstriction syndrome presents with thunderclap headaches accompanied by mild neurologic deficits and is characterized by multifocal narrowing of the cerebral arteries that resolves over days to weeks. This syndrome may be idiopathic or occur in special contexts, most often involving adrenergic or serotonergic overactivity. To the best of our knowledge, reversible cerebral vasoconstriction syndrome has not previously been reported in association with Hydroxycut use in the literature.
  
  
  METHODS
  We report the case of a 65-year-old Caucasian woman on longstanding citalopram who developed reversible cerebral vasoconstriction syndrome two weeks after beginning to take the weight-loss supplement Hydroxycut.
  
  
  CONCLUSIONS
  There are sparse data about the safety of herbal supplements such as Hydroxycut, even though the Food and Drug Administration has banned some herbal ingredients, such as ephedra, that were in this preparation in the past. This case highlights the importance of considering herbal supplements and potential drug interactions in the genesis of otherwise unexplained reversible cerebral vasoconstriction syndrome.
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Gregory_cvetanovich@hms.harvard.edu.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Cvetanovich
authors.forename: Pankajavalli
authors.initials: P
authors.lastname: Ramakrishnan
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Klein
authors.forename: Vikram R
authors.initials: VR
authors.lastname: Rao
authors.forename: Allan H
authors.initials: AH
authors.lastname: Ropper
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