Tremor clenbuterol

The authors reported that these patients had an unusual neuromuscular syndrome (which has not previously been described), characterized by muscle spasms and hyper-reflexia that lasted between 2 and 8 days. They reported that though clenbuterol toxicity has been reported to cause muscle tremors and myalgia, previous patients did not have tetany, muscle spasms, or hyper-reflexia. None of the drug screens detected strychnine, which is a common contaminant of heroin. They concluded that this novel neuromuscular syndrome was probably due to clenbuterol-adulterated heroin, but acknowledged that there could be other possible expla-nations/contaminations that were not detected. 

Drug adulteration Adulteration of heroin with clenbuterol is frequently reported [112 ]. In 13 confirmed cases of exposure to clenbuterol in this way, clenbuterol was identified in the blood and or urine of 12 [113 ]. Symptoms included nausea, chest pain, palpitation, dyspnea, and tremor. The physical findings included significant tachycardia and hypotension, and there was laboratory evidence of hyperglycemia, hypokalemia, and increased lactate concentrations six patients had biochemical evidence of myocardial injury. Ten were given beta-adrenoceptor antagonists without adverse effects. 

A novel neuromuscular syndrome, characterized by muscle spasm, tremor, hyper-refiexia, and raised serum creatine kinase activity, has been described in five heroin users and attributed to clenbuterol adulteration [115. ... 

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