Nonprescription medications increase

Many attempts have been made to determine whether medications were influential as a risk factor. Although use of a prescription or nonprescription medication did not differ substantially between case patients and controls, it appeared that the use of an antidepressant or psychotropic medication (any antipsychotic, antidepressant, benzodiazepines, and/or other anxiolytic) could increase the risk of developing EMS.22-67 It is of interest that a number of medications, such as corticosteroids, oral contraceptives, and estrogen, which can alter tryptophan metabolism, have not been determined to have an effect on the development of EMS. Actually, some clinicians have postulated that EMS itself may be caused by or related to abnormal tryptophan metabolism.42 68... 

Avoid alcohol and nonprescription drug s unless their use has been approved by the primary health care provider. Hypertensive patients should be careful to avoid medications that increase blood pressure, such as over-the-counter drag s for appetite suppression and cold symptoms. 

Phenylpropanolamine (PPA). Until recently, PPA was widely available in a number of nonprescription cold medications and diet control products. Adverse effects are similar to those described for ephedrine. In response to an FDA warning of increased risk of hemorrhagic stroke, especially in women, PPA has been withdrawn from the market by most manufacturers. Before this withdrawal, PPA was another popular starting product for synthesis of S(-f-)-methamphetamine. PPA is also a metabolite of ephedrine and pseudoephedrine. 

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