Abstract
Dietary/Nutritional supplements have become popular in use by a spectrum of different consumers, including the elderly, those aged 65 and over, as a ‘new’ market. In the USA, their numbers have been increasing from 35 million in 2000, to a projected 69 million by 2030. Dopamine, serotonin, epinephrine neurotransmitter homeostasis is important in the ‘healthy’ physiological continuum of all ages. Imbalance in these neurotransmitters, over time, manifests in various ‘disease’ states, such as Obsessive Compulsive Disorder, Parkinson’s Disease, and Schizophrenia. In context, dietary/nutritional supplements may contain contaminants/adulterants that could distort the ‘normal’ equilibrium of neurotransmitters. Therefore, for this investigation fluoxetine a Schedule 5 (South Africa) selective serotonin reuptake inhibitor (SSRI) drug was investigated. The extent of fluoxetine as contaminant/adulterant in dietary/nutritional supplements is not widely known. Further, fluoxetine prescriber caution for treatment (elderly), are adverse effects, particular CNS effects, such as nervousness, agitation, anxiety or excessive sedation, and insomnia. The aim of this study was to determine whether commercially available dietary/nutritional and traditional supplement products contained fluoxetine, even though the manufacturer may not declare this on the product label. A total of 138 dietary/nutritional supplements products formed part of the assessment. The products were laboratory analysed for fluoxetine, as part of an extensive multi-compound ‘screen’, using Tandem Liquid Chromatography Mass Spectrometry. The concentration of fluoxetine was then estimated via calibration curve standards that formed part of the extraction and analysis. The number of ‘positives’ for the tested products for fluoxetine in the overall sample was 54%, for South African produced products 67%, and, for imported products, bought in South Africa 56%. The median concentration estimate for fluoxetine in the products were, 3.9 µg/g for the overall sample, 5.2 µg/g for South African produced products, and 20.1 µg/g for imported products, bought in South Africa.