Dimethylamylamine (4-methylhexan-2-amine, DMAA) is a stimulant
commonly found in athletic training or pre-workout supplements. A number of
commercially available products containing DMAA have been marketed as exercise
boosters, promoting weight loss, or acting as an appetite inhibitor. DMAA is an
aliphatic amine, with structural and pharmacological similarities to other
sympathomimetic amines like tuaminoheptane (1-methylhexylamine). DMAA and
tuaminoheptane are structural isomers, central nervous system stimulants, and
are both included on professional and amateur sports prohibition lists such as
the World AntiDoping Agency (WADA).[1–7] DMAA
was originally developed in the 1940s by Eli Lilly, who commercially advertised
it as the nasal decongestant Forthane.[2,4,8–10] Although
Forthane was later removed from the market, DMAA eventually resurfaced as a dietary
supplement in the 2000s, not long after the US ban of ephedrine.[9,11–13] For
DMAA to qualify as a natural supplement, a single study was used to claim that
it originated from geranium extracts, but this study is now widely debunked and
no substantive evidence exists that DMAA occurs in nature.[3,14] In fact, in a study by Zhang et al.,
the presence of DMAA was not established in multiple geranium products, and the
stereoisomeric compositions of DMAA in synthetic standards and commercial
supplements were indistinguishable, confirming
that DMAA cannot be considered a dietary supplement as defined by the Dietary Supplement Health and
Education Act.[14] DMAA does not currently have any
recognized medical use and the substance is banned or restricted in a number of
countries. Since its introduction as a nutritional supplement, DMAA use has
been controversial. DMAA was detected in multiple routine athletic drug testing
programmes in which it is prohibited, resulting in the athletes being banned
from competition,[3,8,9,14] More
importantly, DMAA has been implicated as contributing to severe adverse effects
and/or death on numerous occasions.[2,15–17] Because
the nature of DMAA as a natural supplement is in question, in 2012 the US Food
and Drug Administration (FDA) sent letters to supplement companies requesting detailed
safety information.[18] Subsequently,
supplement manufacturers have begun to change their formulations, advertising, and
product labels. However, products containing DMAA are still commonly available
in stores and over the Internet, and more recently, DMAA has been found as a
component of abused drug formulations, in particular ‘legal
high’ designer drug mixtures in the USA.[2,19] Because DMAA was identified
as present in multiple non-traumatic deaths in the US military,[15] in early 2012 products containing DMAA were removed from
military bases and their use was prohibited pending further testing on their
health effects. In early 2013, the FDA issued a warning, listing the substance
as dangerous and it is now illegal for military personnel to consume any
product that contains DMAA.[20–22] Regardless, due to the association of DMAA with military fatalities,
sports doping, and abused drug mixtures, testing by such agencies may need to
specifically include it in routine screenings. A
common sequence in routine screenings is to perform a rapid, preliminary assay,
such as an immunoassay, followed by confirmatory
mass spectrometry methods. For example, it is documented that branches of the
US military employ three tests to report a positive result in urine screening,
including two .....
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