Intracranial hemorrhage and cerebral angiopathic changes in a suicidal phenylpropanolamine poisoning

A 27-year-old man had an intracerebral hemorrhage and angiographic evidence of cerebral vasculitis after suicidal ingestion of 13 nasal decongestant tablets containing phenylpropanolamine (PPA). Toxicology screen and gas chromatography demonstrated PPA in the urine. Phenylpropanolamine is found in many over-the-counter preparations, but physicians should be aware of PPA's side effects and should be cautious about prescribing this potentially hazardous drug to suicidal patients.