The US Drug Enforcement Agency maintains a tight leash on drugs of abuse and has already banned newer designer drugs like Spice and Bath Salts. However, there is increase in the use of a new drug called pump it (PI). There is some evidence that it contains Geranamine Methylhexamine (DMAA). This is a report of a patient who exhibited unusual behavior after using PI.

A 40-yo male was brought to the Emergency Room after he stabbed himself in the abdomen using a knife sustaining laceration to the liver. Psychiatry consult was requested for attempted suicide. The patient had total amnesia surrounding the event. Collateral information from the wife revealed that his pupils were widely dilated and he appeared agitated, paranoid and diaphoretic just before stabbing himself. Six weeks prior, he began snorting to self detoxify himself from opioids. He experienced a 40 lb. weight loss, severe insomnia and impulsive behavior translating into dangerous acts like medication overdose and walking into oncoming traffic. He had no such symptoms prior to using PI.

Geranamine is a stimulant is presumed to act by releasing norepinephrine. It is used as a dietary supplement for weight loss and energy gain. It has been reported to produce paranoia, hallucinations, mood lability and seizures.

Substance induced mood disorder should be considered as a differential diagnosis of suicide attempt and clinicians should be aware about the fact that some “dietary supplements” may pose severe danger to patients.