10.3892/ol.2013.1581 267 SunithaK.HemshekharM.ThusharaR
Research published in the Journal of Pharmaceutical Sciences demonstrated that mechanical agitation and high shear forces reduce bioactive peptide concentration by up to 30% even when other storage conditions are optimal
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It isn't overly common, but the risk is greatly increased if you are taking more than one drug that has serotonergic effects The symptoms of serotonin syndrome include: Hyperthermia (increased body temperature) Hypertension (increased blood pressure) Muscle spasms Muscle rigidity Mental status changes (e.g., agitation, delirium, hallucinations, coma) The prescribing information for both phentermine and Adderall warn about serotonin syndrome and recommend not to combine them with other serotonergic agents