The use of complementary and alternative medicines has recently increased, thereby enhancing the market for herbal products worldwide (Budeker and Kronenberg, 2002; Zollman and Vickers, 1999). However, the purity of these herbal formulations exposes the human population to multiple risks and creates major concerns for various health agencies on both national and international levels (Fang, 2002). Adulteration of herbal formulations with undeclared synthetic drugs or by mixing the analogues of prescription drugs that are created by replacing or adding functional groups to the original chemical are the recent major problems since they may cause adverse side effects (Yeun et al., 2007). As a result, analogue generation is a common strategy used in creating investigational drugs for most pharmaceutical companies. For example, 3,4-methylenedioxymethamphetamine and methamphetamine are used by various drug companies as analogues of amphetamine (Wee et al., 2005).
As a result, the World Health Organization (WHO) and the European Union (EU) issued several guidelines concerning safe and appropriate use of herbal medicines (WHO regional publications, 1998; WHO regional publications, 2004). Some traditional Chinese medicine (TCM) slimming aids have been found to contain sibutramine (see structure A), a medicine that should be used only under medical supervision as it may raise blood pressure [Nisoli et al., 2001; Binkley and Knowles, 2002; Cordeiro and Vallada, 2002; Taflinski and Chojnacka, 2001; Vidal and Quandte, 2006; Jung et al., 2006). Others contain an amphetamine-like stimulant called methylphenidate that may lead to high blood pressure and adversely affect the efficacy of antidepressant and antipsychotic drugs (Volkow et al., 2002; Konrad et al., 2004; Faraone et al., 2004). Traditional Chinese herbal medicine is generally both safe and effective, and there are many patients who have experienced dramatic benefits to their health from treatment. Despite the fact that most TCMs are assessed in terms of their risk benefit ratio, it should not be surprising that Chinese herbal medicines may also cause significant adverse effects. For example, consumers were warned to avoid the potentially dangerous and llegal TCM product, Shubao Slimming Capsules, which was responsible for a case of irreversible liver failure in the UK. (Herbal Safety News, 2004). The Medicines and Healthcare Products and Regulatory Agencies have suggested that caution should be exercised when using a TCM slimming aid. The agencies said that the safety, quality, and efficacy of these unlicensed medicines could not be assured due to the possible illegal adulteration or contamination with pharmaceutical drugs or toxic herbal ingredients.