Anorectics drugs

Carli M, Samanin R. (1992). Serotonin2 receptor agonists and serotonergic anorectic drugs affect rats performance differently in a five-choice serial reaction time task. Psychopharmacology (Berlin). 106(2) 228-34. 

When people stop taking anorectic drugs, they may experience withdrawal symptoms. These may include depression, apathy, confusion, and irritability. 

The CSA classifies the methamphetamine Des-oxyn as a stimulant. Anorectic drugs, the diet pills developed to replace amphetamines, are regarded by the government as controlled substances. While these drugs are not as powerful as amphetamines, their effects are similar. 

Thurlby and Samanin (1981) studied the effect of anorectic drugs on food-rewarded runway behaviour. 

Dexamfetamine is extremely variable in its effects, and can even produce drowsiness in a small proportion of subjects. Postmenopausal women are more prone to drowsiness, anger, and sadness than euphoria (1). Adverse effects due to sympathetic overactivity are fairly common but not usually serious. However, in view of dexamfetamine s addiction potential, other anorectic drugs should be considered first. 

Introduction of modified-release formulations has provided some improvement in the use of anorectic drugs. Steady release of the drug permits a constant concentration in the blood throughout the entire day. Thus, a sudden excess of physiological hunger is prevented, and adverse effects involving the central nervous system are diminished. 

Willis JHP. The natural history of anorectic drug abuse. In Garattini S, Samanin R, editors. Central Mechanisms of Anorectic Drugs. New York Raven Press, 1978 367. 

Mlczoch J, Probst P, Szeless S, Kaindl F. Primary pulmonary hypertension Follow-up of patients with and without anorectic drug intake. Cor Vasa 1980 22(4) 251-7. 

Anorectic drugs, which are structurally related to the amphetamines, act mainly on the satiety centre in the hypothalamus and also increase general physical activity (1). All of them, except fenfluramine, stimulate the central nervous system and can cause restlessness, nervousness, irritabihty, and insomnia. Adverse effects also occur through sympathetic stimulation and gastrointestinal irritation. Drug interactions can occur with monoamine oxidase inhibitors. Dexamfetamine, phenmetrazine, and benzfetamine can cause dependence. Some of them have been associated with cardiac valvulopathy and primary pulmonary hypertension (2). 

Anorectic drugs act mainly on the satiety centre in the hypothalamus (1). They also have metabohc effects involving fat and carbohydrate metaboUsm. Most of them are structurally related to amfetamine and increase physical activity. Their therapeutic effect tends to abate after some months, and part of this reduction in effect may be due to chemical alterations in the brain. Fenfluramine commonly produces drowsiness in normal doses, but has stimulaut effects in overdosage. Dexamfetamine, phenmetrazine, and benzfetamine all tend to cause euphoria, with a risk of addiction. Euphoria occasionally occurs with amfepramone (diethylpropion), phentermine, and chlorphentermine, but to a much lesser extent. Some adverse effects are due to sympathetic stimulation and gastrointestinal irritation these may necessitate withdrawal but are never serious. There are interactions with monoamine oxidase inhibitors and antihypertensive drugs. 

Craddock D. Anorectic drugs use in general practice. Drugs 1976 ll(5) 378-93. 

Pathological changes in the lungs were produced with chlorphentermine in laboratory animals (SED-9, 14). Pulmonary complications might therefore occur in humans, which puts in doubt the wisdom of continuing to recommend chlorphentermine as an anorectic drug until more definitive information is available. 

Restrictive cardiomyopathy due to endocardial fibrosis occurred in a 35-year-old woman 5 months after she had started to take fenfluramine 10 mg tds and phentermine 15 mg/day (7). The endocardial findings strongly resembled the valvular lesions associated with the use of fenfluramine-phentermine. Endocardial and valvular fibrosis associated with anorectic drugs is strikingly similar to the plaque material found in patients with carcinoid syndrome and those exposed to methysergide, and all possibly arise from a common mechanism. 

Anonymous. Statement of the American College of Cardiology on recommendations for patients who have used anorectic drugs. Bethesda MD American College of Cardiology, October 18,1997. 

Burger AJ, Charlamb MJ, Singh S, Notarianni M, Blackburn GL, Sherman HB. Low risk of significant echocardiographic valvulopathy in patients treated with anorectic drugs. Int J Cardiol 2001 79(2-3) 159-65. 

Fenproporex, one of the lesser known anorectic drugs, is structurally related to amfetamine, to which it is rapidly metabolized after oral ingestion. Stimulatory effects, somnolence, and electroencephalographic abnormalities are reported to be the major undesired reactions (1). 

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