Appetite suppressants drug interactions

Dexamphetamine is one of the most powerful and best known psychomotor stimulants, and other similar agents include dexfenfluramine. diethylpropion and fenfluramine. All these are on the controlled drugs list, and have a limited medical use as appetite suppressants. Such drugs work by interacting with the release of monoamines within the central (and peripheral) nervous system, and can be regarded as indirect SYMPATHOMIMEtics. Recently, there has been some use of the weak amphetamine-like stimulant methylphenidate to treat attention-deficient hyperactivity disorder (ADHD) in children. 

The biological activities of the different appetite suppressants are summarized in Table 15.9. Because these drugs can increase synaptic levels of multiple neurotransmitters, they often exhibit complex polypharmacology by interacting with entire families of biogenic amine receptors that often have multiple functions. 

On theoretical grounds the manufacturers contraindicate the concurrent use of sibutramine with MAOIs, and they say that it should not be given with serotonei ic drugs because of the risk of the serious serotonin syndrome. The manufacturers say that the use of sibutramine with other centrally acting appetite suppressants is contraindicated and they caution the use of cold and flu remedies. No clinically relevant interactions have been seen between sibutramine and cimetidine, and no interaction occurs with oral contraceptives. 

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