Phentermine Fluoxetine

Fenfluramine HCI (+) Fenfluramine HCI (-) Fenfluramine HCI Methysergide Maleate Ergotamine Tartrate Phentermine Fluoxetine... 

Following the withdrawal of the fenfluramines, alternative combinations have been explored as appetite suppressants. In an open study of a combination of phentermine + fluoxetine in 16 obese patients with... 

The study of ecstasy with citalopram was primarily undertaken to find out how eestasy works, but on the basis of these results and animal studies it seems likely that patients already taking citalopram may not be able to get as high on usual doses of ecstasy, and some adverse effects may also be redueed. Furthermore, if the proposed mechanism of interaction is correct, the same is also likely to be true if they are taking any other SSRI and some cases have been reported. However, be aware of possible pharmaeokinetie interaetions with some SSRIs that are potent CYP2D6 inhibitors (e.g. fluoxetine, paroxetine), which may increase ecstasy levels. There is also a risk of increased serotonergic activity and there have been a few reports of interaetions involving other sympathomimetics and SSRIs or related drugs, see Phentermine + Fluoxetine , p.205. 

Additional ADRs linked to diet pills include psychosis myocardial ischemia drug interactions, such as the interaction of fenfluramine with imipramine, fenfluramine with amitriptyline or desipramine, or the toxic reaction between fluoxetine and phentermine and the release of serotonin while inhibiting its reuptake, contributing to hyperserotonin reactions. When the next craze takes hold of patients and their physicians, hopefully physicians and pharmacists will take a more vocal position and recommend restraint, xmtil some proof of efficacy and lack of toxicity is shown for new faddish off-label combinations. 

Bostwick, J.M. and Brown, T.M., A toxic reaction from combining fluoxetine and phentermine, /. Clin. PsychopharmacoL, 16,189-190,1996. 

Since the withdrawal of fenfluramine and dexfenfluramine, some clinicians have begun coadministering fluoxetine and phentermine. Perhaps this combination will produce the clinical benefit of the Fen-Phen combination without the dangerous complications. Because the efficacy and long-term risk of this combination are unknown, augmentation of fluoxetine with phentermine cannot be recommended for routine practice. 

Spontaneous rupture of a retroperitoneal aneurysm occurred in a 70-year-old woman who had been taking phentermine hydrochloride, 30 mg/day, for about 1 month (6). Other long-term medications included fluoxetine and amitriptyline, and she had no history of coronary artery disease, hypertension, diabetes, or complications of pregnancy. Although it is plausible that phentermine could have contributed to the ruptured aneurysm, other possibilities should be considered, particularly rupture of an anomalous retroperitoneal blood vessel. 

Devlin MJ, Goldfein JA, Carino JS, Wolk SL. Open treatment of overweight binge eaters with phentermine and fluoxetine as an adjunct to cognitive-behavioral therapy. Int J Eat Disord 2000 28(3) 325-32. 

Clinically important, potentially hazardous interactions with amitriptyline, amoxapine, amphetamines, bupropion, citalopram, clomipramine, cyproheptadine, desipramine, dextroamphetamine, dextromethorphan, diethylpropion, dopamine, doxepin, entacapone, ephedra, ephedrine, epinephrine, fluoxetine, fluvoxamine, ginseng, imipramine, levodopa, mazindol, meperidine, methamphetamine, nefazodone, nortriptyline, paroxetine, phendimetrazine, phentermine, phenylephrine, pizotifen, propoxyphene, protriptyline, pseudoephedrine, rizatriptan, sertraline, sibutramine, sumatriptan, sympathomimetics, tramadol, tricyclic antidepressants, trimipramine, tryptophan, venlafaxine, zolmitriptan... 

Kaddoumi, A. Kubota, A. Nakashima, M.N. Takahashi, M. Nakashima, K. High performance liquid chromatography with UV detection for the simultaneous determination of sympathomimetic amines using 4-(4,5-diphenyl-lH-imidazole-2-yl)benzoyl chloride as a label, Biomed.Chromatogr., 2001, 15, 379-388. [human rat plasma derivatization LOD 50-100 nM ephedrine norephedrine 2-phenylethylamine fenfluramine phentermine cyclohexylamine fluoxetine is internal standard pharmacokinetics]... 

Kaddoumi, A. Nakashima, M.N. Maki, T. Matsumura, Y. Nakamura, J. Nakashima, K. Liquid chromatography studies on the pharmacokinetics of phentermine and fenfluramine in brain and blood microdialysates after intraperitoneal administration to rats, J.Chromatogr.B, 2003, 791, 291-303. [fluorescence detection derivatization LOQ 5 nM fluoxetine is internal standard]... 

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