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A higher number of cardiovascular events has been observed in people taking sibutramine versus control (11.4% vs. 10.0%). [16] In 2010, the FDA noted the concerns that sibutramine increases the risk of heart attacks and strokes in patients with a history of cardiovascular disease.
Phentermine is an norepinephrine and dopamine releasing agent (NDRA) and produces stimulant, rewarding, and appetite suppressant effects. [8] [9] [10] Chemically, it is a substituted amphetamine. [11] Phentermine was approved for medical use in the United States in 1959. [3] It is available as a generic medication. [3]
Orlistat (Xenical), the most commonly used medication to treat obesity and sibutramine (Meridia), a medication that was withdrawn due to cardiovascular side effects. Anti-obesity medication or weight loss medications are pharmacological agents that reduce or control excess body fat.
Sibutramine is the name of an SNRI based appetite suppressant with use in the treatment of obesity. This was explored in the treatment of depression, but was shown not to be effective. Both sibutramine and venlafaxine are phenethylamine-based. At high doses, both venlafaxine and sibutramine will start producing dopaminergic effects.
The mechanisms of sympathomimetic drugs can be direct-acting (direct interaction between drug and receptor), such as α-adrenergic agonists, β-adrenergic agonists, and dopaminergic agonists; or indirect-acting (interaction not between drug and receptor), such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors that increase the levels of endogenous catecholamines.
Approximately 5 million people in the United States were given fenfluramine or dexfenfluramine with or without phentermine between 1996 and 1998. [ 8 ] In the early 1990s, French researchers reported an association of fenfluramine with primary pulmonary hypertension and dyspnea in a small sample of patients. [ 8 ]
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