Weight Loss Drugs Prescription and OTC »
Taking a weight loss drug may not result in weight loss by itself. But using diet pills can help an overweight person stay on a diet because nearly all of these medications work on suppressing appetite. "Feeling full" is believed to be related to a number of biochemical processes in the body. Signals to indicate fullness come from fat cells and the gastrointestinal tract; these converge with signals in the central nervous system. Appetite suppressants target a couple of key neurotransmitters in this process: serotonin and norepinephrine. Increased levels of serotonin result in a feeling of fullness. Increasing norepinephrine levels stimulate the central nervous system, decreasing appetite. Only one drug among the weight loss medications works in a different way. Orlistat (Xenical, Alli) works in the gastrointestinal tract to prevent absorption of about a third of ingested fat.
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Cardiovascular: Palpitation, tachycardia, elevated blood pressure, ischemic events.
Valvular heart disease associated with the use of some anorectic agents such as fenfluramine and dexfenfluramine, both independently and especially when used in combination with other anorectic drugs, have been reported. However, no case of this valvulopathy has been reported when phendimetrazine tartrate has been used alone.
Central Nervous System: Overstimulation, restlessness, insomnia, agitation, flushing, tremor, sweating, dizziness, headache, psychotic state, blurring of vision.
Gastrointestinal: Dryness of the mouth, nausea, diarrhea, constipation, stomach pain.
Genitourinary: Urinary frequency, dysuria, changes in libido.
Controlled Substance: Bontril® PDM (phendimetrazine tartrate) is a Schedule lll controlled substance.
Dependence: Phendimetrazine tartrate is related chemically and pharmacologically to the amphetamines. Amphetamines and related stimulant drugs have been extensively abused, and the possibility of abuse of phendimetrazine should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. There are reports of patients who have increased the dosage to many times that recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. The most severe manifestation of chronic intoxications is psychosis, often clinically indistinguishable from schizophrenia.
Efficacy of phendimetrazine tartrate with other anorectic agents has not been studied and the combined use may have the potential for serious cardiac problems.
Last reviewed on RxList: 3/25/2009
This monograph has been modified to include the generic and brand name in many instances.
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