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- False-Positive DaTscan Features With Methylphenidate and Phentermine Therapy. [Journal Article]
- MCMayo Clin Proc 2018; 93(11):1690-1691
- Pharmacotherapy of obesity: available medications and drugs under investigation. [Review]
- MMetabolism 2018 Oct 31
- Obesity is a chronic disease with a continuously rising prevalence that currently affects more than half a billion people worldwide. Energy balance and appetite are highly regulated via central and p...
Obesity is a chronic disease with a continuously rising prevalence that currently affects more than half a billion people worldwide. Energy balance and appetite are highly regulated via central and peripheral mechanisms, and weight loss triggers a homeostatic response leading to weight regain. Lifestyle and behavioral modifications are the cornerstones of obesity management; however, they often fail to achieve or sustain long-term weight loss. Pharmacotherapy added onto lifestyle modifications results in an additional, albeit limited, weight reduction. Regardless, this weight reduction of 5-10% conveys multiple cardiovascular and metabolic benefits. In this review, evidence on the food and drug administration (FDA)-approved medications, i.e., orlistat, lorcaserin, phentermine/topiramate, liraglutide and naltrexone/bupropion, is summarized. Furthermore, anti-obesity agents in the pipeline for potential future therapeutic use are presented.
- Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [BOOK]
- BOOKAgency for Healthcare Research and Quality (US): Rockville (MD)
- CONCLUSIONS: We found that behavior-based weight-loss interventions with or without weight loss medications resulted in more weight loss than usual care conditions. The degree of weight loss we observed with the behavior-based weight loss interventions in the current review is slightly smaller but consistent in magnitude with our 2011 review on this topic. As in the previous review, we noted that weight loss interventions resulted in a decreased risk of developing diabetes, particularly among those with prediabetes, although the prevalence of other intermediate health outcomes was less well reported. Limited evidence exists regarding health outcomes associated with weight loss interventions. Weight loss medications, but not behavior-based interventions, were associated with higher rates of harms compared with control arms. Heterogeneity within each individual intervention arm confounded with differences in the populations, settings, and trial quality, making it difficult to disentangle which variables may be driving larger effects. Long-term weight and health outcomes data, as well as data on important subgroups (e.g. those who are older, nonwhite, or overweight) were lacking and should be a high priority for future study.
- A randomized, double-blind, placebo-controlled, crossover study to evaluate the human abuse liability of solriamfetol, a selective dopamine and norepinephrine reuptake inhibitor. [Journal Article]
- JPJ Psychopharmacol 2018 Oct 01; :269881118796814
- CONCLUSIONS: Solriamfetol appears to have abuse potential similar to or lower than phentermine.
- Effects of Education and Experience on Primary Care Providers' Perspectives of Obesity Treatments during a Pragmatic Trial. [Journal Article]
- OObesity (Silver Spring) 2018; 26(10):1532-1538
- CONCLUSIONS: PCPs initially overvalued exercise and undervalued weight-loss medications. PCPs exposed to education and experience gave higher comfort and effectiveness ratings to weight-loss medications.
- Cardiovascular Safety During and After Use of Phentermine and Topiramate. [Journal Article]
- JCJ Clin Endocrinol Metab 2018 Sep 21
- CONCLUSIONS: Overall, the data indicate no increased risk of MACE for current PHEN/TPM users, but confidence intervals for the PHEN/TPM groups were broad, indicating that the data were compatible with a wide range of possible values.
- Pharmacotherapy of obesity - state of the art. [Journal Article]
- EPEndokrynol Pol 2018; 69(4)
- Obesity, which affects about 13% of the world population, results in significant deterioration of health and serious clinical, mainly meta-bolic and cardiovascular complications. Although the basis o...
Obesity, which affects about 13% of the world population, results in significant deterioration of health and serious clinical, mainly meta-bolic and cardiovascular complications. Although the basis of therapeutic treatment is behavioural treatment, often non-pharmacological effects do not produce the desired effect. Currently there are several drugs with a safe action profile that improve the effect of treatment (5-10% weight reduction). The aim of the paper is to present the potential of modern pharmacotherapy in the treatment of obesity, in terms of mechanism of action, efficacy, and side effects, in order to individualise therapy. The drugs already registered include substances with a variety of mechanisms of action, including phentermine, orlistat, lorcaserin, and liraglutide. Compounded preparations (phenter-mine/topiramate, naltrexone SR/bupropion SR) are also available, which, by using low doses of active substances, have beneficial effects while reducing side effects. In addition, several drugs used to treat diabetes, such as metformin, SGLT2 inhibitors, GLP-1 agonists, and pramlintide, promote weight loss, although their use is reserved for diabetics, especially type 2 patients. Regarding the current alarm-ing epidemiological data there is a need for intensive prevention and treatment of obesity as well as the development of a new form of pharmacotherapy (new substances and treatment regimens) to develop effective, safe, and, above all, long-term effective therapy for the treatment of obesity.
- Phentermine: A Systematic Review for Plastic and Reconstructive Surgeons. [Journal Article]
- APAnn Plast Surg 2018; 81(4):503-507
- CONCLUSIONS: The relationship between phentermine and anesthesia, if any, is unclear. Hypotension on induction of general anesthesia is the most reported complication of perioperative phentermine use. Specifically, phentermine-induced hypotension may be unresponsive to vasopressors that rely on catecholamine release, such as ephedrine. Therefore, the decision to perform surgery, especially elective surgery, in a patient taking phentermine should be made with caution. Because of the half-life of phentermine, we recommend discontinuing phentermine for at least 4 days prior to surgery. This differs from the classic 2-week discontinuation period recommended for "fen-phen." The patient should be made aware of the increased risk of surgery, and a skilled anesthesiologist should monitor intraoperative blood pressure and body temperature for signs of autonomic derailment.
- 5-alpha-dihydrotestosterone elevations associated with phentermine use. [Journal Article]
- TATher Adv Endocrinol Metab 2018; 9(8):255-258
- CONCLUSIONS: A 72-year-old male with metastatic prostate cancer experienced profound increases in DHT upon initiation of phentermine despite continuation of his baseline dutasteride therapy. The etiology of these increases is still unclear.
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- Phentermine associated recurrent intracerebral hemorrhage. [Letter]
- JNJ Neurol Sci 2018 Oct 15; 393:135-137