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Long-term weight control study. VII (weeks 0 to 210). Serum lipid changes.

We analyzed serum total cholesterol, triglycerides, and lipoprotein profile changes occurring in the participants (N = 121) through 210 weeks of the study. On average, baseline lipid levels were within normal limits. The most consistent changes occurred in the high-density lipoprotein cholesterol (HDL-C), serum total cholesterol/HDL-C ratios, and triglyceride levels. HDL-C increased significantly (p less than 0.01), compared with baseline, by 10% at week 34, 15% at week 54, 19% at week 104, and 27% at week 139. At week 210, 20 weeks after treatment had ended, HDL-C was 15% higher than baseline

Generalized lipidosis in newborn rats and Guinea pigs induced during prenatal development by administration of amphiphilic drugs to pregnant animals.

Pregnant rats and guinea pigs were treated throughout the second half of gestation with amphiphilic drugs (chlorphentermine, chlorcyclizine, chloroquine) known to induce generalized lipidosis. The offspring were sacrificed immediately after birth, and several tissues (lung, liver, kidney, spleen, pituitary gland, adrenal gland, spinal cord, hypothalamus) were examined by electron microscopy. Generalized lipidosis was found in the offspring of both species, albeit of lesser degree than in the mothers. The results show that fetal and adult tissues respond to lipidosis-inducing drugs in a qualita…

An assessment of heart-valve abnormalities in obese patients taking dexfenfluramine, sustained-release dexfenfluramine, or placebo. Sustained-Release Dexfenfluramine Study Group.

BACKGROUND: The appetite-suppressant drug fenfluramine, usually given in combination with phentermine, has been reported to be associated with cardiac valvular regurgitation. Concern has been raised that the d-enantiomer of fenfluramine, dexfenfluramine, may also cause this problem. We were able to study the question by modifying an ongoing trial comparing dexfenfluramine with regular dexfenfluramine and placebo. METHODS: We modified our randomized, double-blind, placebo-controlled study of dexfenfluramine to include echocardiographic examinations of 1072 overweight patients within a median o…

Practical Use of Pharmacotherapy for Obesity.

Obesity management requires a multidisciplinary approach, as there are many factors that contribute to the development of obesity, as well as the preservation of excess weight once it has been gained. Diet, exercise, and behavior modification are key components of treatment. In addition to lifestyle changes, weight gain secondary to medications is an important modifiable risk factor. Even after appropriate lifestyle modification, and medication adjustments (where possible) to avoid agents that can contribute to weight gain, many patients are still unable to achieve clinically meaningful weight

Dopamine/serotonin releasers as medications for stimulant addictions.

The use of 'agonist therapy' for cocaine and methamphetamine addiction involves administration of stimulant-like medications (e.g. monoamine releasers) to reduce withdrawal symptoms and prevent relapse. A significant problem with this strategy is that many candidate medications possess abuse liability due to activation of mesolimbic dopamine (DA) neurons in the brain. One way to reduce DA-mediated abuse liability of candidate drugs might be to add in serotonin (5-HT)-releasing properties, since substantial evidence shows that 5-HT neurons provide an inhibitory influence over mesolimbic DA neur

Mental health outcomes in obesity interventions with GLP-1 receptor agonists: is it similar to other obesity interventions? A narrative review with systematic evidence synthesis.

Obesity is a chronic, debilitating condition with complex biological, psychosocial, and behavioral underpinnings. While the cardiometabolic … ased suicidality after five years. Pharmacotherapies, including orlistat, bupropion/naltrexone, and phentermine/topiramate, showed mixed psychiatric impacts. The GLP-1 receptor agonists (Semaglutide, liraglutide, Tirzepatide) have shown an improvement in patient-reported mental wellbeing in several trials. Concerningly, pharmacovigilance data initially sugges …

Incretin-Based Therapies and Post-Bariatric Surgery Alcohol Use Disorder.

IMPORTANCE: Patients who have undergone bariatric surgery have an elevated risk for alcohol use disorder (AUD). Incretin-based therapies (IB … surgery treatment with an IBT (semaglutide, liraglutide, or tirzepatide) vs non-IBT AOMs (orlistat, phentermine, low-dose naltrexone, benzphetamine, phendimetrazine, or diethylpropion). MAIN OUTCOMES AND MEASURES: Outcomes of interest were incidence rates (per 1000 person-years) and hazard ratios (HRs) of new-onset AUD and initiation of MAUDs, estimated usin …

A nationwide pharmacovigilance investigation on trends and seriousness of adverse events induced by anti-obesity medication.

INTRODUCTION: Despite rising concerns regarding the safety of anti-obesity medications, there is a lack of comprehensive pharmacovigilance i … odds ratio (OR) and their 95% CIs. RESULTS: The most common causative anti-obesity medication was phentermine, followed by liraglutide. ADEs associated with psychiatric disorders (ROR = 1.734; 95% CI = 1.111-2.707), liver and biliary system disorders (ROR = 22.948; 95% CI = 6.613-70.635), cardiovascular disorders (ROR = 5.707; 95% CI = 1.965-16.574), and re …

Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus.

BACKGROUND: Obesity is closely related to type 2 diabetes and long-term weight reduction is an important part of the care delivered to obese … significant decrease in weight was noted in three studies of mazindol, one of phenmetrazine, two of phentermine. No studies were identified that fit inclusion criteria for pseudophedrine, ephedra, sertraline, yohimbine, amphetamine or its derivatives, bupropion, topiramate, benzocaine, threachlorocitric acid, sertraline, and bromocriptine. AUTHORS' CONCLUSIO …

Obesity Management Pharmacotherapies and Lifestyle Treatment for Pediatric Obesity Management: A Systematic Review and Network Meta-Analysis.

IMPORTANCE: Pediatric obesity is a global health challenge. Although health behavior and lifestyle treatment (HBLT) is foundational, the com … esity management pharmacotherapies (glucagon-like peptide-1 receptor agonists, metformin, orlistat, phentermine topiramate), or their combination vs control. DATA EXTRACTION AND SYNTHESIS: Data were extracted and validity assessed according to PRISMA guidelines. A random-effects network meta-analysis was used to pool data. Meta-regression was used to explore …

Glucagon-Like Peptide-1 Receptor Agonists and Age-Related Macular Degeneration.

IMPORTANCE: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for weight loss, but their ocular effects in nondiabe … lutide or OWLDs including lorcaserin, sibutramine, setmelanotide, fenfluramine, mazindol, orlistat, phentermine, and diethylpropion. MAIN OUTCOMES AND MEASURES: The primary outcome was development of nonexudative AMD at 5, 7, and 10 years. The secondary outcome was progression to exudative AMD at 10 years. Risk ratios (RRs) with 95% CIs were calculated. Stan …

Obesity Pillars roundtable: Excessive weight reduction with highly effective anti-obesity medications (heAOMs).

BackgroundHistorically, many anti-obesity medications (AOMs) were withdrawn from development and/or the market due to safety concerns. Another challenge was that, with some exceptions, most of these AOMs had limited weight reducing efficacy. Approved AOMs often did not meet the weight reduction expectations of either clinicians, or their patients. Currently, newer approved and investigational AOMs achieve greater weight reduction than older AOMs. This has prompted an emerging new challenge of "too much weight loss" with some of these highly effective anti-obesity medications (heAOM) - somethin

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… Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. Obesity. 2013;21:2163–2171. doi: 10.1002/oby.20584. 4. Wilding J.P.H., Batterham R.L., Calanna S., Davies M., Van Gaal L.F., Lingvay I., et al. … Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012;95:297–308. doi: 10.3945/ajcn.111.024927. 7. …

Separation of mephentermine from other structural analogues of phenethylamine and amphetamine in biological matrices using Liquid Chromatography-Tandem Mass Spectrometry.

Stimulants exert euphorigenic and relaxing effects which warrant intervention of regulatory authorities in non-medical usage of these doping agents. Thus, a semi-quantitative method utilizing Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) was developed to monitor potential misuse of 10 structural analogues of amphetamine and phenylethylamine derivatives. The extraction protocol for urine was dilute and shoot (DS) with 1 mL aliquot size, while that for plasma/serum was solid-phase extraction (SPE) with a 100 µL aliquot size. Chromatographic separation was ac