Anorectic

Anorectics, anorexigenics or appetite suppressants are drugs that reduce the desire to eat ("anorectic", from the Greek an- = "not" and oreg- = "extend, reach").

("Anorectic" is also a term for an anorexic person, a person suffering from Anorexia nervosa.) Compare to "anorexic" alone which simply means, "without appetite". By contrast, anorexia nervosa is a mental disorder regarding the loss of appetite.

History and initial uses

Used on a short term basis clinically to treat obesity, some appetite suppressants are also available over the counter. Drugs of this class are frequently stimulants of the phenethylamine family, related to amphetamine (speed).

The German military experimented with issuing amphetamines to soldiers in 1945, when food supplies were very short in Germany. Following the Second World War, amphetamines were re-directed for use on the civilian market. Indeed, amphetamine itself was sold commercially as an appetite suppressant until it was outlawed in most parts of the world in the late 1950s due to increasing exploitation of its stimulant properties ("abuse"). Many amphetamines produce side effects including addiction, tachycardia and hypertension, making prolonged unsupervised use dangerous.

Public health concerns

Epidemics of fatal pulmonary hypertension and heart valve damage associated with anorectic agents have led to the withdrawal of products from the market. This was the case with aminorex in the 1960s, and again in the 1990s with fenfluramine (see: Fen-phen). Likewise, association of the related appetite suppressant phenylpropanolamine with hemorrhagic stroke led the Food and Drug Administration (FDA) to request its withdrawal from the market in the United States in 2000, and similar concerns regarding ephedrine resulted in an FDA ban on its inclusion in dietary supplements, in 2004.

Currently marketed appetite suppressants

In spite of these precedents, numerous compounds are marketed today as appetite suppressants. These include:

• Phentermine (Fastin®, Adipex®, Ionamin® and others)
• Diethylpropion (Tenuate®)
• Phendimetrazine (Prelu-2®, Bontril®)
• Benzphetamine (Didrex®)
• Sibutramine (Meridia®, Reductil®) is a recent addition, which is used with orlistat by doctors to control obesity
• Rimonabant (Acomplia®), a cannabinoid receptor antagonist available in Europe since 2006
• Oxyntomodulin
• Fluoxetine hydrochloride (Prozac)

and others.

See also

• Appetite
• Amphetamine
• Addiction
• Obesity
• Stimulant
• Phenethylamine
• Aminorex
• Fen-phen
• Ephedrine
• Food and Drug Administration

References

• Abenhaim L, Moride Y, Brenot F, Rich S, Benichou J, Kurz X, Higenbottam T, Oakley C, Wouters E, Aubier M, Simonneau G, Begaud B. Appetite-Suppressant Drugs and the Risk of Primary Pulmonary Hypertension. N Engl J Med 1996;335:609. Fulltext. PMID 8692238.
• Fishman AP. Aminorex to Fen/Phen: An Epidemic Foretold. Circulation 1999;99:156. Fulltext. PMID 9884392.

External links

• Questions and Answers about appetite suppressant medication treatment from the Medical College of Wisconsin
• Appetite Suppressants - History, products, pros and cons, dangers.