Anorectic

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An anorectic or anorexic (from the Greek an- = "without" and orexis = "appetite"), also known as anorexigenic, anorexiant, or appetite suppressant, is a dietary supplement and/or drug which reduces appetite and food consumption, and, as a result, causes weight loss to occur.[1]

List of anorectics[edit]

Numerous pharmaceutical compounds are marketed as appetite suppressants.

The following drugs listed as "centrally-acting antiobesity preparations" in the Anatomical Therapeutic Chemical Classification System:[2]

  • Phentermine (Adipex, Duromine, Fastin, Ionamin, Metermine, etc.)
  • Diethylpropion (Tenuate)
  • Rimonabant† (Acomplia; cannabinoid antagonist selective for CB1. Withdrawn amidst concerns about psychiatric consequences of drug treatment)
  • Sibutramine† (Meridia, Reductil; withdrawn from the market due to concerns regarding its cardiovascular effects. )
  • Oxymetazoline (Over the Counter Afrin nasal decongestant)

The following are listed as appetite depressants by MeSH.[3]

Other compounds with known appetite suppressant activity include:

Where † indicates drugs that have been since withdrawn from the market due to adverse effects.

Public health concerns[edit]

Epidemics of fatal pulmonary hypertension and heart valve damage associated with pharmaceutical 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).[4] 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 (a Federal judge later overturned this ban in 2005 during a challenge by supplement maker Nutraceuticals). It is also debatable as to whether the ephedrine ban had more to do with its use as a precursor in methamphetamine manufacture rather than legitimate health concerns.

History and initial uses[edit]

Used on a short-term basis clinically to treat obesity, some appetite suppressants are also available over-the-counter. Most common natural appetite suppressants are based on hoodia, a genus of 13 species in the flowering plant family Apocynaceae, under the subfamily Asclepiadoideae. Several appetite suppressants are based on a mix of natural ingredients, mostly using green tea as its basis, in combination with other plant extracts such as fucoxanthin, found naturally in seaweed. Drugs of this class are frequently stimulants of the phenethylamine family, related to amphetamine (informally known as speed).

The German and Finnish[5] militaries issued amphetamines to soldiers commonly to enhance warfare during the Second World War.[6] Following the war, amphetamines were redirected 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 safety issues. Many amphetamines produce side effects, including addiction, tachycardia and hypertension,[7] making prolonged unsupervised use dangerous.

References[edit]

  1. ^ Lemke, Thomas L.; Williams, David A. (2012). "Anorexiants as Pharmacologic Agents in the Management of Obesity". Foye's Medicinal Chemistry. 
  2. ^ ATC/DDD Index
  3. ^ MeSH list of agents 82001067
  4. ^ Fishman AP. Aminorex to Fen/Phen: An Epidemic Foretold. Circulation 1999;99:156. Fulltext. PMID 9884392
  5. ^ "Pervitiini". Retrieved 2011-01-05. 
  6. ^ Andreas Ulrich, Andreas. "The Nazi Death Machine: Hitler's Drugged Soldiers - SPIEGEL ONLINE - News - International". Spiegel Online. Retrieved 2011-01-05. 
  7. ^ 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. doi:10.1056/NEJM199608293350901 PMID 8692238

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