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Sleep Medicine Jun 2017Mazindol is an imidazo-isoindole derivative, a tricyclic compound and a non-amphetamine central nervous system stimulant that blocks dopamine and norepinephrine... (Review)
Review
Mazindol is an imidazo-isoindole derivative, a tricyclic compound and a non-amphetamine central nervous system stimulant that blocks dopamine and norepinephrine reuptake. Mazindol was withdrawn from the US and European markets in 1999 for reasons unrelated to its efficacy or safety around a time when other anorexic drugs were found to be associated with the development of pulmonary arterial hypertension (PAH). Despite the use of mazindol for decades, reports of PAH due to mazindol intake have been extremely rare. Recent interest on mazindol has emerged for the treatment of narcolepsy and attention-deficit/hyperactivity disorder. Therefore, an updated understanding of the potential benefits and risks of mazindol in these patient populations is warranted.
Topics: Central Nervous System Stimulants; Humans; Hypertension, Pulmonary; Mazindol; Risk Factors
PubMed: 28522087
DOI: 10.1016/j.sleep.2017.02.020 -
Nihon Rinsho. Japanese Journal of... Jan 2011
Review
Topics: Appetite Depressants; Humans; Mazindol; Metabolic Syndrome; Obesity
PubMed: 21766681
DOI: No ID Found -
Obesity Research Nov 1995An anoerxiant, mazindol suppresses food intake by 1) stimulating beta-adrenergic receptors, 2) inhibiting the feeding center and, 3) stimulating the satiety center in... (Review)
Review
An anoerxiant, mazindol suppresses food intake by 1) stimulating beta-adrenergic receptors, 2) inhibiting the feeding center and, 3) stimulating the satiety center in the hypothalamus. In Japan, mazindol is available for clinical use. We examined the effects of mazindol on 1) body weight, appetite, and abnormalities of obesity-related diseases in long-term use 2) maintenance of the reduced body weight after very-low-calorie diet (VLCD) therapy 3) combined use with VLCD therapy and, 4) inhibition of body weight gain in Prader-Willi syndrome. In long-term effects of mazindol, the average reduction of individual body weight was around 6.8 kg. The appetite of 59% of obese subjects was moderately suppressed. Systolic blood pressure, serum GOT, serum triglyceride, serum cholesterol, and glucose tolerance were also improved. With mazindol, 53.3% of obese subjects kept the reduced body weight after VLCD, in contrast, 20.0% of them kept it without mazindol. Combined use of mazindol with VLCD made the VLCD therapy more effective in outpatients. Two of 3 patients with Prader-Willi syndrome inhibited their body weight gain with mazindol. Thus, mazindol produced positive effects in these studies, although the effects were limited.
Topics: Appetite Depressants; Diet, Reducing; Humans; Japan; Mazindol; Obesity
PubMed: 8697057
DOI: 10.1002/j.1550-8528.1995.tb00226.x -
British Medical Journal Mar 1980
Topics: Body Weight; Dehydration; Drug Synergism; Female; Humans; Indoles; Lithium; Mazindol; Middle Aged
PubMed: 7363020
DOI: 10.1136/bmj.280.6215.684-a -
Acta Pharmaceutica (Zagreb, Croatia) Jun 2021The current study investigates the anorectic interaction and safety of the mazindol-metformin combination in rats. Isobologram and interaction index were used to... (Comparative Study)
Comparative Study
The current study investigates the anorectic interaction and safety of the mazindol-metformin combination in rats. Isobologram and interaction index were used to determine anorectic interaction between mazindol and metformin in the sweetened milk model. The safety profile of the mazindol-metformin combination was determined by measuring anxiety, blood pressure, hematic biometry and blood chemistry. An acute dose of mazindol and metformin administered per os, individually or as a mixture, has reduced the milk consumption in rats in a dose-dependent manner. Theoretical effective dose 40 (ED40t) did not differ from the experimental effective dose 40 (ED40e) obtained with the mazindol-metformin mixture in the anorexia experiments, by Student's t-test. In addition, the interaction index confirmed the additive anorectic effect between both drugs. A single oral dose of ED40e mazindol-metformin mixture induced anxiolysis in the elevated plus-maze test. Moreover, oral administration of mazindol-metformin combination for 3 months significantly decreased glycemia, but not blood pressure nor other parameters of hematic biometry and blood chemistry. Results suggest that mazindol-metformin combination exerts an additive anorectic effect, as well as anxiolytic and hypoglycemic properties. Mazindol-metformin combination might be useful in obese patients with anxiety disorders or diabetes risk factors.
Topics: Administration, Oral; Animals; Appetite Depressants; Dose-Response Relationship, Drug; Drug Therapy, Combination; Hypoglycemic Agents; Male; Maze Learning; Mazindol; Metformin; Rats; Rats, Wistar
PubMed: 33151165
DOI: 10.2478/acph-2021-0019 -
Clinics (Sao Paulo, Brazil) May 2017The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global evaluation of Cochrane resulted in 19 studies with a high level of bias and six with unclear risk. Due to the lack of information in primary studies, direct meta-analyses were conducted only for amfepramone and mazindol. Compared to placebo, amfepramone resulted in higher weight loss in the short-term (<180 days; mean difference (MD) -1.281 kg; p<0.05; I2: 0.0%; p=0.379) and long-term (≥180 days; MD -6.518 kg; p<0.05; I2: 0.0%; p=0.719). Only studies with long-term follow up reported efficacy in terms of abdominal circumference and 5-10% weight reduction. These results corroborated the finding that the efficacy of amfepramone is greater than that of placebo. Treatment with mazindol showed greater short-term weight loss than that with placebo (MD -1.721 kg; p<0.05; I2: 0.9%; p=0.388). However, metabolic outcomes were poorly described, preventing a meta-analysis. A mixed treatment comparison corroborated the direct meta-analysis. Considering the high level of risk of bias and the absence of important published outcomes for anti-obesity therapy assessments, this study found that the evaluated drugs showed poor evidence of efficacy in the treatment of overweight and obese patients. Robust safety data were not identified to suggest changes in their regulatory status.
Topics: Appetite Depressants; Diethylpropion; Humans; Mazindol; Obesity; Overweight; Publication Bias; Reproducibility of Results; Risk Factors; Treatment Outcome; Weight Loss
PubMed: 28591345
DOI: 10.6061/clinics/2017(05)10 -
The American Journal of Clinical... Jan 1992The Japanese Mazindol study group investigated the action of an anorexiant, mazindol, and found that it reduced food intake by directly suppressing neurons in the... (Clinical Trial)
Clinical Trial Review
The Japanese Mazindol study group investigated the action of an anorexiant, mazindol, and found that it reduced food intake by directly suppressing neurons in the lateral hypothalamus, inhibited gastric acid secretion, increased motor activity, decreased glucose absorption, and inhibited insulin secretion. It thus appears that the main effect of mazindol is to decrease food intake through suppressing feeding centers in the hypothalamus. A multicenter open study of mazindol in Japan revealed that loss of body weight and relative body weight in 14 wk were 4.6 kg and 9.2%, respectively, with suppression of appetite in the majority of obese patients. A multicenter double-blind study demonstrated that mazindol was superior to the placebo in the treatment of simple obesity. We also suggest that mazindol is effective in the maintenance of reduced body weight after obesity therapy and in the treatment of obesity-related diseases such as diabetes, hypertension, or hyperlipidemia.
Topics: Animals; Eating; Female; Humans; Hypothalamus; Japan; Mazindol; Obesity
PubMed: 1728834
DOI: 10.1093/ajcn/55.1.199s -
Revista Da Associacao Medica Brasileira... Mar 2017Antiobesity pharmacotherapy remains the main point of disagreement among both scientists and regulators. This is probably due to small sample sizes, high levels of...
Antiobesity pharmacotherapy remains the main point of disagreement among both scientists and regulators. This is probably due to small sample sizes, high levels of heterogeneity, and low methodological quality. For many years, Brazil was one of the largest consumers of appetite suppressants worldwide, with evidence of irrational use of this drug class. Therefore, the country was the scene of a debate that divided the Brazilian Health Surveillance Agency (Anvisa - Agência Nacional de Vigilância Sanitária) and medical societies over the maintenance record of diethylpropion, mazindol and fenproporex. In this context, this commentary presents new arguments to contribute to the discussion, as well as recommendations for future studies.
Topics: Amphetamines; Appetite Depressants; Brazil; Cyclobutanes; Diethylpropion; Drug Approval; Humans; Mazindol; Obesity; Risk Assessment; Treatment Outcome
PubMed: 28489121
DOI: 10.1590/1806-9282.63.03.203 -
The Medical Letter on Drugs and... Oct 1982
Topics: Adipose Tissue, Brown; Animals; Humans; Indoles; Mazindol; Obesity
PubMed: 7144688
DOI: No ID Found -
Acta Neurologica Scandinavica Oct 1979Thirty-four subjects with the narcoleptic syndrome were treated with mazindol 3--8 mg daily for 1 year. Treatment cuased a sustained improvement in narcolepsy, but had...
Thirty-four subjects with the narcoleptic syndrome were treated with mazindol 3--8 mg daily for 1 year. Treatment cuased a sustained improvement in narcolepsy, but had no effect on cataplexy or sleep paralysis. The response to mazindol was excellent in six subjects, good in 14, moderate in 12 and poor in two. No cardiovascular effects, haematological toxicity, tolerance or dependence occurred. Mazindol 6 mg had the same effect on narcolepsy as d-amphetamine 50 mg, but caused less side effects.
Topics: Adolescent; Adult; Aged; Female; Humans; Indoles; Male; Mazindol; Middle Aged; Narcolepsy
PubMed: 525256
DOI: 10.1111/j.1600-0404.1979.tb02976.x