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Obesity Surgery Aug 2021
Topics: Acute Kidney Injury; Bariatric Surgery; Humans; Hypertension; Obesity, Morbid; Phentermine; Weight Gain
PubMed: 33890226
DOI: 10.1007/s11695-021-05438-2 -
Journal of Medical Case Reports Jan 2022Obesity and eating disorders can present together, and pose diagnostic and therapeutic challenges to the clinician. Generally, lifestyle interventions alone for the...
BACKGROUND
Obesity and eating disorders can present together, and pose diagnostic and therapeutic challenges to the clinician. Generally, lifestyle interventions alone for the treatment of obesity have modest long-term effectiveness. Phentermine-topiramate extended release is a relatively new medication approved for weight reduction. Sleep-related eating disorder is a rare condition that is often underdiagnosed. Both conditions are chronic and require long-term management. There is no definitive treatment for sleep-related eating disorder, and therapeutic options are based on case reports.
CASE PRESENTATION
A 35-year-old Caucasian male with a body mass index of 41.7 kg/m presented for obesity treatment. History revealed nocturnal episodes of hyperphagia associated with amnesia of overeating and other features of sleep-related eating disorder. Treatment was initiated with phentermine-topiramate extended release. Five months later he lost 5% of his body weight and demonstrated resolution of sleep-related eating disorder behaviors. He reported no adverse side effects. Upon self-discontinuation of the medication, his eating disorder recurred.
CONCLUSIONS
Clinicians intending to help patients reduce body weight should screen for nocturnal eating and other eating disorders. Sleep-related eating disorder can be associated with significant morbidity and excess weight. Patients report adverse effects on quality of life as a result. Phentermine-topiramate extended release may be a good therapeutic option for patients presenting with comorbid obesity and sleep-related eating disorder. More research is needed to explore the efficacy and safety in this patient population.
Topics: Adult; Anti-Obesity Agents; Feeding and Eating Disorders; Fructose; Humans; Male; Obesity; Phentermine; Quality of Life; Sleep; Topiramate
PubMed: 35081980
DOI: 10.1186/s13256-021-03250-1 -
The Nurse Practitioner Aug 1997
Review
Topics: Appetite Depressants; Clinical Trials as Topic; Drug Therapy, Combination; Fenfluramine; Humans; Phentermine; Weight Loss
PubMed: 9279853
DOI: No ID Found -
Annals of Internal Medicine Nov 2001
Topics: Appetite Depressants; Drug Interactions; Drug Therapy, Combination; Fenfluramine; Obesity; Phentermine
PubMed: 11694113
DOI: 10.7326/0003-4819-135-9-200111060-00018 -
South African Medical Journal =... Aug 2023Phentermine is an internationally recognised amphetamine derivative with significant appetite-suppressing properties. The drug is indicated for the short-term management...
BACKGROUND
Phentermine is an internationally recognised amphetamine derivative with significant appetite-suppressing properties. The drug is indicated for the short-term management of obesity, as the long-term (LT) use of phentermine may potentially be associated with severe cardiovascular side-effects, abuse and dependence. The LT use hereinafter describes periods exceeding 12 consecutive weeks. This use may also be associated with potential drug-drug interactions (PDDIs), which may result in adverse drug reactions (ADRs). The literature reports that phentermine is often prescribed LT and for several other off-label indications, increasing the risk for individuals to experience adverse drug events (ADEs) and drug-drug interactions (DDIs). There are, to our knowledge, no South African (SA) studies investigating the prevalence of co-prescribing LT phentermine with drugs that may potentially cause DDIs.
OBJECTIVE
To determine the prevalence of mild, moderate and severe DDIs with phentermine use when the duration of therapy in private healthcare exceeded 12 consecutive weeks.
METHODS
A cross-sectional drug utilisation review (DUR) was done by using data obtained from a SA pharmacy benefit management (PBM) company's database. Retrospective data of medicine claims for phentermine, from 1 January 2015 to 31 December 2019, were extracted for analysis. The number of days phentermine was supplied was used to identify the study population, in other words, those patients who received the drug LT. A drug interaction checker (Drugs.com) was used to identify potential mild, moderate and severe DDIs when using phentermine and co-prescribed drugs concurrently.
RESULTS
A total of 889 patients received phentermine LT. The top 20 drugs identified as being frequently co-prescribed in this study population demonstrated no mild PDDI, 15 (75%) moderate PDDIs and 5 (25%) severe PDDIs. The most common co-prescribed drug in the moderate group was dextromethorphan (n=282, 31.72%) and the least co-prescribed was formoterol (n=52, 5.85%). Among the drug group 'severe PDDIs', tramadol (n=416, 46.79%) was most frequently prescribed, whereas phenylpropanolamine (n=69, 7.76%) was the least prescribed to patients in this group.
CONCLUSION
There are patients who receive LT phentermine therapy despite the potential severe consequences that may result. These patients may receive concomitant therapy with phentermine and other pharmaceutical constituents, which may potentially cause DDIs, more specifically, moderate and severe DDIs. As such, these patients are not only confronted with the consequences of DDIs but are also at risk to experience ADRs as the residual effect of PDDIs.
Topics: Humans; Phentermine; Retrospective Studies; Cross-Sectional Studies; South Africa; Drug-Related Side Effects and Adverse Reactions; Drug Interactions
PubMed: 37882119
DOI: 10.7196/SAMJ.2023.v113i8.428 -
FP Essentials May 2020Pharmacotherapy, adjunctively with lifestyle interventions, is an option for any patient diagnosed with obesity (ie, body mass index [BMI] of 30 kg/m or greater) or with...
Pharmacotherapy, adjunctively with lifestyle interventions, is an option for any patient diagnosed with obesity (ie, body mass index [BMI] of 30 kg/m or greater) or with a BMI of 27 kg/m or greater and at least one coexisting condition, including type 2 diabetes, hypertension, hyperlipidemia, and sleep apnea. If the appropriate criteria are met, pharmacotherapy should be initiated for patients with overweight or obesity if lifestyle modification does not produce adequate weight loss. Lifestyle modifications should be continued and emphasized throughout treatment because it has been shown that adjunctive pharmacotherapy produces greater weight loss and weight loss maintenance than lifestyle interventions alone. Currently, five drugs are approved for weight management in adults: phentermine, orlistat, phentermine-topiramate, bupropion-naltrexone, and liraglutide. Certain drugs are approved for short-term management while others are approved for long-term management. Drug therapy should be customized to the individual patient, depending on needs, contraindications, and cost. Benefits of these drugs should be assessed regularly and a different drug should be considered if at least 5% of body weight is not lost by 3 months of therapy.
Topics: Adult; Anti-Obesity Agents; Benzazepines; Diabetes Mellitus, Type 2; Humans; Obesity; Phentermine
PubMed: 32383845
DOI: No ID Found -
International Journal of Obesity (2005) Feb 2014To investigate if phentermine treatment induces phentermine abuse, psychological dependence (addiction) or phentermine drug craving in overweight, obese and weight loss...
OBJECTIVE
To investigate if phentermine treatment induces phentermine abuse, psychological dependence (addiction) or phentermine drug craving in overweight, obese and weight loss maintenance patients. To investigate whether amphetamine-like withdrawal occurs after abrupt cessation of long-term phentermine treatment.
DESIGN
Clinical intervention trial with interruption of phentermine treatment in long-term patients.
SUBJECTS
269 obese, overweight or formerly obese subjects (age: 20-88 years, BMI: 21-74 kg m(-2)) treated with phentermine long-term (LTP, N=117), 1.1-21.1 years, or short-term (ATP, N=152), 4-22 days, with phentermine doses of 18.75-112.5 (LTP) and 15-93.75 (ATP) mg per day.
MEASUREMENTS
Module K of the Mini International Neuropsychiatric Interview modified for phentermine (MINI-SUD), Severity of Dependence Scale (SDS), 45-item Cocaine Craving Questionnaire-NOW (CCQ-NOW) modified for phentermine (PCQ-NOW), and Amphetamine Withdrawal Questionnaire (AWQ) modified for phentermine (PWQ).
RESULTS
MINI-SUD interviews were negative for phentermine abuse or psychological dependence in all LTP patients. SDS examination scores were low for all LTP and ATP patients, indicating they were not psychologically dependent upon phentermine. PCQ-NOW scores were low for all LTP and ATP patients, indicating neither short-term nor long-term phentermine treatment had induced phentermine craving. Other than an increase in hunger or eating, amphetamine-like withdrawal symptoms did not occur upon abrupt phentermine cessation as measured by sequential PWQ scores.
CONCLUSIONS
Phentermine abuse or psychological dependence (addiction) does not occur in patients treated with phentermine for obesity. Phentermine treatment does not induce phentermine drug craving, a hallmark sign of addiction. Amphetamine-like withdrawal does not occur upon abrupt treatment cessation even at doses much higher than commonly recommended and after treatment durations of up to 21 years.
Topics: Adult; Aged; Aged, 80 and over; Appetite Depressants; Behavior, Addictive; Drug Administration Schedule; Female; Guideline Adherence; Humans; Male; Middle Aged; Obesity; Phentermine; Substance-Related Disorders; Surveys and Questionnaires; Time Factors; United States; United States Food and Drug Administration; Weight Loss
PubMed: 23736363
DOI: 10.1038/ijo.2013.74 -
Endocrine Practice : Official Journal... Sep 2020Obesity is a well-known risk factor for infertility. However, the use of weight loss medications prior to conception is underutilized. The objectives of our study are to...
OBJECTIVE
Obesity is a well-known risk factor for infertility. However, the use of weight loss medications prior to conception is underutilized. The objectives of our study are to describe weight loss, pregnancy rates, and live birth rates after short-term phentermine use in women with obesity and infertility.
METHODS
This was a retrospective analysis of 55 women (18 to 45 years old) who were overweight or obese, diagnosed with infertility, and prescribed phentermine for weight loss in an ambulatory endocrinology clinic at a single, tertiary level academic medical center. Main outcome measures were mean percent weight change at 3 months after starting phentermine, and pregnancy, and live birth rates from start of phentermine to June 30, 2017.
RESULTS
Median duration of phentermine use was 70 days (Q1, Q3 [33, 129]). Mean ± SD percent weight change at 3 months after starting phentermine was -5.3 ± 4.1% (P<.001). The pregnancy rate was 60% and the live birth rate was 49%. There was no significant difference in pregnancy rates (52% versus 68%; P = .23) or live birth rates (44% versus 54%; P = .50) in women who lost ≥5% versus <5% of their baseline weight. The number of metabolic comorbidities was negatively associated with the pregnancy rate. Phentermine was generally well-tolerated with no serious adverse events.
CONCLUSION
Phentermine can produce clinically significant weight loss in women with obesity during the preconception period. Higher pregnancy or live birth rates were not observed with a greater degree of weight loss with phentermine.
Topics: Adolescent; Adult; Anti-Obesity Agents; Female; Humans; Middle Aged; Phentermine; Pregnancy; Pregnancy Outcome; Retrospective Studies; Weight Loss; Young Adult
PubMed: 33471704
DOI: 10.4158/EP-2019-0609 -
Journal of the American Academy of... Aug 1997
Review
Topics: Appetite Depressants; Fenfluramine; Humans; Obesity, Morbid; Patient Selection; Phentermine
PubMed: 9325813
DOI: 10.1111/j.1745-7599.1997.tb01261.x -
The Primary Care Companion For CNS... Feb 2024
Topics: Humans; Bipolar Disorder; Phentermine; Mania; Weight Loss
PubMed: 38395144
DOI: 10.4088/PCC.23cr03624