• Korean Journal of Biological Psychiatry
• /
• v.24 no.3
• /
• pp.134-141
• /
• 2017

Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

• Journal of Korea Association of Health Promotion
• /
• v.4 no.1
• /
• pp.28-38
• /
• 2006

Background : Phentermine classified by "sympathomimmetic amie", is a stimulant of sympatheic tone But there has been no concrete study which presents the influence of phentermine on autonomic nervous system. Analysis of Heart rate variability is reliable, non-invasive and very useful for evaluating function of autonomic nervous system. We tried to elucidate the influence of phentermine on autonomic nervovs system by heart rate variability. MethodsAmong the 70 candidates who participated in the double-blind case control study whichwas designed in purpose of approving whether- Adipekⓓ is effective for treatment of obesity, 45persons were folled up. From April, 2005 to May 2005, HRV of the candidates who takes phentermine or placebo for 1month, was recorded using BFM-5000ⓓ(medi-core) for 5 minutes in resting state. HRV measures were assessed by time-domain and by frequency- domain analysis. Time domain parameters contain SDNN(Standard Deviation of NN intervals) and RMSSD(Root-Mean-Square of Successive Differences), etc and frequency domain Parameters contain Total Power(TP), Low frequency(LF'0.04-0.15Hz) power. High Frequency(HF:0.15-0.4Hz) power and LF/HF ratio etc. Results: Intakes of phentermine reduce HRV significant1y. SDNN & RMSSD, the main tine domain parameters of HRV, were decreased significantly(P=0.007. 0.016). PSI(Physical Stress Index of Pressure Index) was increase significantly(P=0.002)The main frequency domain parameters(TP, LF & VLF), also decreased significantly. (P=0.024,0.033, 0.015)Conclusion: The result showed that intakes of phentermine reduce heart rate variability and influence on most parameters of HRV. So phentermine not only accelerates sympathetic tone, but also inhibit the balance and function of autonomic nervous system.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.12 no.1
• /
• pp.35-38
• /
• 2014

Phentermine has been widely used as an appetite suppressant since 2004 in Korea. The authors experienced two cases of acute phentermine overdose and report with the literature review. A 36-year-old man and a 24-year-old woman presented together to the emergency department with taking 13 tablets (390 mg) of phentermine 16 hours ago. They had tachycardia, hypertension and complained visual symptoms, nausea, insomnia and anxiety. These symptoms were resolved by conservative management.

• Journal of health informatics and statistics
• /
• v.43 no.4
• /
• pp.290-299
• /
• 2018

Objectives: This study aimed to evaluate the change in weight and heart rate associated with the use of phentermine through meta-analysis based on the published literatures. Methods: Eight electronic databases, PubMed, EMBASE, Cochrane library, and five domestic databases were used to search the literature. Randomized controlled trials that evaluated the change in weight and heart rate with the use of phentermine compared with placebo were included in this study. The fixed-effect model weighted by the Mantel-Haenszel method was used in the meta-analysis, and the random-effects model was used when heterogeneity was present. Results: We included 12 studies comprising 677 patients. The change in weight observed with the use of phentermine (SMD = -1.37, 95% CI: -1.55, -1.19) was statistically significant compared with that observed with placebo. As per the subgroup analysis results, the change in weight by publication year, country, phentermine dosage, follow-up check was not heterogeneous. The change in heart rate observed with the use of phentermine (SMD = 0.64, 95% CI: 0.35, 0.92) was significant compared with that observed with placebo. Conclusions: Weight loss and increased heart rate were confirmed in phentermine compared with placebo.

• Korean Journal of Biological Psychiatry
• /
• v.29 no.1
• /
• pp.22-31
• /
• 2022

Objectives Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses. Methods In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized. Results All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia. Conclusions These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.

• YAKHAK HOEJI
• /
• v.47 no.5
• /
• pp.266-270
• /
• 2003

We evaluated four commercially available methamphetamine immunoassays for their relative cross-reactivities of amphetamine analogues in human urine: Abbott TDx, Vitalab Selectra and on-site test kits (Accusign MET, SD bioline MET). High cross-reactivities were shown at designer's drugs such as methylenedioxyamphetamine (MDA), methylenedioxymethamphetamine (MDMA) and methylenedioxyethylamphetamine (MDEA) in all of the tested immunoassays. Methoxyphenamine, fenfluramine and phentermine were positive in TDx and Selectra, but were not positive in on-site test kits. Pseudoephedrine, norpseudoephedrine, ephedrine, norephedrine, MDMA, MDA, fenfluramine and phentermine were detected by gas chromatography/mass spectrometry(GC/MS) in false positive urines. Since the overall specificity of any of the devices was not 100％, we found it is important to confirm any positive screening test result, so we developed simultaneous determination of amphetamine analogues in urines. After alkalinization of the urine samples with 6-N NaOH, the analytes were extracted using ethyl acetate, derivatized with pentafluoropropyl anhydride (PFPA) prior at GC/MS analysis.

• Archives of Obesity and Metabolism
• /
• v.1 no.1
• /
• pp.43-45
• /
• 2022

Intensive lifestyle modifications and anti-obesity medications are essential for obesity treatment. Antiobesity medications should be selected according to the patient's comorbidities, symptoms, and preferences. This case report describes the treatment of a morbidly obese patient with a history of depression, who complained of tingling and numbness after total thyroidectomy for papillary thyroid cancer. Very low-dose controlled-release phentermine/topiramate was prescribed and intensive lifestyle modifications were encouraged. As a result, the patient effectively lost weight and reached a near-normal weight without adverse drug effects. This implies that even an off-label anti-obesity medication low dose may be better for some patients, and the most important factor in obesity treatment is patient-tailored treatment.

• YAKHAK HOEJI
• /
• v.57 no.6
• /
• pp.420-425
• /
• 2013

Phentermine (PT) and phenmetrazine (PM) have been widely used as anti-obesity drugs. These drugs should be used with caution due to its close relation to amphetamine in its structure and toxicity. PT and PM, amphetamine-type anorectics, have recently been considered as alternatives for methamphetamine abuse in Korea. In addition, the misuse and abuse of PT and PM obtained by illegal sources such as the internet become a serious social problem. In the present study, a simultaneous detection and quantification method for determining PT and PM in human urine was developed and validated according to the international guidelines. The urine samples were screened using a fluorescence polarization immunooassay and analyzed by gas chromatography mass spectrometry (GC-MS) after extraction using automatic solid phase extraction (SPE) with a mixed-mode cation exchange cartridge and derivatization with pentafluoropropionic anhydride (PFPA). The validation results for selectivity, linearity, limits of detection (LOD) and quantification (LOQ), intra- and inter-assay precision and accuracy and recovery were satisfactory. The validated method was successfully applied to authentic urine samples collected from 38 drug abuse suspects. PT and/or PM were identified with or without methamphetamine in urine samples. Abuse of PT and PM have increased continuously in Korea, therefore, closer supervision of the inappropriate use of anoretics is necessary.

• The Korean Journal of Medicine
• /
• v.93 no.6
• /
• pp.501-508
• /
• 2018

Obesity is a chronic disorder that is a significant risk factor for diabetes, cardiovascular diseases, malignancy, and other chronic diseases. Lifestyle modifications form the basis of most treatments for obesity, but it has become clear that such modifications alone are not enough for many obese patients. When a behavioral approach is insufficient, pharmacological treatment may be recommended. In recent years, the US Food and Drug Administration (FDA) has withdrawn several therapeutic options for obesity due to their side effects, but has approved four novel anti-obesity agents. Until recently, orlistat was the only drug approved for the management of long-term obesity, but the US FDA approved the novel anti-obesity drugs lorcaserin and phentermine/topiramate in 2012, and naltrexone/bupropion and liraglutide in 2014. The present review discusses the different pharmacotherapeutic options for the treatment of obesity.

• Journal of Life Science
• /
• v.31 no.11
• /
• pp.1037-1045
• /
• 2021

The prevalence of obesity is increasing worldwide, and since obesity is associated with dietary factors and sedentary lifestyles, it is a disease that is readily developing in the modern population. Because obesity is accompanied by serious complications such as diabetes and cardiovascular disease, prevention and treatment are important. Currently, drugs such as liraglutide and phentermine are used to treat obesity by suppressing appetite and inducing gastrointestinal motility delay. However, various side effects may occur, including thyroid cancer, cardiovascular problems, and central nervous system disorders. Therefore, to explore an obesity treatment method with relatively few side effects, a method known as "fat browning" was introduced to change white adipose tissue into brown adipose tissue to increase energy consumption. Ongoing studies are attempting to find effective natural substances to safely induce browning. Many natural substances have been identified. The induction of browning by treatment with natural substances generally involves three mechanisms: positive control of browning-inducing factors, inhibition of differentiation into white adipose tissue, and the activation of mechanisms related to browning. In this study, we describe plant extracts with known browning-inducing effects, such as strawberry, black raspberry, cinnamomum cassia, and Ecklonia stolonifera extracts. We also summarize the underlying mechanisms of action identified thus far, including the signaling pathway mediated by these extracts to induce browning. Furthermore, the effects of brown adipose tissue generated through browning on heart disease as an endocrine organ disruptor are discussed.