• 생물정신의학
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• 제24권3호
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• pp.134-141
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• 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.

• 한국건강관리협회지
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• 제4권1호
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• pp.28-38
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• 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.

• 대한임상독성학회지
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• 제12권1호
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• pp.35-38
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• 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
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• 제43권4호
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• pp.290-299
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• 2018

목적: 식욕억제제인 펜터민의 투여에 따른 체중과 심박수 변화를 출판된 문헌을 토대로 메타분석을 시행하여 평가하고자 한다. 방법: 펜터민 투여군과 위약군의 체중과 심박수 변화를 측정한 무작위배정비교임상시험을 대상으로 PubMed, EMBASE, Cochrane library와 5개의 국내 전자데이터베이스 등 모두 8개의 전자데이터베이스로부터 검색전략에 따라 문헌들이 수집되었다. 메타분석에 따른 통합효과크기의 추정은 Mantel-Haenszel법에 의한 고정효과모델이 사용되었으며, 연구 간의 이질성이 존재하는 경우 변량효과모델이 사용되었다. 결과: 메타분석은 12개의 연구, 677명의 대상자에 대해 시행되었다. 펜터민의 투여에 따른 체중변화의 통합효과크기 추정치(SMD)는 -1.37 (95% 신뢰구간: -1.55, -1.19)로 통계적으로 유의하였으며, 출판연도, 국가, 펜터민의 용량, 추적관찰기간에 따른 하위그룹 분석에서 하위그룹 간 이질성은 나타나지 않았다. 펜터민의 투여에 따른 심박수 변화의 통합효과크기 추정치는 0.64 (95% 신뢰구간: 0.35, 0.92)로 통계적으로 유의하였다. 결론: 펜터민의 투여는 위약에 비해 유의하게 체중을 감소시키나, 심박수를 증가시킨다.

• 생물정신의학
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• 제29권1호
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• pp.22-31
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• 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.

• 약학회지
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• 제47권5호
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• pp.266-270
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• 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.

• 비만대사연구학술지
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• 제1권1호
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• pp.43-45
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• 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.

• 약학회지
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• 제57권6호
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• pp.420-425
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• 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
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• 제93권6호
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• pp.501-508
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• 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.

• 생명과학회지
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• 제31권11호
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• pp.1037-1045
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• 2021

전세계적으로 비만의 유병률은 증가하고 있으며 비만 유행은 식이요인과 좌식 생활 방식과 관련이 있기 때문에 현대인에게 발병하기 쉬운 질병이다. 또한 비만은 당뇨병, 심혈관계 질환과 같이 심각한 합병증을 동반하기 때문에 비만을 예방하고 치료하는 것이 중요해지고 있다. 현재 Liraglutide와 phentermine과 같은 의약품이 식욕억제 및 위장관 운동 지연을 유도해 비만 치료를 하고자 사용되고 있지만 갑상선암, 심혈관계 부작용, 중추 신경계 부작용 등 다양한 부작용이 발생하는 것으로 알려져있다. 따라서 상대적으로 부작용이 적은 비만 치료 방법을 탐색하기 위해 백색 지방조직을 갈색조직지방으로 바꾸어 에너지 소비를 증가시켜 비만을 치료하는 "Fat browning"이라는 방법이 도입되었다. 임상적으로 안전하게 "browning"을 유도하기 위해 효과 있는 천연 물질을 탐색하기 위한 연구가 진행중이며 현재 많은 천연물 소재가 연구되었다. 천연 물질 치료를 통한 "Browning" 유도는 일반적으로 "Browning" 유도 인자의 긍정적인 제어, 백색지방조직으로의 분화 억제, "Browning"과 관련된 메커니즘의 활성화의 세 가지를 포함한다. 따라서 Strawberry, Black raspberry, Cinnamomum cassia, Ecklonia stolonifera와 같은 "Browning" 유도 효과가 알려진 식물 추출물에 대한 연구를 설명한다. 우리는 또한 이러한 추출물이 "Browning"을 유도하고 그들이 매개하는 신호 경로를 통해 지금까지 확인된 메커니즘을 요약한다. 나아가 Browning을 통해 생성된 갈색지방조직이 내분비 기관으로써 심장 질환에 미치는 영향까지 확인해본 후 정리했다.