Lower dosages of phentermine-fenfluramine given in the afternoon: Five cases with significant weight loss

Katz, Debra A.; Maloney, Michael J.; Sutkamp, Jerry C.; McConville, Brian J.

doi:10.1002/(sici)1098-108x(199905)25:4<469::aid-eat13>3.0.co;2-h

Cited by 2 publications

(1 citation statement)

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“…Subsequent studies confirmed longterm weight losses that were superior to diet and exercise alone and to treatment with single drugs. [3][4][5][6][7][8][9] Weight losses at 1 year were approximately 15-17% of initial body weight with phen-fen [3][4][5][6][7][8][9] compared to losses of 6-10% of initial body weight with single-drug treatment using fenfluramine. [10][11][12][13][14][15][16][17][18][19] When fenfluramine and dexfenfluramine were removed from the market in September 1997 because of concerns about cardiac valve lesions, 4,6,[20][21][22][23][24][25][26][27][28][29][30][31][32][33] some physicians turned to combinations of phentermine and other serotonin-active drugs such as fluoxetine and sertraline in an attempt to reproduce the phen-fen effect.…”

Section: Introductionmentioning

confidence: 99%

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

et al. 2006

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Background: Obesity treatment with single drugs produces weight losses of about 8-10% of initial body weight. Few studies of combinations of drugs for treating obesity have been published. The combination of phentermine, an adrenergic agent, and fenfluramine, a serotonergic agent, (phen-fen) produced weight losses of about 15% of initial body weight. Fenfluramine is no longer available because it was associated with cardiac valve lesions. Phentermine-fluoxetine (phen-flu) has been proposed as an alternative for phen-fen. Objective: To compare the efficacy of treatment and prevalence of cardiac valve abnormalities on phen-flu vs phen-fen. Design: Retrospective chart review of all patients treated for at least 3 months with phen-flu (N ¼ 97) to a random sample of patients treated with phen-fen (N ¼ 98) in the Clinical Nutrition Clinic at the University of Wisconsin. Comparison of echocardiograms in all patients treated solely with phen-flu (N ¼ 21) to a random sample of patients treated with phen-fen (N ¼ 47), and to a group of subjects never treated with obesity drugs (N ¼ 26). Results: With last observation carried forward analysis (LOCF), at 6 months of treatment the phen-fen patients lost 12.670.6% of baseline weight and phen-flu patients lost 9.070.6% (Po0.001). With completers analysis, there were no significant differences in weight loss as a percent of baseline weight at 6 months (14.470.6 vs 13.370.9%). LOCF decreases in body mass index (BMI) at 6 months were À5.3 and À3.6 kg/m 2 for phen-fen and phen-flu, respectively (Po0.001), and 6.270.3 vs 5.470.4 kg/m 2 , respectively, for the completers analysis (P -NS). Dropout rate at 6 months was higher in phen-flu subjects (44 vs 28%). In subjects without atherosclerosis of valves (presumably pre-existing), cardiac valve lesions occurred in eight of 38 phen-fen subjects and in none of 15 phen-flu subjects or 25 control subjects who had not been treated with drugs. Conclusions: The combination of phentermine and fluoxetine was not as effective as phen-fen, but was not associated with cardiac valve lesions. Longer term, larger scale studies of phen-flu are warranted.

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