Fluoxetine increases the anorectic and long-term dopamine-depleting effects of phentermine. A comparison of cocaine, GBR 12909, and phentermine self-administration by rhesus monkeys on a progressive-ratio schedule. Diet drugs and cardiac valvulopathy: a survey of dental patients. Ionamin online references

Ionamin online research references

Synapse. 2000 Dec 15;38(4):471-6.
Fluoxetine increases the anorectic and long-term dopamine-depleting effects of phentermine.

Callahan BT, Yuan J, Ricaurte GA.

Department of Neurology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.

The anorectic drug phentermine produces dose-related toxic effects on brain dopamine (DA) neurons in animals. Until recently, phentermine was widely used in combination with fenfluramine for purposes of appetite suppression and weight loss. With the recent withdrawal of fenfluramine from the market, many people have begun combining phentermine with fluoxetine, a serotonin reuptake inhibitor which also produces mild anorectic effects. Fluoxetine, in addition to inhibiting serotonin reuptake, inhibits hepatic mixed function oxidase, which plays an important role in the metabolic degradation of amphetamines. The purpose of the present study was to assess the effects of fluoxetine on the anorectic and DA neurotoxic effects of phentermine in mice. Phentermine, in combination with fluoxetine, produced greater reductions in food intake and body weight than phentermine alone. The phentermine/fluoxetine combination also produced greater long-term reductions in brain DA levels than phentermine alone, likely reflecting greater DA neurotoxicity of the drug combination. Brain concentrations of phentermine were also found to be higher in animals pretreated with fluoxetine. These findings indicate that fluoxetine potentiates both the anorectic and DA neurotoxic effects of phentermine, probably by increasing phentermine brain levels. The clinical significance of these findings remains to be ascertained. Copyright 2000 Wiley-Liss, Inc.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11044894&dopt=Abstract

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Drug Alcohol Depend. 2001 Mar 1;62(1):41-7.
A comparison of cocaine, GBR 12909, and phentermine self-administration by rhesus monkeys on a progressive-ratio schedule.

Stafford D, LeSage MG, Rice KC, Glowa JR.

Department of Pharmacology and Therapeutics, Louisiana State University Medical Center, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.

The dopamine reuptake inhibitor GBR 12909 and the dopamine releaser phentermine may have potential for the treatment of cocaine abuse in humans. Pre-session treatment with either drug can decrease cocaine-maintained responding in rhesus monkeys while not affecting food-maintained responding. Both drugs are self-administered, but in some reports the patterns of responding they maintain differ from typical cocaine-reinforced responding. This study compared self-administration of cocaine (1--100 microg/kg/inj), GBR 12909 (3--100 microg/kg/inj), and phentermine (10--170 microg/kg/inj) in rhesus monkeys on a progressive-ratio schedule. Individual unit doses of each drug were available across several consecutive sessions. Cocaine self-administration was typical: the average number of ratios completed per session was a bitonic (increasing/decreasing) function of unit dose. Phentermine self-administration was variable across subjects (two of four monkeys self-administered reliably); one subject exhibited clear signs of behavioral toxicity. Self-administration of GBR 12909 was similarly variable across subjects. In the two subjects that self-administered GBR 12909 reliably, self-administration of small to mid-sized unit doses was enhanced following exposure to large unit doses. These data indicate that differences in self-administration of these drugs can be observed under progressive ratio procedures. Further, the data add to existing evidence suggesting that phentermine and GBR 12909 have at least moderate potential to be abused by humans.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11173166&dopt=Abstract

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J Calif Dent Assoc. 2000 Dec;28(12):955-9.
Diet drugs and cardiac valvulopathy: a survey of dental patients.

Rudin R, Carpenter W.

University of the Pacific School of Dentistry, USA.

The recent finding that several appetite suppressant drugs (fenfluramine and dexfenfluramine) were linked to cardiac valvular disease in a significant percentage of the population led to their voluntary withdrawal. The Centers for Disease Control and Prevention issued a series of recommendations in 1997 for evaluating dental patients who had taken these drugs. Since that time, several studies have further investigated the prevalence of valvular abnormalities. This information is crucial because of the problem of dentally associated bacterial endocarditis. This study surveyed more than 1,300 dental patients and determined the prevalence of patients taking these diet drugs and cardiac valvulopathy and the percentage of dental patients required to take antimicrobial endocarditis prophylaxis before "at risk" dental procedures. It remains important for dentists to query their patients for this information.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11323951&dopt=Abstract

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