The potential usefulness of these anti-hunger drugs in the treatment of obesity it is a particularly delicate and debated issue, subject - over the years - to growing restrictions and prohibitions.
The anorectics used in therapy are largely centrally acting drugs which, through the enhancement of dopaminergic, adrenergic and serotonergic activity, stimulate the satiety center and / or inhibit the hunger center.
, mazindol, phentermine, phenylpropanolamine, amfepramone, dexfenfluramine.Since the use of amphetamine-like anorectic drugs is burdened by important side effects: irritability, anxiety, euphoria, depression, confusion, headache, insomnia, tremor, palpitation, tachycardia and arrhythmia, their therapeutic use has been greatly reduced in years, up to their withdrawal from the market. These substances, in fact, cause even very serious side effects, capable of endangering the patient's life:
- Phenylpropanolamine: increases the risk of hemorrhagic stroke, especially in women;
- Fenfluramine: although it does not have the typical side effects of amphetamine derivatives, it increases the risk of suffering heart valve lesions:
- Phendimetrazine: the last of the anorectics to retire in August 2011, presents the typical side effects of amphetamine derivatives: irritability, anxiety, tachycardia, palpitations, arrhythmias, tremor hypertension; in addition to this, the excessive euphoria and the sense of well-being deriving from the first assumptions gradually turn into depression as phenomena of tolerance and dependence arise with continued use.
Please note
Amphetamine derivatives have been revoked and are no longer marketed in Italy, so they can no longer be used and much less prescribed.
or by activating their receptors, but also commonly used antidepressants. These drugs work by blocking the reabsorption of norepinephrine, dopamine and serotonin at the level of the synapses of the central nervous system, enhancing their signal. Among all, it is above all the so-called serotonergic drugs to be studied and used as anorectics; serotonin, in fact, is capable not only of promoting good mood and tranquility, but also of decreasing food intake. With reference to this last point, it is believed that serotonin can determine an "early onset of the signal of satiety, can reduce the palatability of food and the total amount of food ingested, can reduce the ingestion of carbohydrates and can increase the ingestion of proteins without affecting fat intake and the frequency of meals.
Compared to amphetamine derivatives, which exert their anorectic effect also through the generalized stimulation of the body metabolism (greater energy expenditure), serotonergic drugs do not perform this action.
In the past, the most widely used serotonergic drugs for anorectic activity were fenfluramine and dexfenfluramine, which were then banned in 1997 for serious side effects, such as pulmonary hypertension and alteration of the heart valves. Fluoxetine and sertraline, on the other hand, are drugs with a lower anorectic effect. and short-term, whose use is approved only and exclusively for the treatment of psychiatric disorders of various types (depressive disorders, panic attacks, obsessive-compulsive disorders, etc.) and certainly not for anorectic purposes. "anorectic effect is a side effect.
Please note
Antidepressants must NEVER be used as anorectic drugs, but must be used only and exclusively for the approved indications.
(Ectiva, Reductil, Reduxade). However, the medicines containing it have been withdrawn from the market due to decidedly unfavorable and dangerous side effects: dry mouth, constipation, headache, insomnia, hypertension, tachycardia, stroke and heart attack.Therefore, sibutramine medicines can no longer be used or prescribed.
and are part of the system used by the body to control food intake. Receptors are also present in adipocytes (adipose tissue). Consequently, rimonabant reduces food intake and favors the establishment of a more favorable metabolic framework (increase insulin sensitivity and lipid reduction); the reasons for its withdrawal from the market are to be found in the high risk of serious psychiatric and neurological disorders, including the risk of suicide.
, an antiepileptic agent authorized for the treatment of epilepsy and for the prophylaxis of migraine, has been the subject of numerous studies to evaluate its potential anorectic properties. In the past, a drug has been developed for the treatment of obesity containing the active ingredient in question associated with phentermine, whose marketing authorization was first denied and then re-evaluated by the United States FDA (Food and Drug Administration). . In fact, even for topiramate there is a risk of serious side effects, such as psychological effects, such as affective disorders, psychotic disorders and aggressive behavior.
In any case, in Italy, topiramate for weight loss CANNOT and must not be used; its use is reserved exclusively for the treatment of epilepsy and the prophylaxis of migraine.
.In fact, there are many natural substances capable of tracing the action of synthetic anorectic drugs, albeit with a milder action at common doses of use. This is the case, for example, of caffeine (mate, cola, guarana, coffee, tea left to infuse for a long time, cocoa), synephrine (bitter orange, peel) and ephedrine (Ephedra, aerial parts, not allowed as a supplement) , which act as anti-hunger by mimicking the action of amphetamine derivatives both in terms of appetite suppression and for the stimulating effect on the body's metabolism.
As for the serotonergic anorectic supplements, we point out the 5-hydroxytryptophan, an amino acid derivative, capable of crossing the blood brain barrier and increasing the synthesis of serotonin.
Finally, an anorectic effect can be ascribed to the fibers (bran, guar and guar gum, xanthan, karaya gum, psyllium, psyllium seeds, agar agar, glucomannan, pectin, Konjac flour, algin and alginic acid, carrageenan), which , if taken before meals together with plenty of water, they swell in the stomach, stretching the gastric walls, increasing the sense of satiety and reducing the intake of food.
PLEASE NOTE
It is very important to underline that the use of any type of product with anorectic effects - including supplements - to promote weight loss must NOT be done without first consulting your doctor.
Furthermore, we remind you that the information given here is for illustrative purposes only and that it is not intended in any way to substitute the opinion of this health professional and the doctor-patient relationship. We conclude, therefore, by reiterating once again the need to contact the doctor or specialist before taking any type of anorectic in order to lose weight.
