Sibutramine
toxic and banned substance believed to reduce obesity
Sibutramine, formerly sold under the brand name Meridia among others, is an appetite suppressant which has been discontinued in many countries. Amphetamine derivate, psychostimulant drug. It works as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI) similar to certain antidepressants. Until 2010, it was widely marketed and prescribed as an adjunct in the treatment of obesity along with diet and exercise.
Sibutramine was originally developed in 1988 by Boots in Nottingham, UK, and manufactured and marketed by Abbott Laboratories and sold under a variety of brand names including Reductil, Meridia, Siredia, and Sibutrex. It was classified as a Schedule IV controlled substance in the United States.
In 2010, the drug was withdrawn from most markets, including Australia, Canada, China, the European Union, Hong Kong, India, Mexico, New Zealand, the Philippines, Thailand, the United Kingdom, and the United States, after a study associated it with an increased risk of myocardial infarction and ischaemic stroke. However, the drug remains legally available in countries such as Russia, where it is available only by prescription exclusively to adults, and Brazil. It has also continued to circulate in the form of counterfeit weight-loss products, including dietary and herbal supplements.
Contraindications
Sibutramine is contraindicated in patients with:
Psychiatric conditions as bulimia nervosa, anorexia nervosa, severe depression, or pre-existing mania
Patients with a history of or a predisposition to drug or alcohol abuse
Hypersensitivity to the drug or any of the inactive ingredients
Patients below 18 and above 65 years of age
Concomitant treatment with a monoamine oxidase inhibitor (MAOI), antidepressant, or other centrally active drugs, particularly other anoretics
History of peripheral artery disease
Hypertension that is not sufficiently controlled (e.g., >145/90 mmHg), caution in controlled hypertension
Existing pulmonary hypertension
Existing damage on heart valves, congestive heart failure, previous myocardial infarction (heart attack), tachycardia, arrhythmia, or cerebrovascular disease (e.g., stroke or transient ischemic attack [TIA])
Hyperthyroidism (overactive thyroid gland)
Closed-angle glaucoma
Epilepsy
Enlargement of the prostate gland with urinary retention (relative contraindication)
Pheochromocytoma
Pregnant and lactating women (relative contraindication)
Side effects
A higher number of cardiovascular events has been observed in people taking sibutramine versus control (11.4% vs.
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