Which drugs are no longer used or are ineffective in the treatment of obesity?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The history of obesity medications is replete with disasters that have taught caution in the use of this group of medicines. For example, among the initial medications used for obesity management were amphetamine, methamphetamine, and phenmetrazine. These were all withdrawn because of their high potential for abuse.

The combination of fenfluramine and phentermine (“fen-phen”) was used in some long-term trials with excellent results. However, fenfluramine was withdrawn in 1997 (along with D-fenfluramine) because of the potential for adverse cardiac, valvular, and pulmonary hypertensive effects in patients taking this drug.

Other former antiobesity medications, and the reasons for their abandonment, include the following:

  • Thyroid hormone - Hyperthyroidism, with its attendant sequelae

  • Dinitrophenol - Cataracts and neuropathy

  • Rainbow pills (a mixture of digitalis and diuretics) - Fatal arrhythmias and electrolyte derangements

  • Aminorex - Pulmonary hypertension

  • Phenylpropanolamine - Increased risk of myocardial infarction and stroke

Other drugs withdrawn from the US market include benzphetamine and mazindol.

Some agents that initially showed promise were later demonstrated to be poor prospects in rigorous randomized intervention trials. These include the following:

  • Guar gum

  • Chitosan

  • Axokine - Or ciliary neurotrophic factor, the use of which was associated with the development of autoantibodies and marked reduction in anorexiant potency in about 30% of subjects

  • St. John's wort

  • Psyllium

  • Conjugated linoleic acid

  • Chromium

  • Ginseng


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