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Lower dosages of phentermine‐fenfluramine given in the afternoon: Five cases with significant weight loss
Author(s) -
Katz Debra A.,
Maloney Michael J.,
Sutkamp Jerry C.,
McConville Brian J.
Publication year - 1999
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/(sici)1098-108x(199905)25:4<469::aid-eat13>3.0.co;2-h
Subject(s) - phentermine , fenfluramine , weight loss , medicine , anorectic , evening , morning , dexfenfluramine , diabetes mellitus , obesity , anesthesia , endocrinology , body weight , physics , receptor , astronomy , serotonin
Phentermine and fenfluramine are widely used in the treatment of obesity. Despite the fact that primary pulmonary hypertension and mitral valve insufficiency have been associated with fenfluramine use, many of these patients need medication to achieve weight loss. Small degrees of weight loss have been shown to significantly improve obesity‐related medical conditions such as hypertension, hypercholesterolemia, and noninsulin‐dependent diabetes mellitus. Current practice is to give phentermine and fenfluramine in the morning and afternoon. Doses for phentermine have ranged from 15 to 37.5 mg and for fenfluramine from 20 to 120 mg per day. We report five cases of severely obese women with medical complications who were treated with phentermine 8 mg twice per day (at 1:00 p.m. and 4:00 p.m.) and fenfluramine 20 mg per day (at 4:00 p.m.). Because many obese patients skip breakfast and eat more in the afternoon and evening, medication was dosed in order to cover these high‐risk eating periods. Overall, these patients lost a mean of 22.4% of their initial weight (range 18.6% to 32.8%) over an average of 8.4 months (range 3.5 to 16 months). These cases suggest that short‐term weight loss can be achieved with a low dose of fenfluramine when both medications are given in the afternoon to better target the eating patterns of obese subjects. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 25: 469–474, 1999.