INAPPROPRIATE PRESCRIBING OF COMPOUNDED ANTIOBESITY FORMULAS IN BRAZIL

Volunteers posing as patients underwent paid medical consultations at the offices of 107 Brazilian doctors (in two Brazilian cities) with th e purpose of obtaining an antiobesity prescription. In 80.3% of 71 Sao Paulo visits, as well as in 47.2% of 36 Recife visits, compounded pre parations were prescribed. Four to six active components predominated, but there were prescriptions listing as many as 17 components. All co ntained anorectic substances and benzodiazepines. Diuretics, thyroid a gents, laxatives, medicinal plants, and a variety of other substances were often included. The prescribed doses were frequently above recomm ended limits, reaching amounts as much as live times the international ly defined standard doses. In some instances two anorectic substances were prescribed simultaneously. Most doctors failed to warn volunteers of the possible occurrence of adverse reactions to the prescribed sub stances. Furthermore, in the case of all volunteers involved, antiobes ity prescriptions would be completely unnecessary, a fact that points to improper medical conduct on the part of doctors. It is concluded th at the practice by some Brazilian medical doctors of prescribing manip ulation formulas based on anorectic and benzodiazepine drugs is a grea ter hazard than a benefit to patients. (C) 1998 John Wiley & Sons, Ltd .