Use of sibutramine and other noradrenergic and serotonergic drugs in the management of obesity

Drugs that act through noradrenergic and serotonergic mechanisms have histo rically served as the mainstays of pharmacologic treatments for obesity. Th is review addresses the following three topics: a brief discussion of older weight loss medications approved for short-term use (benzphetamine, phendi metrazine, diethylpropion, mazindol, and phentermine), as well as over-the- counter adrenergic drugs (phenylpropanolamine and ephedrine); recent clinic al studies documenting the safety and efficacy of a new medication for obes ity treatment, sibutramine, recently approved by the Food and Drug Administ ration for long-term use; and recent studies characterizing the valvulopath y associated with fenfluramine and dexfenfluramine, serotonergic medication s for obesity which have been removed from the markets.