Brain & Drugs
blood pressure increase, arrhythmias,Prozac, norepinephrine, serotonin

Sibutramine (Meridia) Withdrawn Oct 2010

Meridia has been one of the most prescribed of recent weight loss drugs. We have expressed concerns about Meridia's efficacy and safety over the past 10 years and have advised against its use. Favorable pre-marketing studies showed modest weight loss benefits and the manufacturer claimed that sibutramine was a safe and effective drug. More objective data suggested that its modest benefits are not significant in light of potentially serious adverse effects.

Meridia was associated with death from cardiovascular causes. The drug was withdrawn first in Italy and was under scrutiny in other countries. The know effects of sibutramine include increases in blood pressure, heart rate and arrhythmias. This drug is similar to Prozac and was originally developed as an antidepressant. Its main action is to increase serotonin transmission in the brain by inhibiting the reuptake of the neurotransmitter. Increased serotonin activity in appetite regulating regions of the brain are associated with decreased appetite. Sibutramine taken with other antidepressants increased norepinephrine and serotonin levels. Its use was contraindicated in patients with cardiovascular disease. James et al reported as study of 10,744 overweight or obese subjects 55 years and older with preexisting cardiovascular conditions who were given long-term sibutramine treatment have an increased risk for nonfatal myocardial infarction and nonfatal stroke, but not cardiovascular death or all-cause mortality.

In October, 2010 the US FDA announced that Abbott Laboratories withdrew sibutramine (Meridia) from the market in light of clinical trial data pointing to an increased risk for stroke and myocardial infarction. The Sibutramine Cardiovascular Outcomes Trial (SCOUT), demonstrated a 16% increase in the risk for serious cardiovascular events such as nonfatal heart attack, nonfatal stroke, the need for resuscitation after the heart stopped, and death in a cohort of patients given sibutramine compared with another given a placebo.

Consider an objective evaluation of the drug published In 2001.

Sibutramine: slight weight loss. Prescrire Int 2001 Oct;10(55):140-5 (ISSN: 1167-7422)

(1) The reference treatment for achieving weight loss by obese patients is a combination of dietary measures, exercise and behavioral interventions. There is currently no drug treatment with demonstrated efficacy on the morbidity or mortality associated with excess body weight.

(2) Sibutramine, a serotonin- and noradrenaline-reuptake inhibitor structurally related to the amphetamines has been granted marketing authorization in France for the treatment of obesity and excess body weight in patients with associated risk factors.

(3) The clinical file on sibutramine contains no trial focusing on morbidity or mortality end points.

(4) According to comparative clinical trials, weight loss during a 6-12 month course of sibutramine is, on average, between 3 and 9 kg greater than that on placebo. Patients regain weight after sibutramine cessation. (5) Sibutramine has little or no benefit on blood sugar or lipid parameters. (6) The main known adverse effect of sibutramine is increased blood pressure. Sibutramine also has amphetamine-like side effects.

(7) In practice, sibutramine currently has no place in the management of obesity.

See Eating and Weight Management

    • You are viewing the Brain Drugs at Alpha Online. Understanding the human brain is essential to become a well-informed, modern citizen. Responsible adults need to become better informed about prescription drugs and exercise constraint when seeking and accepting prescriptions that alter brain function. The topics online are from the book, Human Brain, by Stephen Gislason MD, a physician-writer who is good at making complex subjects more understandable.

    • Alpha Online is a Division of Environmed Research, founded in 1984 at Vancouver, BC, Canada. Online Since 1995.
      Alpha Nutrition is a trademark and a division of Environmed Research Inc.
    • Download The Human Brain as an eBook

      All Alpha Education and Persona Digital books, eBooks and Starter packs are ordered at Alpha Online. Prices are listed in Canadian Dollars.
      US $ cost is lower depending on the daily dollar exchange rate. Physical shipments by the Post Office are available to all destinations in the USA and Canada. We are located in Sechelt, close to Vancouver, British Columbia, Canada.

      Brain Rescue Starter Pack

      This starter pack includes the Alpha Nutrition Program, the Human Brain in Health and Disease and one 500 Gram jar of Alpha DMX. There are a host of clues that link the food supply to mysterious and threatening neurological diseases. We suggest that a prudent person suffering early brain-dysfunction symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity. Because some brain dysfunction compromises judgment learning and motivation, family members, friends and professional advisor often have to initiate diet revision and provide the right direction and support.

      Order Brain Rescue Starter Pack

    • Order Persona Digital Books

      Click the Add to Cart buttons on the left to begin your order for printed books from Alpha Online (mail delivery to US and Canada).
      Download eBooks
      Click the Download button to order eBooks (PDF file) for download. Click book title (center column) to read topics from each book.

      Print Book Read Topics Download
      Human Nature
      The Good Person
      The Puzzle
      Sound of Music
      Surviving Humans
      Language & Thinking
      I and Thou
      Emotions & Feelings
      Neuroscience Notes
      Human Brain
      Children & Family
      Intelligence & Learning
      Religion 21st Century

      Further reading: Neuroscience Notes, Intelligence and Learning, Language & Thinking

      Persona Digital

      Persona Digital Books is the publisher of The Human Brain, Neuroscience Notes, Intelligence & Learning and related books.