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

Drugs that act through noradrenergic and serotonergic mechanisms have historically served as the mainstays of pharmacologic treatments for obesity. This review addresses the following three topics: a brief discussion of older weight loss medications approved for short-term use (benzphetamine, phendimetrazine, diethylpropion, mazindol, and phentermine), as well as over-the-counter adrenergic drugs (phenylpropanolamine and ephedrine); recent clinical studies documenting the safety and efficacy of a new medication for obesity treatment, sibutramine, recently approved by the Food and Drug Administration for long-term use; and recent studies characterizing the valvulopathy associated with fenfluramine and dexfenfluramine, serotonergic medications for obesity which have been removed from the markets.