• Tachycardia (erratic heart beat)
• Elevation of blood pressure
• Restlessness
• Dizziness and tremors
• Insomnia
• Euphoria
• Headache
• Psychotic episodes (occur rarely at recommended doses).

Therefore, the minimum effective dose of the drug should be used in every case. Other possible side effects include dryness of the mouth and unpleasant taste, diarrhea, constipation, skin allergy, changes in sex drive, and occassionally even impotence.

Long term therapy with Adipex, especially in combination with another class of appetite suppressants called SSRI’s (also used in depression) can lead to permanent alterations in the blood vessels of the lung and the inner lining of the heart. This can cause abnormal functioning of the heart valves.

Awareness of this possibility is essential and any deterioration in tolerance for exercise (heavy breathing, etc) should be immediately reported. Treatment will need to be discontinued if new, unexplained symptoms like breathing difficulty, chest pain, episodes of unconsciousness or lower limb swelling should occur. For the same reason Adipex must be avoided in people with existing defects in blood flow through the lungs and abnormally functioning heart valves.

The potential of drug abuse needs to be kept in mind for physicians prescribing Adipex. Regular monitoring for signs of insomnia, irritability, hyperactivity, personality changes and signs of “drug seek” behavior is essential. The most severe manifestation of chronic abuse is psychosis, often differing very little from full-blown schizophrenia.

Abrupt cessation following a prolonged period of treatment may result in extreme fatigue, mental depression, and changes in sleep patterns. This drug should be tapered off gradually.

An overdose of Adipex diet pills may result in restlessness, tremor, rapid respiration, confusion, aggressiveness, hallucinations and panic states. It may also result in irregular heart beats, hypertension or hypotension, even circulatory collapse. Gastrointestinal symptoms include nausea, vomiting, diarrhea, and abdominal cramps. Fatigue and depression usually follow this state of over-stimulation.

Fatal poisoning usually terminates in convulsions and coma.

In the event of a suspected overdose, medical attention needs to be sought. Depending on the severity of the reaction, admission for observation, sedation and intravenous therapy for elevated blood pressure may be required.

Accomplia targets the endocannabinoid system, which controls appetite and energy expenditure (as well as the urge to smoke). People who tend to overeat often have an over-stimulated endocannabinoid system. Accomplia blocks some receptors in the endocannabinoid system, giving it better balance, which in turn curbs appetite and the urge to overeat.

The French company Sanofi-Synthelabo is the creator of Accomplia, which it intends to market in the United States by as early as 2006 and possibly sooner in Europe. The drug has undergone thorough testing, with the first animal study conducted by the National Institute of Health in in 2001. In that study, genetically altered mice that lacked cannabinoid receptors were found to eat less than mice with an intact endocannabinoid system. The normal mice were then given Accomplia, and their food intake significantly decreased as well.

Human testing of Accomplia began in 2002. In one study, more than 1500 people participated in a trial in which they received either 5 mg per day of Accomplia, 20 mg per day of Accomplia or a placebo.

All of the participants began the study with a body mass index that classified them as obese, as well as high levels of blood fat, high blood pressure or both. Though approximately one third of participants dropped out of the study due to Accomplia side effects, the results support the claim that Accomplia is an effective weight loss medication.

After a year, more than 67 percent of those given a 20 mg dose of Accomplia had lost at least 5% of their original body weight, with 39% losing 10% of that weight or more. Those taking 5 mg doses of Accomplia lost more weight than those taking a placebo, but less weight than those taking 20 mg of the drug.

Another study reported by the American Heart Association included more than 3000 participants. The study showed that people who took Accomplia not only lost weight but showed lower levels of cholesterol, blood sugar and blood pressure, indicating that Accomplia may have the potential to replace other medications used to treat high blood pressure, high cholesterol and diabetes.

Time will tell whether the results of studies conducted on Accomplia are significant. Diet and exercise will likely always play a part in the battle against obesity, and it is possible that the 5-10% weight loss achieved in a year’s time by people using Accomplia can occur without the use of any medication, which always has the risk of side effects.

Accomplia side effects include gastrointestinal discomfort and dizziness. Mood disorders and headaches may be side effects as well. In general, Accomplia side effects seem to subside once adjustment to the drug is made.

Side effects also appear to be fewer and less severe than those of many other weight loss medications on the market. Accomplia, then, shows promise due to its relatively low incidence of side effects, as well as its positive effects on weight loss and its apparent ability to maintain healthy blood pressure, blood sugar and cholesterol levels.

With an increase incidence of abnormal weight gain and associated metabolic disorders (i.e., type II diabetes and cardiovascular diseases), the need for newer therapeutic strategies to stem this epidemic continues to grow.

The most common drugs used in the management of obesity are appetite suppressants (eg, Phentermine). These drugs are only effective for short term weight loss, and have plenty of side effects to go along with them.

Thus, a long standing wish of obesity drug researchers has been the quest for an effective, natural substance with fewer sideeffects.

Researchers though they’d found the holy grail with leptin, an adipocyte-derived hormone. However, despite initial successes with leptin on both patients and animals, further studies failed to confirm its effectiveness — largely due to the patents’ development of resistance to its action.

This observation was further confounded by the high levels of natural leptin documented in overweight individuals. This ineffectiveness of endogenous leptin was due to the development of leptin resistance, and leptin even at very high concentrations is ineffective in reducing the body weight of clinically obese patients.

And so the quest continued.

As with so many things, it was blind luck that lead researchers to the next “holy grail”. During experiments on animals with motor neuron disease, a chemical called ciliary neurotrophic factor (AXOKINE), was found to cause profound weight loss.

Axokine was found to act on the feeding center in the hypothalamic area of the brain — as did leptin. Further research in this field has shown that Axokine induced weight loss was via mechanism similar to that of leptin. Both have been found to activate similar molecular pathways resulting in weight loss. This explains why the weight-reducing effects of Axokine are free of side effects. Axokine differs from leptin in that it does not appear to normally play a physiologic role in weight control.

Axokine diet pills have been found to be effective in leptin resistant, diet induced obesity — similar to that of human obesity. Axokine has been found to suppress food intake without triggering hunger or associated stress responses associated with food deprivation. Thus, unlike forced dieting or other treatments for obesity, Aoxkine treatment lowers the weight set point of the body in the hypothalamic area of the brain. Best of all, Cessation of Axokine administration does not result in a spree of overeating and immediate rebound weight gain.

At 0.1 mg/kg/day Axokine produced a marked reduction in food intake and bodyweight. Improvement in insulin levels and fat metabolism was also seen in the animal models. There was no increase in circulating levels of certain steroids on therapy with Axokine, indicating that the therapy was not stressful.

Compare this to the steroid response to forced dieting. Forced dieting increases circulating steroids resulting in muscle wasting, weak bones and other unwanted effects. Therefore Axokine is unique in its ability to produce weight loss at physiological levels through a leptin-like mechanism, in situations were leptin itself is not effective and axokine diet pills do this without inducing a stressful response.

However, in the same animal models, at supra-physiological doses AXOKINE was associated with a significant elevation in steroid levels and a decrease in spontaneous motor activity. The weight loss was very rapid and severe (33% of body weight within 7 days) resulting in significant loss of lean body mass.

Even at such high doses, the muscle wasting seen with Axokine was much lower than would have been seen following equivalent levels of food deprivation. Research has demonstrated that enforced food-restriction activates hunger signals that make compliance with any diet difficult. Treatment with Axokine produces the same degree of weight loss without activating the hunger center and the person doesn’t even realize that he is dieting.

It should be noted that though Axokine diet pills are free of adverse effects at physiological levels, severe muscle wasting may be produced at higher doses. Recent reviews on Axokine has suggested that it ran into some problems during phase III clinical trials.

The patients developed antibodies to Axokine, which resulted in drug resistance and decreased effectiveness. Further reports are awaited. Even though research involving Axokine in the management of obesity is still in its infancy, it gives all of us a hope for a novel and side effect free treatment for obesity.

One set of side effects are a result of its stimulatory action on the sympathetic nervous system. These include restlessness, sleeplessness, tremors, headaches, dizziness, blurring of vision. This may result in elevated blood pressure and an increased heart rate. If that weren’t enough, there are other related side effects as well. These include dryness of the mouth, nausea, diarrhea constipation, stomach pain, increased urination and changes in sexual drive. .

The second mechanism that results in Bontril side effects is the hypersensitivity that some patients have to this drug. Such an allergic reaction can manifest itself as itching, rash, blebs or swelling of the lips and eyelids. Such symptoms warrant an immediate termination of drug therapy. Continued therapy in such an individual experiencing such side effects can lead to anaphylactic shock and respiratory arrest.

Drug abuse:

Abuse of amphetamines and related drugs like Bontril may be associated with intense psychological dependence and severe social dysfunction. Signs suggestive of abuse include skin changes, irritability, hyperactivity, aggressiveness and personality changes. Prolonged use of Bontril diet pills at doses much higher than therapeutic recommendations have led to psychosis not unlike that seen in Schizophrenia.

Overdose:

An acute overdosae of the drug will result in symptoms like: unusual restlessness, confusion, belligerence, hallucinations, and panic states. Fatigue and depression usually follow the central stimulation. It may also result in…

i) very low blood pressure or very high blood pressure

ii) nausea

iii) vomiting

iv) diarrhea

v) abdominal cramps.

Poisoning may result in convulsions, coma, and death. The management of a Bontrol overdose is largely symptomatic. It includes hospitalization with intravenous sedation. If hypertension is marked, the use of a powerful anti-hypertensive may be administered under cardiovascular monitoring. There is no specific antidote or modality available to remove the drug from the system.

How does Bontril work?

The action of Bontril diet pills is very similar to that of amphetamines, which act upon the brain to stimulate the sympathetic nervous system. It is believed that the appetite suppression seen with this type of drug results from a combination of this central action and other unknown effects on metabolism. Because of its ability to surpress appetite, Bontril is known as an “anorexiant.”

Bontril may be prescibed by a physician if a patient has failed to make progress on a conventional diet and exercise program, and the cause of obesity has been determined to be exogenous (related to eating behavior) with no underlying hormonal or metabolic abnormality.

Bontril treatment guidelines:

Bontril diet pills are prescribed in 35 mg increments, distributed over 12 hours. The maximum permissible dose is 70 mg three times a day. The drug should be taken 1 or 2 hours prior to a meal. Late evening dosing should be avoided for fear of causing insomnia at night. The lowest possible amount of drug should be prescribed since this class of drug has a very narrow safety margin.

Therapy with Bontril diet pills should be re-evaluated at the end of 4 week period.If the patient has lost less than 2 kg/4.5 lbs., then Bontril may not be the ideal treatment — either the dose should be increased or a different drug should be used.

This drug should not be used beyond a 3 month period for two reasons…

One, the body develops tolerance to its appetite suppressing effects and would fail to respond even to increased doses. The other is the absence of clear documentation regarding effectiveness and safety of the drug beyond a 12 week period.

Contraindications:

Bontril diet pills are not to be used in people…

i) with known allergic reactions to this class of drugs (the sympathomimetics).

ii) suffering from advanced arteriosclerosis, heart disease, moderate to severe hypertension, thyroid abnormalities & glaucoma

iii) with a past history of drug dependence or abuse (as with all centrally acting stimulants, Bontril diet pills have a potential for abuse)

iv) who use drugs that act on the brain or the heart and blood vessels. Such combinations may can alter the magnitude of each individual drug’s response and can also aggravate the underlying disease.

v) under 12 years of age.

Precautions:

As Bontril diet pills can elevate the blood pressure, caution is has to be exercised in prescribing for patients with even mild hypertension. It may also interfere with the action of other anti-hypertensive medications — Guanethidine is a good example.

In patients with diabetes, the insulin requirements and the concomitant dietary regimen may be altered in association with the use of the drug.

Bontril diet pills are not be taken by women who are, or may become pregnant. The exception to this? If the opinion of the physician is that the potential benefits outweight the possible hazards.

The body develops tolerance to the weight loss effects of Bontril diet pills within a few weeks. The recommended dosage should never be exceeded in an attempt to increase the effect. Instead, drug therapy needs to be stopped. Increasing the dose at this point will only broaden the spectrum of its side effects.

Abrupt cessation following high-dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep pattern. It is recommended therefore, that the dosage be “tapered off” over time.

Patients on this drug are to be cautioned against operating machinery or driving a motor vehicle.

These drugs have never really been tested over long durations of time. Most scientific data that is available is limited to short term studies of 3-4 months. Therefore it is very hard to say whether dietary pills like Didrex are actually worth taking – do they actually provide enough benefits, given all the risks that go along with them?

The drug is known to increase blood pressure & heart rate, cause restlessness, dizziness, sleeplessness, headache, depression, skin rashes, and changes in sexual performance. A Didrex diet pill is therefore generally taken in the morning when its CNS (central nervous system) stimulatory effects are going to be the least disruptive. It may also result in dryness of the mouth.

Abuse of Didrex diet pills is associated with intense psychological dependence and severe social dysfunction as side effects. With addiction as a side effect, the use of Didrex diet pills in persons with a previous history of drug abuse is not recommended. Reports show that abuse of Didrex has lead to skin diseases, sleeplessness, irritability, overactivity, and personality changes. The most severe manifestation of chronic abuse is an extreme psychosis that resembles schizophrenia.

The recommended dosage should not be exceeded in an attempt to increase the effectiveness of the drug as it becomes less effective. In most cases treatment needs to be stopped. Realize that this class of drug, irrespective of the dose, only works for a short duration (generally 3-4 weeks) before the body develops tolerance to it.

Getting off Didrex diet pills can be tricky -abrupt stoppage after long duration of treatment often results in tiredness and mental depression. A gradual tapering off of the dosage is recommended.

How does Didrex work?

Diet pills like Didrex that are used in treatment of obesity usually work by suppressing the appetite, but this has not been proven to be the mode of action of this drug. Didrex has a central nervous system stimulating action which may also elevate blood pressure. Continuous usage of the drug may result in tolerance, decreasing its efficacy.

Generally, it has been found that obese adults treated with weight reducing drugs show greater effect in loosing weight when the consumption of the drug is coupled with dietary restrictions. The effect of a single dose of Didrex lasts for about 12-14 hours.

Didrex treatment guidelines:

Didrex should not be used in patients suffering from advanced vessel wall thickening, high blood pressure, diseases of the thyroid gland, and in people with a known allergy to this class of drugs. Simultaneous use of two drugs that act on the central nervous system should be avoided. These drugs should not be used with or within 14 days of use of certain anti-depressants (MAO inhibitors). A side effect of both Didrex diet pills and MAO anti-depressants is hypertension. Thus, a combination of the two may result in a very high increase in blood pressure.

Didrex is not to be used with other CNS stimulants. The safety profile of Didrex has not been studied in growing children, pregnant and nursing mothers. The use of these diet pills is therefore not recommended among pregnant women and young children (less than 16 years).

Special note: A contraceptive is generally advisable when women of child-bearing age are taking this drug to protect against inadvertent pregnancies. Nursing mothers taking this drug should be advised to refrain from breast feeding the baby, as the drug is found to be excreted in human milk.

Insulin requirements and the dietary restrictions for those with diabetes may need to be altered in association with use of anorexigenic drugs. Psychiatric problems and disturbances have been reported in patients who receive a weight reducing drug together with a restricted diet.

Caution is the word when prescribing this group of drug to patients with mild hypertension, as it may further elevate blood pressure. Only the least amount feasible should be prescribed. Patients on this drug need to avoid activities such as operating machinery or driving a motor vehicle.

Didrex overdose symptoms:

Acute overdose with Didrex may result in restlessness, tremor, increase in the breathing rate, confusion, and panic states. It may also result in lowered blood pressure or increased blood pressure, irregular heart beats, nausea, vomiting, diarrhea, and abdominal pain. An overdose of Didrex diet pills may require hospitalization, observation, sedation and intravenous therapy to control the hypertension that may be present.

Fatal poisoning is usually preceded by involuntary muscle contractions and long periods of unconsciousness.

Side effects of Ionamine diet pills are significant. On the one hand, the stimulatory action of the drug can cause complications. Then there are issues related to allergic reactions, drug interactions, overdose and drug abuse. All relevant guidelines need to be kept in mind and therapy should be closely monitored by a qualified physician.

Ionamin’s excitation of the sympathetic nervous system affects almost every organ in the human body.

At doses bordering on tolerance levels, hyper-stimulation of the cardiovascular system can produce uneasy and discomforting heart rhythms or heart rates, and high blood pressure. At higher dosages, side effects include restlessness, sleeplessness, irritability, tremors and headache. The normal motility of the gut and the urinary bladder can also be disrupted. This can lead to diarrhea, constipation, urinary frequency, painful urination and changes in libido.

Ionamine diet pills should only be used after accounting for all the possible interactions with the other drugs that a person might be taking. Unnecessary side effects arising out of drug incompatibility and interactions can thus be prevented.

The efficacy of anti-hypertensive drugs can be reduced, while the effect of diabetic drugs is enhanced while on Ionamine therapy. Appropriate dose adjustments may be necessary. Other drugs that act on the brain can cuase problems when taken in conjunction with Ionamine. Being a central nervous stimulant, Ionamine can enhance the effects of other stimulants and anti-depressants.

Simultaneous use with anti-depressants called SSRI’s is not recommended as host of cardiovascular side effects can result. For unknown reasons, this combination of drugs makes the blood vessels in the lungs and the inner lining of the heart very stiff. The blood circulation in the lungs and the flow through the heart is disrupted, leading to inefficient blood distribution through both these organs.

Another group of centrally acting drugs that interact with Ionamine are Monoamine Oxidase Inhibitors (MOA). These should never be taken together, or within 14 days of each other.

The third type of problem that arises with Ionamine is the rare but serious hypersensitivity to the drug. Symptoms start with itching, rash, transient blebs, swelling of the lips and eyelids.

Discontinuation of therapy and symptomatic treatment should be resorted to in such cases.

The last consideration is the potential for drug dependence. This is a complex problem. Due consideration should be given to any psychological, social and past medical history that indicates any potential for abuse prior to starting therapy. Ionamine diet pills are also unsuitable for persons with suspected eating disorders (i.e., Bulimia and Anorexia nervosa), where there are pre-existing problems of starvation and malnourishment.

Keeping this discussion in mind, Ionamine diet pills should be taken under medical supervision, and only if the appropriate clinical indications and situations exist for their use. Suitable adjustments must be made for any pre-existing medical condition — like hypertension, diabetes mellitus, drug abuse, anxiety and current medications.

How does Ionamin work?

Diet pills like Ionamin stimulate the sympathetic nervous system through the central nervous system or the brain. It is believed that the stimulation of the satiety centre and some unknown metabolic effects enable Ionamin diet pills to curb hunger and reduce food intake.

Ionamin is most appropriate where compulsive eating behavior is the cause of obesity or the obesity is exogenous (caused by external sources). Endogenous causes of obesity like endocrine abnormalities or enzyme defects in metabolism are not amenable to this therapy and therefore need to be ruled out prior to initiating treatment.

The effects of the drug are immediate and last for 12 to 14 hours. Information on Ionamin suggests that in comparison to a placebo, these diet pills produce weight loss in excess of 2-8 kgs over a period of 3 months. This only happens provided appropriate lifestyle, behavioral and nutritional modifications are in place. Given the safety profile of Ionamin diet pills, the smallest effective dose of the drug should be ascertained and used in each individual.

An important aspect of obesity treatment with Ionamin diet pills is the phenomenon of tolerance. After 2 to 3 months of therapy the drug slowly stops working as the body tends to return to normal metabolism. This effect is seen with all drugs belonging to this class.

It is important that at the end of 3 months the dose should not be increased in an attempt to achieve further weight loss. Higher doses will not facilitate greater effectiveness. Instead the extra drug may start acting at new receptors and tissues, broadening its spectrum of side effects.

The drug has no effect on the body weight during the drug maintenance phase. This is one of the disadvantages of the “anorexiants” class of drugs. The person has to solely depend on diet and activity modification to sustain the weight loss realized after 3 months of drug therapy.

There are well-defined indications for pharmacological treatment of obesity with Ionamine diet pills. An initial Body Mass Index of 30kg/m2 (or a BMI of 27 kg/m2 along with other risk factors like hypertension, coronary artery disease, diabetes or hyperlipidemia is required) is a pre-requisite to consider drug treatment for obesity. It is believed that the incidence of diseases at this level of BMI justifies the risk of pharmacological therapy to produce weight loss.

Note: Body Mass Index is calculated as so… BMI=weight(kg)/ [height(m)2. You can use this online BMI calculator to determine yours!

Treatment Guidelines:

Weight reduction should always start off with lifestyle, diet and behavioral modifications for a period of 6 months. If the average weight loss during this therapy has been less than 1 lb. /month in the absence of other complicating diseases, then a diet pill like Ionamin can be started (at the lowest dose possible and under medical supervision). The treatment goal of drug therapy is a weight loss of 5-10 % of the initial body weight over a period of 6-12 months.

After treatment begins, the individual is then closely monitored for side effects and weight loss for a period of 4 weeks, at which point treatment is re-evaluated.

If weight loss of more than 2 kgs/4.5 lbs. is recorded at this point, clinical trials and research information on Ionamine suggests that a full course of therapy will be useful. If the person does not achieve this target weight loss after a month on Ionamine diet pills, then further treatment with this drug is unlikely to provide any benefit and probably needs to be discontinued.

According to FDA recommendations, the drug should not be continued for durations longer than 3 months. There are no long term studies that document the effectiveness and safety of Ionamine diet pills beyond this duration.

The drug dose varies between 8mg to 37.5 mg depending on the individual response. The lowest effective dose is recommended. Ionamine is taken two hours after breakfast in the morning so that its stimulatory effects do not result in insomnia. The effect of a single dose lasts for about 12 to 14 hours.

Once a certain dose has been found to be effective, no alteration in drug dosing is recommended. The efficacy of the drug tapers off within 3 months at which time it should be gradually tapered off and then stopped. A hasty withdrawal of this central nervous system stimulant can throw the body off. Extreme fatigue, depression and changes in awake/sleep patterns can result from such an abrupt termination of therapy.

The drug is not recommended during pregnancy and breast feeding. It should also be avoided in children under 12 years old and in the elderly. Ionamine and other nor-adrenergic stimulant anorexiants interact with numerous medical conditions and drugs. There is a potential for permanent harm with inappropriate use of this drug and therefore, it should always been taken under the supervision and monitoring of a medical practitioner.

Ionamine diet pills and other drugs in this class are very similar to amphetamines and derive their abuse potential from the same properties. Use of these drugs, especially in individuals with a past history of drug abuse can lead to psychological dependence. Sleeplessness, irritablility and hyperactivity have all been attributed to Ionamin. Severe forms of psychosis, not different from schizophrenia, have been recorded after chronic abuse of high doses of Ionamine.

The most serious side effect of Meridia is an increase in the blood pressure and/or the heart rate, seen in 2.1 to 2.6% of people on the medication. Meridia was removed from the market in Italy after 50 adverse events and 2 deaths were attributed to its use.

However, in the majority of individuals, the increase is of little clinical significance. Only 0.4 % of people initiated on Meridia diet pills required cessation of therapy because of this complication. To exclude this possibility, pre-existing heart disease should be ruled out prior to starting therapy.

During the course of drug administration, cardiovascular parameters should be watched closely for abnormally sustained stimulation. A dose reduction from 10 mg to 5 mg is justified in case of a persistent increase in heart rate and blood pressure. If the effect persists after dose reduction, the drug might have to be discontinued.

Other individuals who exhibit allergic side effects like itching, rashes, blebs, swelling of the eyelids or lips are not suitable for continuation of the drug.

Simultaneous use of this drug along with other centrally acting or cardiovascular drugs can lead to a widening of the spectrum of side effects and should be avoided. For the same reason, use of other weight loss drugs along with Meridia is not advisable. Use of Meridia diet pills in people with eating disorders like anorexia nervosa or bulimia will exacerbate the nutritional side-effects seen in these populations and re-enforces abnormal behavior.

Other side effects of Meridia involving the digestive, musculoskeletal, respiratory system and other organ systems are rarely seen.