期刊
AMERICAN JOURNAL OF THERAPEUTICS
卷 16, 期 4, 页码 354-364出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MJT.0b013e31817fde95
关键词
amphetamine; obesity; cardiac valve disease; fenfluramine; ephedrine; addiction
资金
- National Institutes of Health
- National Institute on Drug Abuse.
The prevalence of obesity in the United States is a major health problem associated with significant morbidity, mortality, and economic burden. Although obesity and drug addiction are typically considered distinct clinical entities, both diseases involve dysregulation of biogenic amine neuron systems in the brain. Thus, research efforts to develop medications for treating drug addiction can contribute insights into the pharmacotherapy for obesity. Here, we review the neurochemical mechanisms of selected stimulant medications used in the treatment of obesity and issues related to fenfluramine-associated cardiac valvulopathy. In particular, we discuss the evidence that cardiac valve disease involves activation of mitogenic serotonin 213 (5-HT2B) receptors by norfenfluramine, the major metabolite of fenfluramine. Advances in medication discovery suggest that novel molecular entities that target 2 different neurochemical mechanisms, that is, combination pharmacotherapy, will yield efficacious antiobesity medications with reduced adverse side effects.
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