Sibutramine (Meridia® in the USA, Reductil® in Europe), usually as sibutramide hydrochloride monohydrate, is an orally administered agent for the treatment of obesity. It is an anorectic (i.e. it decreases appetite) although it also has antidepressant properties. It was approved by the Food and Drug Administration (FDA) in November 1997 for the treatment of obesity.
Sibutramine acts by increasing serotonin and nor adrenaline levels in the brain. The serotonergic action, in particular, is thought to influence appetite. Recognized side-effects are dry mouth, headache, constipation and insomnia. It may increase the blood pressure, and is therefore contraindicated in patients with arterial hypertension, or others in whom a rise in blood pressure would be harmful (e.g. patients with angina). Pulmonary hypertension, a problem in some other anorectics, is not a recognized side-effect.
A study is ongoing into reports of sudden death, heart failure, renal failure and gastrointestinal problems. Despite petitions, the drug has not been banned by the FDA, but was part of a Senate hearing in 2005.
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