Some science behind the scenes

Obesity drugs other [reuptake inhibitors]

 

The following lists the main anorectic drugs. As you will see, on the whole, this class of drugs does not give people hallucinations, because they are stimulants. Where hallucinations have been experiences it is through overdose and in effect delirium or if you prefer poisoning. 

Dopamine reuptake inhibitor

  • Difemetorex (Cleofil, diphemethoxidine), was used as an appetite suppressant, but produced “intolerable side effects such as insomnia” which limited its clinical use.
  • Fencamfamine (Glucoenergan, Reactivan) - is an appetite suppressant, but was later withdrawn for this application due to problems with dependence and abuse. It is around half the potency of dextroamphetamine, although abusers of the drug tend to rapidly develop tolerance and escalate their dose. Reactivan is still used, though rarely, for 'treating depressive day-time fatigue, lack of concentration and lethargy'. Some experiments also suggest a role for opioid receptors in the activity of fencamfamine, as low doses can cause paradoxical sedation, and some effects of the drug are blocked by naloxone
  • Levophacetoperane (Lidepran) is a psychostimulant which has been used as an antidepressant and anorectic It is the reverse ester of methylphenidate.

 Norepinephrine-dopamine reuptake inhibitor (NDRI)

  • Ciclazindol (WY-23,409) is an antidepressant and anorectic drug of the tetracyclic chemical class that was developed in the mid to late 1970s, but was never marketed. It acts as a norepinephrine reuptake inhibitor, and to a lesser extent as a dopamine reuptake inhibitor. Ciclazindol has weak affinity for the H1 receptor. As suggested by its local anaesthetic properties, ciclazindol may also inhibit sodium channels. It is known to block potassium channels as well
  • Manifaxine (GW-320,659) is a drug developed by structural modification of radafaxine, the active metabolite of bupropion. It was researched for treatment of ADHD and obesity . Its current status is unclear
  • Pipradrol ("Meratran") is a norepinephrine-dopamine reuptake inhibitor that is no longer widely used in most countries due to concerns about its abuse potential. It was developed in the 1950s and was used for treating obesity, narcolepsy, ADHD, and the symptoms of senile dementia, this being the only application for which it is still used medically. Pipradrol was made illegal in many countries in the late 1970s, at the same time as many other drugs which had a history of abuse. Side effects include insomnia, anorexia, tachycardia, anxiety, dry mouth, tremor, hypertension, depression, and very rarely psychosis or convulsions.

Serotonin-norepinephrine-dopamine reuptake inhibitor (SNDRI)

Cocaine is a dopamine transporter and norepinephrine transporter blocker that competitively inhibits dopamine uptake to increase the lifetime of dopamine and augments an overabundance of dopamine (an increase of up to 150 percent) within the parameters of the dopamine neurotransmitters.

Thus anorectics come within the same overall class of drugs as cocaine

Others

  • Tesofensine (NS2330) is a serotonin–noradrenaline–dopamine reuptake inhibitor being developed for the treatment of obesity. The right to develop and market tesofensine is held by NeuroSearch, a Danish pharmaceutical company