Anorectic


 * Note: "Anorectic" is also a term for an anorexic person; a person suffering from Anorexia nervosa

Overview
Anorectics, anorexigenics or appetite suppressants are drugs that reduce the appetite ("anorectic", from the Greek an- = "not" and oreg- = "extend, reach").

History and initial uses
Used on a short term basis clinically to treat obesity, some appetite suppressants are also available over the counter. Drugs of this class are frequently stimulants of the phenethylamine family, related to amphetamine (speed).

The German military experimented with issuing amphetamines to soldiers in 1945, when food supplies were very short in Germany. Following the Second World War, amphetamines were re-directed for use on the civilian market. Indeed, amphetamine itself was sold commercially as an appetite suppressant until it was outlawed in most parts of the world in the late 1950s due to increased recreational use. Many amphetamines produce side effects including addiction, tachycardia and hypertension, making prolonged unsupervised use dangerous.

Many people who obtain these drugs are more interested in the amphetamine-like stimulant effects than weight loss. In those cases, it is important to make sure to keep forcing oneself to eat even when it is undesirable.

Public health concerns
Epidemics of fatal pulmonary hypertension and heart valve damage associated with anorectic agents have led to the withdrawal of products from the market. This was the case with aminorex in the 1960s, and again in the 1990s with fenfluramine (see: Fen-phen). Likewise, association of the related appetite suppressant phenylpropanolamine with hemorrhagic stroke led the Food and Drug Administration (FDA) to request its withdrawal from the market in the United States in 2000, and similar concerns regarding ephedrine resulted in an FDA ban on its inclusion in dietary supplements, in 2004 (a Federal judge later overturned this ban in 2005 during a challenge by supplement maker Nutraceuticals.)

Currently marketed appetite suppressants
In spite of these precedents, numerous compounds are marketed today as appetite suppressants.

The following are listed as "centrally acting antiobesity preparations" by ATC:


 * Phentermine (Fastin®, Adipex®, Ionamin® and others)
 * Diethylpropion (Tenuate®)
 * Sibutramine (Meridia®, Reductil®)
 * Rimonabant (Acomplia®)

The following are listed as appetite depressants by MeSH.
 * benfluorex
 * butenolide
 * diethylpropion
 * FG 7142
 * norpseudoephedrine
 * phenmetrazine
 * phentermine
 * phenylpropanolamine
 * pyroglutamyl-histidyl-glycine
 * sibutramine

Other compounds marked as appetite suppressants include:
 * Phendimetrazine (Prelu-2®, Bontril®)
 * Benzphetamine (Didrex®)
 * Oxyntomodulin
 * Methylphenidate (Concerta) (Ritalin®)
 * Phenylethylamine (Trimspa®)