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Re: Running out of med options... » lillabelle

Posted by SLS on May 26, 2003, at 10:25:23

In reply to Re: Running out of med options..., posted by lillabelle on May 26, 2003, at 3:54:03

> Because I live overseas in a country where stimulants are banned I resorted to ordering the diet pill ionomin from the net. Well, the ionomin (phentermine) caused a paranoid anxious reaction and now I have to stop taking it after one week of trying to ignore the anguish. My question to all you kind and caring people out there, is this. Is phentermine related to the other stims and therefore will I have a similiar anxious reaction to them?


Hi lillabelle.

Phentermine does not share all of the properties of psychostimulants (amphetamine, Adderall, Ritalin, Cylert, etc.) Phentermine causes the release of norepinephrine only. Psychostimulants affect the release or reuptake of dopamine in addition to norepinephrine. This seems to be critical in the modulation of reward mechanisms. Phentermine seems to be regionally specific to the hypothalamus. The psychostimulants affect other regions in the brain (limbic and cortical) associated with vigilance and reward. I don't think one can extrapolate how the psychostimulants will affect them based upon their reaction to phentermine.

The diet drug that most closely approximates the actions of typical antidepressants is the antiobesity drug, sibutramine (Meridia). It inhibits the reuptake of dopamine, serotonin, and norepinephrine. I think it was originally developed as an antidepressant. I guess it didn't show sufficient efficacy for depression to get it approved for that indication. However, I still have sibutramine on my list of drugs to try if nothing else works.


- Scott

 

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