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Other Prescription Weight-Loss Drugs
There are just two weight loss drugs, Xenical and Meridia, that are currently have approval for long-term use in the United States. The FDA is also considering approval of Acomplia.
Any other drugs all are recommended for short-term use. Patients should read the description of the side-effects and risks so they understand what they are.
Acomplia or Rimonabant
Blocks CB1 receptor in Endocannabinoid System, thought to play a critical role in regulation of food intake and physical energy.
Xenical or Orlistat
Active in the intestines and blocks the fat people eat from being absorbed as it's digested.
Meridia or Sibutramine
Decreases appetiite by inhibiting the re-uptake of serotonin, norepinephrine, and brain dopamine.
Ionamin or Phentermine
Activates central nervous system, increasing the heart rate and blood pressure and lessens appetite
Adipex-P or Phentermine
Energizes central nervous system, upping heart rate and blood pressure and decreasing desire for food
Bontril or Phendimetrazine
Boosts central nervous system, drives heart rate and blood pressure and does the reverse for appetite
Didrex or Benzphetamine
Powers central nervous system, increasing the rate of the heart and increases blood pressure while decreasing appetite
Tenuate or diethylpropion
Charges the central nervous system, reving heart rate, ups patient blood pressure and kills the appetite
Diet Drugs, Weight Loss Drugs Beingr Developed
APD356
Arena Pharmaceuticals
serotonin 5-HT2C receptor agonist
Acomplia
Sanofi-Aventis
cannabinoid CB1 receptor antagonist
CP-945598
Pfizer
cannabinoid CB1 receptor antagonist
Peptide YY3-36
Nastech/Merck
satiety
Peptide YY3-36
Amylin Pharmaceuticals
satiety
Simlyn
Amylin Pharmaceuticals
diabetes drug
AMG076
Amgen
MCHR1 receptor antagonist
823093
GlaxoSmithKline
dipeptidyl peptidase (DPP)-IV inhibitor
Vildagliptin (LAF237)
Novartis
dipeptidyl peptidase (DPP)-IV inhibitor
Sitagliptin (MK-0431)
Merck
dipeptidyl peptidase (DPP)-IV inhibitor
Saxagliptin
Bristol-Myers Squibb
dipeptidyl peptidase (DPP)-IV inhibitor
PSN9301
OSI Pharmaceuticals
dipeptidyl peptidase (DPP)-IV inhibitor
CYT009-GhrQb
Cytos Biotechnology
vaccine induces antibodies against ghrelin
Ro27-3225
Roche
melanocortin-4 agonist
AOD9604
Metabolic Pharmaceuticals
peptide that increases fat metabolism
ATL-962
Alizyme/Takeda
inhibitor of gastrointestinal lipases
Serotonin could be a key in regulating body weight
By Lee Bowman
SCRIPPS HOWARD NEWS SERVICE
Tucson, Arizona - 07.20.2006 - The brain chemical serotonin activates some cells that curb appetite and blocks others that normally increase hunger at the same time, according to a new study into the effects of several weight-loss drugs.
Working with mice, researchers from several institutions sought to learn whether serotonin acts on specific brain circuits in the hypothalamus region that are known to regulate the body's energy balance.
Their tracer experiments showed that receptors for serotonin dot specific nerve cells within these circuits. And they found that both serotonin and drugs such as fenfluramine and sibutramine (Meridia), which change levels of serotonin, act on those brain cells to reduce the release of one protein that stimulates appetite and aids the release of another protein that helps curb the desire to eat.
The findings, published today in the journal Neuron, reinforce the role of serotonin in affecting a key molecular pathway that controls weight, in addition to its better-known function as a regulator of sleep, mood and emotions.
Fenfluramine with phentermine, known as fen-phen, helped tens of thousands of people lose weight. But the combination was also linked to heart problems, including defects in the valves of the heart or a form of hypertension, in many patients. It was removed from the market in 1997. The mechanisms of how the drugs caused weight loss never were fully determined.
Researchers led by Dr. Joel Elmquist, then at Harvard Medical School and now at the University of Texas Southwestern Medical Center in Dallas, began studying those molecular pathways that reduce appetite, working with both normal mice and those genetically engineered to be lean or fat.
In 2002, they found that drug-induced serotonin releases activate brain cells to, in turn, release a hormone that reduces appetite.
The team's new study shows how serotonin also simultaneously blocks other neurons from being able to inhibit the activity of the hunger-suppressing system, and concluded that both mechanisms are required to promote weight loss.
"The more we understand about the pathways and the way serotonergic drugs regulate body weight, the more it one day might lead to harnessing the beneficial properties of anti-obesity treatments like fen-phen and minimizing the harmful side effects," said Elmquist, a professor of internal medicine at UT Southwestern.
According to the U.S. Centers for Disease Control and Prevention, about two-thirds of American adults are overweight, as are 16 percent of those from 6 to 19 years old. Being overweight or obese increases the risk of many harmful health conditions, including heart disease, stroke, diabetes and liver disease.
On the Net: Learn more about the findings at www.neuron.org
Life? It isn't all about navel-gazing
Western Mail
Mar 31 2007 - So says Yvonne Davies, a woman who has battled the odds after a double lung transplant. Cameras follow her as she fulfils seven wishes for herself while she still has time on her side
SEARCH the internet and you'll find no end of crazy things to do before you die. But for Yvonne Davies from Rhydymain, near Dolgellau, wish fulfilment is a serious matter - she's already lived well beyond all expectations and shocked the medical world.
In the S4C show O'r Galon: Saith Peth (From the Heart: Seven Things), Yvonne, who had a double lung transplant 15 years ago, finally realises the seven things she wants to do while time is still on her side, each one an uplifting and inspirational gift to herself.
Yvonne, aged 45, knew as a child that all was not well with her health. Unlike her twin sister, Thelma, she was always short of breath and unable to do things that children her age could normally do.
She was just 27 when she was told she had primary pulmonary hypertension and was then put on the waiting list for a double lung transplant.
She eventually had the transplant at Harefield Hospital in November 1991 and the world-famous surgeon who carried out the operation, Sir Magdi Yacoub is full of admiration for her.
He says, "Yvonne is typical of what transplantation can do. One of the special things about Yvonne is her love for life and her interpretation of life. She sees all the beauty and depth, all of what life means. She's like a model of how people should behave, how they make use of such a special thing - life - and her interpretation of life is just perfect."
For someone who's had a double lung transplant, Yvonne's first achievement on her list of seven is, perhaps, the most remarkable - she climbs to the top of Craig Ffynnon mountain, in the heart of the landscape in Rhydymain where she grew up.
Having left her job as a librarian, she has returned to her roots and divides her time between her caravan at Rhydymain, spending time with her elderly parents, Lloyd and Mari Davies in Dolgellau and with a friend, Lydia Barton in the Peak District.
Her own lungs had damaged her heart and the medication she's now on slows down her heartbeat.
Despite all this, she reaches the summit of Craig Ffynnon with her three dogs, having reduced her drug dosage for the day.
"I'd love to live life free of drugs but I have to be disciplined. A body that's had transplantation tries to reject the new organs daily," says Yvonne who has to take daily doses of tablets.
She admits that climbing to the summit of Craig Ffynnon might not have been wise but her reward is the remarkable view at the journey's end.
"It took me about two hours to reach the top. I had been dreading the thought of doing it with the cameras there. These days I only walk with people who go at the same pace as I do. In the past, seeing people's backs disappear into the distance tended to discourage me."
From the summit, she could look down on Rhydymain, on Llyn y Fign, the lake she used to think of as her personal "swimming pool" as a child, and even as far as Barmouth.
"Craig Ffynnon has been my anchor in many respects. In another sense, it has always symbolised my weakness. It was the sight I saw from the front door of our house in Rhydymain before my parents moved to the family farm."
The setting for realising her second ambition is quite different. She travels to London for a reunion with her twin sister, Thelma Coyle, a sports scientist, who lives with her husband and three children in Provence.
The two hadn't met for three years and they very quickly get down to some of the things sisters do when they get together - chat, shop and drink a toast to the future.
Mixing socially, travelling and being in crowded places all have a risk for those who've had lung transplants so even a decision to go on a trip to London can't be made lightly.
"My sister and I have different lifestyles. I can't mix socially in quite the same way she does but that doesn't concern me. No doubt, the transplantation has changed my life but I've never wanted a hectic social life, even before my operation. My routine is quite simple.
"I don't believe I have to go out and prove myself."
Ambition number three is to regain some confidence on horseback.
During her college days, Yvonne fell from a horse and so she takes some lessons to recover her nerve - a fall this time around could be disastrous but all ends well and Yvonne appears to be a natural rider.
Medically, the balance of her life is always on something of a knife edge.
"However long you've lived after a transplant, nothing is as good as your own body," said Yvonne, who has to take antibiotics, steroids, heart tablets and immuno-suppressive drugs daily and has regular blood tests and return trips to Harefield.
"The natural balance of the body is brilliant. No tablets can give you that balance. The concoctions of drugs I take keep my body from rejecting the new lungs but they all have their side effects."
Yvonne's fourth wish involves another reunion. This time it's with the ambulance man, Aubrey Thomas, who rushed her to Harefield for her transplant.
He no longer drives an ambulance - quite the opposite, in fact. He now steers barges on the canal and Yvonne responds to his invitation to join him on a leisurely cruise along the waterway including crossing the Froncysyllte aqueduct, near Wrexham. They recall their life or death journey 15 years ago when Yvonne had to be rushed to Harefield within four hours in case the donated lungs deteriorated.
Before her transplant, Yvonne became a Roman Catholic and has derived much support from St Beuno's Ignatian Spirituality Centre at St Asaph. For her fifth wish, she re-visits St James' Roman Catholic Church in Spanish Place, London where she worshipped during frequent visits to London's Brompton Hospital for pre-op tests.
She worked as a librarian at the National Library in Aberystwyth and at libraries in Blaenau Ffestiniog, St Asaph and Rhuddlan before her transplantation. She had also been accepted for training as a deacon within the Bangor Diocese of the Church in Wales. Her sixth mission is to be reunited with all the friends she has made in the Jesuit community at St Beuno's.
"I have no children or a partner of my own but I love people and can love them at a deep level. I have learned the value of friendship and I have made friends I wouldn't have come to know were it not for my situation.
"Jesuits are very open and very good at working with people in their own situations. They help you understand that God does not impose himself but is with you where you are. Even when I was at Harefield for the transplant, knowing others were praying for me gave me strength."
While waiting for surgery, Yvonne started writing prayers and poems which she now sells to raise money for charity. One of her poems, Memory of Stars, was the inspiration for a musical first performed at the 2001 National Eisteddfod in Denbigh, Atgof o'r Ser, at which Bryn Terfel sang John Stoddart's translation of the poem set to a special musical composition by Robert Arwyn.
But she no longer writes poems saying, "I now use my energy to experience life. I'm building up memories and you don't do that by writing poetry, though I do like to read other people's poems. Life isn't about navel-gazing. I like to think I now live life in 3D. For me, yesterday is gone, tomorrow doesn't exist and I live for the present moment.
"I didn't expect to live a year. Fifteen years is great but I don't think in terms of 15 years. I think 'right I've got another day' and it builds up to 15 years. I love life and I've loved the life I've had since my transplant. I tend not to think 'why me?' but to value the life I've got." Secretly, Yvonne harbours an eighth ambition - one she hopes, more than anything, to realise before she dies. "I'm very proud of what grey hairs I've got," she adds, "and my greatest wish is to live to have a full head of grey hair."
O'r Galon: Saith Peth is on S4C at 9pm on Tuesday. English subtitles are available. Words by Eurgain Haf
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