Anorectic drugs, or anorexiants, primarily act on the satiety center in the hypothalamus to suppress appetite, leading to anorexia (loss of appetite). These medications stimulate certain regions of the brain, particularly the hypothalamus and limbic system, which are responsible for controlling satiety and hunger. By altering neurotransmitter levels, such as increasing the release of norepinephrine and dopamine or modulating serotonin receptors, these drugs help reduce appetite and food intake.
In addition to their effects on appetite, anorectic drugs also have various metabolic effects. These effects involve the metabolism of fats and carbohydrates, which can include:
- Increased Lipolysis: Enhanced breakdown of fat stores for energy.
- Decreased Lipogenesis: Reduced formation of new fat.
- Improved Glycemic Control: Better regulation of blood sugar levels.
However, many of these metabolic effects are often secondary to the weight loss achieved through reduced calorie intake due to appetite suppression.
Here is a comprehensive list of anorectic drugs, with detailed information about each:
- Amphetamine – Commonly used in the treatment of ADHD under brand names like Adderall, it also acts as an appetite suppressant by increasing the levels of dopamine and norepinephrine in the brain, which helps reduce hunger.
- Benzphetamine (Didrex) – A central nervous system stimulant that suppresses appetite, used short-term as part of a weight loss regimen. It works by stimulating the release of norepinephrine and dopamine.
- Bupropion/Naltrexone (Contrave) – This combination drug targets multiple pathways involved in appetite regulation. Bupropion is an antidepressant that affects dopamine and norepinephrine levels, while naltrexone is an opioid antagonist that blocks opioid receptors involved in food reward.
- Diethylpropion (Tenuate) – A sympathomimetic amine similar to amphetamines, used short-term to aid weight loss by reducing appetite through the stimulation of the central nervous system.
- Lorcaserin (Belviq) – Acts on serotonin 2C receptors in the brain, helping to promote feelings of fullness and reduce food intake. It was withdrawn from the U.S. market due to concerns about an increased risk of cancer.
- Liraglutide (Saxenda) – A GLP-1 receptor agonist, initially developed for diabetes management, that helps control appetite and food intake by mimicking the GLP-1 hormone, which slows gastric emptying and promotes satiety.
- Methamphetamine (Desoxyn) – A potent central nervous system stimulant, approved for short-term use in the treatment of obesity. It suppresses appetite by increasing the levels of norepinephrine, dopamine, and serotonin in the brain.
- Orlistat (Alli, Xenical) – Unlike other anorectic drugs, Orlistat works by inhibiting the absorption of dietary fats in the intestines, which reduces overall calorie intake. It does not directly suppress appetite.
- Phendimetrazine (Bontril) – A stimulant that is used to reduce appetite as part of a short-term weight loss plan. It works by increasing the release of norepinephrine in the brain, which helps control hunger.
- Phentermine (Adipex-P, Lomaira) – A widely used appetite suppressant that stimulates the release of norepinephrine in the brain, which helps reduce hunger and increase energy expenditure.
- Phentermine/Topiramate (Qsymia) – Combines phentermine, a stimulant, with topiramate, an anticonvulsant, to help control appetite and promote weight loss. Topiramate may also reduce food cravings and increase feelings of fullness.
- Semaglutide (Wegovy) – A GLP-1 receptor agonist used for chronic weight management. It helps control appetite and food intake by mimicking the GLP-1 hormone, similar to liraglutide but with a different molecular structure.
- Setmelanotide (Imcivree) – Targets the melanocortin 4 receptor (MC4R) to regulate appetite and energy balance. It is specifically approved for certain genetic conditions that cause severe obesity.
Other drugs with anorectic properties include:
- Sibutramine – Was used to manage obesity by inhibiting the reuptake of serotonin, norepinephrine, and dopamine. Withdrawn from the U.S. market in 2010 due to cardiovascular risks.
- Mazindol – A stimulant with appetite-suppressing properties, similar to amphetamines.
- Phenmetrazine – Was used as an appetite suppressant but has been withdrawn in some countries due to the risk of addiction.
These drugs are typically prescribed as part of a comprehensive weight management plan that includes diet, exercise, and behavioral modifications.
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