CHLORPHENTERMINE S.A. IN THE TREATMENT OF OBESITY AND THE EFFECT OF WEIGHT LOSS ON STEROID EXCRETION.

Abstract

A number of trials have been undertaken to test the efficacy of chlorphentermine (l-(p-chlorophenyl)-2-methyl 2-amino propane hydrochloride ; Lucofen) as an anorectic agent, and it has been shown to be superior to placebo (Lucey and Hadden, 1962 ; Levin et al., 1963). Recently a sustained-action chlor phentermine (chlorphentermine S.A.) has become available and has been used by Seaton et al. (1964) in a group of patients with refractory as defined by Duncan et al. (1960). Their results showed a small but significant loss of weight after six weeks by patients on chlorphentermine S.A. compared with those on a dummy preparation, but thereafter the loss of weight was not significant. For many obese patients the difficulties in losing weight by adherence to low-calorie diets are immense, and the availability of a drug which can act as an appetite suppressant would theoretically seem of advantage in such cases. In practice the anorectic agents, most of which are derived from amphetamine, have not only proved disappointing in the management of obesity but have also produced serious side-effects, including habituation and addiction (Kiloh and Brandon, 1962). Modell (1960) has suggested that the anorexigenic action of the amphetamines is closely related to their cortical excitatory action, a fact which probably accounts for their addictive quali ties. Chlorphentermine differs chemically from amphetamine (see Formulae) and appears to be metabolized differently, prob ably owing to the para-chloro substitution ; certainly neither in experimental animals (Holm et al., 1960) nor in therapeutic dosage in clinical practice (Levin et al., 1963) has chlorphentermine been reported to produce cortical stimulation.