DEXFENFLURAMINE (REDUX)

                                                       By:

                       

 Christina Yeonas
 

    One of the biggest goals Americans today set for themselves is to lose weight.  It is a quest which many seek out and never reach.  The twentieth century has brought about many changes in the world, but it has also brought about many self image problems.  With waif-thin models walking the runway, and anorexic fourteen year olds as our role models it is not a wonder. Many young and older women are feeling threatened to fit this particular image.

    Naturally, the lack in self confidence and esteem in these women has motivated doctors to new heights.  Women want to be thin, so we will get them there.  This is the mentality of many doctors;  it is also for some women.  Looking good has become such a goal for so many women that it outweighs the methods of getting there.

   The non-obese person maintains normal weight without drugs.  He/She experiences a sense of fullness which informs them when it is time to stop eating, simply stated- "I have had enough."  Studies, similar to one in Metabolism, have shown that these feelings of fullness occur when certain neuro transmitters in the brain, known as serotonin molecules, are released

    With the development of fenfluramine, or fen-phen,  and dexfenfluramine, more commonly known as Redux, many females have been reaching their aspirations. Many concerns have been raised, however, with the side-effects and risks of these weight loosing pills.

DEXFENFLURAMINE AND WHAT IT DOES:

  Dexfenfluramine , otherwise known as Redux, is an anti-obesity drug. It is compose of serotonin and dexfenfluramine hydrochloride.

    Redux is commonly taken by overweight people.  The primary task is to lessen the calorie intake related to an increased serotonin level in the brain.  This increases level provides the sense of satisfaction which obese people lack.  An increase in serotonin ( a hormone in the brain) eventually leads to weight loss.  The combination of a decrease in caloric intake along with the excess production of serotonin by redux is what causes some to lose body weight.  This redux treatment  is associated with a loss of appetite and may slow gastric emptying.

    In one clinical trial, redux demonstrated a reduction in carbohydrate consumption at meals and declined the crave to snack of high carbohydrate foods.  In another clinical study, those patients on redux, along with a reduced calorie diet produced a significant weight loss between the first four to six months.  Weight loss was apparent within the first four weeks of treatment.

    Patients who were priorly successful in losing at least ten pounds by some other method of weight lose resulted in a additional twenty-six percent of initial excess weight.

WHO IT IS FOR AND TYPICAL DOSAGE AND ADMINISTRATION:
 
    Redux is prescribed for obese people under the age of sixty.  Weight losers must currently on a reduced caloric diet.  It is recommended for those with a BMI (body mass index) greater than or equal to 30 kg/m2.

    The typical dosage is oral 15 mg pills taken twice a day with meals.

SIDE EFFECTS:
       Redux may cause potential drowsiness and fatigue.  It is also potent with the consumption of alcohol or any drugs.  The dosage should be reduced if reactions occur, such as nausea, vomiting, and diarrhea.

    Patients with any mental disorders (anorexia, bulimia, or depression) are not advised for treatment.

    Although dexfenfluramine has not been proven to cause any mutagenic activity, it is not advisable to take it during pregnancy.

    Because dexfenfluramine is an appetite suppressant, it has the same warnings as other suppressants do.  Redux does increase the risk of developing primary pulmonary hypertension, which is often results as a fatal disorder.

   The most common short term effects resulting form redux were consecutively, diarrhea, dry mouth, and somnolence;  most adverse reactions are mild.  In a study with dexfenfluramine treated and placebo treated patients other effects were recorded (ranging from highest to lowest percentage of frequency): insomnia, headache, diarrhea, asthenia, dry mouth, somnolence, abdominal pain, pharyngitis, dizziness, depression, cough increase, bronchitis, vomiting, vertigo, emotional liability, chills,
accidental injury, thirst, urinary frequency, rash, polyuria, abnormal dreams, and abnormal thinking.

    These effects are minimal and minor.  However, many HMO's have been cutting back reimbursement for Redux.  Many weight loss programs have been keeping their distance as well.  As well as its mild effects dexfenfluramine has lethal reactions.  Seven patients had come down with a heart valve during the treatment of Redux.  A woman died  during less than one month of treatment of phen-fen.  Redux has also been proven to  be associated with fatal lung conditions.  During a study in lab animals, both fen-phen and Redux cause brain damage in its animals.

    More and more doctors are keeping their prescription of Redux to a minimum.  Patients with a sever weight problem, thus a BMI over thirty, are candidates for Redux.

STUDIES AND RESEARCH:
    There has been  a plenitude of research on both fen-phen and redux to prove its effectiveness.  One study, taken from Metabolism, does just that.  In past years it has been demonstrated that serotonin drugs, such as dexfenfluramine also reduces energy intake and reverse body weight.  Redux has acted as a sufficient stimulus for the reduction of fat consumption and snacking.  Traditionally, serotonin (5-HT) has been most commonly linked with (carbohydrate (CHO) intake.  A study taken from Metabolism, used thirty obese subjects with excess weight ranging from 20% to 80% of their ideal weight.  They were assigned to a 3 month treatment period of either placebo or dexfenfluramine.  The main focus of the study was an examination of basal metabolic rate, but the body weights and energy intakes were also monitored.  At the end of the 3 months, the energy intake of the dexfenfluramine patients was 16% less than that of the placebo patients.  This consisted of a 13% reduction from meals and 23% reduction of snacking. Thus, there was a 25% reduction of fat consumption.  Overall, dexfenfluramine exerts a strong inhibition on the consumption of high-fat foods.

    This study's results are one which someone would find hopeful, promising, and encouraging. However, much research has also been done to prove redux's hazards and lethal side effects.  The use of food consumption suppressants over over a period of 3 months results in the risk of developing PPH.  High dosages of dexfenfluramine in animals over short periods of time resulted in brain concentrations 10 times higher than in humans.  The significance to humans is not yet know.

    Over the summer, the FDA revealed that 82 patients had developed defects in their heart valves. These findings correspond to the article published by  The New England Journal of Medicine published on August 27, 1997.  It stated that 24 women had evidently developed a heart disease as a result of usage of fen-phen.  Prior to this publication, fenfluramine's most serious side-effect  was PPH, Primary Pulmonary Hypertension.  This is a fatal disorder  in which the arteries to the heart are constricted; thus producing high blood pressure, shortness of breath, and fatigue.
 

    What technology and further medical development holds for us in the future is unknown.  Our bodies our very precious things.  Weight loss plays an important factor in very few cases.  People need to resolve to the "old fashion" ways of  loosing weight; such as eating right and exercising regularly.  Until the day when people become happy with themselves or find healthier methods of weight loss, we are stuck in this whirlpool of unsafe and hazardous methods.
 
 

GENERAL INFORMATION:
    Ben Z. Krentzman, M.D. has been promoting the usage of Redux.  Little of the information provided above is taken from
his beliefs.  His notes are outdated, nor have they accurately followed recent findings.
    A recent article in TIME, accurately describes the "Dark Side of Diet Pills."
 
 

BIBLIOGRAPHY:

    http://www.loop.com/~bkrentman/meds/dex.com.htmml#anchor247890

    http://www.pathfinder.com/@@2YAe1Jg...m/970922/health.dark_side_of_.html

    http://www.rxlist.com/cgi/generic/dexfen.htm

    http://pharminfo.com/medwatch/mwwrpt5.html

     Blundell, John and Lawton, Clare.  "Serotonin and Dietary Fat Intake: Effects of Dexfenfluramine."  Metabolism.  Vol 44.  Pennsylvania: WB Saunders Co, 1995.

 

 

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