Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fenfluramine has been used for a number of years as a short-term adjunct to diet in the management of obesity. Controlled studies and clinical experience have shown that it possesses anorectic activity at least as good as that of other therapeutically useful drugs of its type, but like these drugs it has only a limited role in the overall management of obesity. Tolerance to the anorectic effects of fenfluramine may possibly develop more slowly than to other chemically related drugs in patients with refractory obesity. The mechanism of its anorectic action is probably by an effect on the appetite control centres in the hypothalamus, rather than by an effect on glucose and lipid metabolism. However, its effect in enhancing glucose uptake into skeletal muscle may be of advantage in diabetes mellitus, preliminary studies suggesting that it is of potential use in maturity-onset obese diabetics who cannot be adequately controlled by dietary measures alone. The starting dosage in obesity of 40mg daily should be increased gradually over 2 to 4 weeks to 60 to 120mg. In general, little extra benefit is gained by higher dosage. When a course of therapy is to be discontinued, fenfluramine dosage should be reduced gradually over a period of 2 to 4 weeks in order to avoid mood depression which has occurred in some patients on abrupt withdrawal of the drug. With these recommendations, the majority of patients tolerate fenfluramine satisfactorily, although some patients may have to discontinue the drug because of troublesome gastro-intestinal problems, diarrhoea, drowsiness or dizziness. Unlike other amphetamine-derived anorectics, fenfluramine is not a central stimulant in therapeutic doses, and it probably has little abuse potential.
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PMID:Fenfluramine: a review of its pharmacological properties and therapeutic efficacy in obesity. 76

We compared the patient acceptance and efficacy of 60 mg extended-release fenfluramine and placebo before the evening meal in a 10-week, double-blind trial. All 51 participants were 130% to 180% of ideal body weight. They received instruction in diet and behavior modification for 2 wk before the beginning of and during the medication period. Mean weight loss was 5.9 kg (8.0 +/- 4.6% of initial weight) in the fenfluramine group and 3.3 kg (5.5 +/- 3.5%) in the placebo group. Fenfluramine-treated participants reported lower hunger ratings and greater fullness in the target supper-to-bedtime period than participants receiving placebo. Both groups reported dry mouth, dizziness, drowsiness, fatigue, and diarrhea. Although the fenfluramine group reported more complaints, these diminished to less than half after 2 wk of treatment. Four of the fenfluramine and three of the placebo group dropped out for drug-related reasons. In all, 10 fenfluramine and 8 placebo participants dropped out. Fenfluramine participants had a higher benefit score with no difference in risk scores. The fenfluramine group's global evaluation was better than that of the placebo group. Participants viewed the study and the dosing regimen positively but had negative ideas about anorexiants in general. Extended-release fenfluramine taken in the evening was well tolerated and maintained its efficacy as measured by standard and novel techniques.
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PMID:Extended-release fenfluramine: patient acceptance and efficacy of evening dosing. 634 Sep 9

We evaluated the ability of fenfluramine, a serotonin releaser, to increase the analgesic potency of morphine administered by tailored i.v. infusion. Ten normal volunteers participated in 4 test sessions, involving different treatments on different days: (1) oral placebo/saline infusion, (2) oral placebo/morphine infusion, (3) oral fenfluramine (60 mg)/saline infusion, and (4) oral fenfluramine/morphine infusion. Subjects experienced repetitive painful dental electrical stimuli at strong but tolerable intensities during testing. On the 2 test days involving morphine, the opioid was administered by a computer-pump system that used individual pharmacokinetic parameters to achieve consecutive, steady plasma concentrations near target values of 16, 32 and 64 ng morphine/ml; each morphine concentration plateau was maintained for 45 min. On the saline infusion days, our procedures were identical to morphine test days except that the infused fluid contained no drug. For all sessions outcome measures included subject ratings of pain intensity, dental evoked potential (EP) amplitude, and visual analog scale (VAS) ratings of subjective side-effect intensities (nausea, alertness, dizziness, itching, mood). We obtained these measures during baseline and at each morphine concentration plateau or at corresponding times during saline infusions. Fenfluramine significantly increased the analgesic potency of morphine during the opioid infusion, while fenfluramine alone produced borderline analgesic effects. Fenfluramine alone decreased alertness slightly, but did not significantly increase morphine side effects. Thus, we conclude that fenfluramine enhances the analgesic potency of morphine without a parallel increase in opioid side-effect potency.
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PMID:Enhancement of morphine analgesia by fenfluramine in subjects receiving tailored opioid infusions. 844 41