The pharmacological treatment of obesity: Past, present and future

2012 ◽  
Vol 153 (10) ◽  
pp. 363-373 ◽  
Author(s):  
Gábor Simonyi ◽  
Gyula Pados ◽  
Mihály Medvegy ◽  
J. Róbert Bedros
Keyword(s):  
Weight Reduction ◽  
Pharmacological Treatment ◽  
Behavioral Therapy ◽  
Management Strategies ◽  
Term Treatment ◽  
Pharmacological Therapy ◽  
Long Term Treatment ◽  
Induce Weight Loss ◽  
Treatment Of Obesity ◽  
Obesity Drugs

Currently, obesity presents one of the biggest health problems. Management strategies for weight reduction in obese individuals include changes in life style such as exercise and diet, behavioral therapy, and pharmacological treatment, and in certain cases surgical intervention. Diet and exercise are best for both prevention and treatment, but both require much discipline and are difficult to maintain. Drug treatment of obesity offer a possible adjunct, but it may only have modest results, limited by side effects; furthermore, the weight lowering effects last only as long as the drug is being taken and, unfortunately, as soon as the administration is stopped, the weight is regained. These strategies should be used in a combination for higher efficacy. Drugs used to induce weight loss have various effects: they increase satiety, reduce the absorption of nutrients or make metabolism faster; but their effect is usually moderate. In the past, several drugs were used in the pharmacological therapy of weight reduction including thyroid hormone, dinitrophenol, amphetamines and their analogues, e.g. fenfluramine, At present, only orlistat is available in the long term treatment (≥24 weeks) of obesity as sibutramine and rimonabant were withdrawn form the market. Several new anti-obesity drugs are being tested at present, and liraglutide, a GLP-1 analogue (incretin mimetic), is the most promising one. Orv. Hetil., 2012, 153, 363–373.

The long-term treatment of schizophrenia

2012 ◽  
Vol 153 (26) ◽  
pp. 1007-1012
Author(s):  
Róbert Herold
Keyword(s):  
Pharmacological Treatment ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Challenging Tasks ◽  
Achievable Goal ◽  
Long Acting

The long-term treatment of schizophrenia is one of the most challenging tasks for practicing physicians. The most pronounced difficulty arises from the deficient compliance due to the lack of insight. Thus the treatment of schizophrenia requires a multimodal approach, which always includes psychosocial interventions beside the pharmacological treatment. The antipsychotic medication means the cornerstone in the pharmacological treatment of schizophrenia within which an increasing role of the long-acting second-generation injections can be detected. The outcome of schizophrenia can be modified by adequately organized management strategies, which in turn can lead to better quality of life and social functioning. If patients are provided with timely initiated effective medication and rehabilitation, then enduring remission can be a realistically achievable goal for the patients. Orv. Hetil., 2012, 153, 1007–1012.

scholarly journals What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report

2021 ◽  
Vol 18 (4) ◽  
pp. 1425
Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Opioid Use Disorder ◽  
Term Treatment ◽  
Pharmacological Therapy ◽  
Daily Clinical Practice ◽  
Short Report ◽  
Opioid Use ◽  
Cross Sectional ◽  
Long Term Treatment ◽  
Social Profiles

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.

scholarly journals Pharmacological treatment of obesity

2006 ◽  
Vol 50 (2) ◽  
pp. 377-389 ◽  
Author(s):  
Marcio C. Mancini ◽  
Alfredo Halpern
Keyword(s):  
Insulin Resistance ◽  
Pharmacological Treatment ◽  
Energy Homeostasis ◽  
Extensive Review ◽  
Obesity Management ◽  
Physiological Mechanisms ◽  
Triggering Factor ◽  
Treatment Of Obesity ◽  
Obesity Drugs ◽  
Cannabinoid Agonist

This review offers an overview of physiological agents, current therapeutics, as well as medications, which have been extensively used and those agents not currently available or non-classically considered anti-obesity drugs. As obesity - particularly that of central distribution - represents an important triggering factor for insulin resistance, its pharmacological treatment is relevant in the context of metabolic syndrome control. The authors present an extensive review on the criteria for anti-obesity management efficacy, on physiological mechanisms that regulate central and/or peripheral energy homeostasis (nutrients, monoamines, and peptides), on beta-phenethylamine pharmacological derivative agents (fenfluramine, dexfenfluramine, phentermine and sibutramine), tricyclic derivatives (mazindol), phenylpropanolamine derivatives (ephedrin, phenylpropanolamine), phenylpropanolamine oxytrifluorphenyl derivative (fluoxetine), a naftilamine derivative (sertraline) and a lipstatine derivative (orlistat). An analysis of all clinical trials - over ten-week long - is also presented for medications used in the management of obesity, as well as data about future medications, such as a the inverse cannabinoid agonist, rimonabant.

scholarly journals Pharmacological Treatment of Obesity in Patients with Polycystic Ovary Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hassan Kahal ◽  
Stephen L. Atkin ◽  
Thozhukat Sathyapalan
Keyword(s):  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Weight Reduction ◽  
Pharmacological Treatment ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Prevalence Of Obesity ◽  
Treatment Of Obesity

Polycystic ovary syndrome (PCOS) is a common disorder affecting women of reproductive age and it is associated with increased cardiovascular risk. Obesity plays an important role in the pathogenesis of PCOS, and the majority of patients with PCOS are obese. Over the last 20 years, the prevalence of obesity has dramatically increased, with probable associated increase in PCOS. Weight reduction plays an integral part in the management of women with PCOS. In this paper, current available weight reduction therapies in the management of PCOS are discussed.

Management of congestive heart failure: is the role of positive inotropic therapy fading?

1996 ◽  
Vol 5 (6) ◽  
pp. 455-460
Author(s):  
LG Futterman ◽  
L Lemberg
Keyword(s):  
Term Treatment ◽  
Pharmacological Therapy ◽  
Control Treatment ◽  
Inotropic Therapy ◽  
Digitalis Glycoside ◽  
Inotropic Drugs ◽  
Long Term Treatment ◽  
Clinical Benefits ◽  
Current Concerns ◽  
Digoxin Therapy

Significant strides have been made in the medical therapy of chronic CHF in the past two decades. Treatment has evolved from therapy based on the older concepts of the pathophysiology of CHF to evidence-guided therapy supported by results of major landmark studies that expand the understanding of the pathophysiology. Attenuation of neurohumoral activation is now a goal of pharmacological therapy, and we know that agents that offer hemodynamic and early clinical improvement may not necessarily prolong survival-unless they also modulate these neurohormonal systems. Positive inotropic therapy (e.g., use of a digitalis glycoside) is no longer considered essential in patients with CHF in sinus rhythm. Although impressive hemodynamic benefits can be observed with the use of positive inotropic agents, long-term treatment with these drugs has not produced clinical benefits and may increase mortality. Long before the current concerns about the use of positive inotropic therapy for CHF, cardiovascular physiologists had advised that contractility does not equate with overall cardiac performance. Stimulation of myocardial contractility is a property of digoxin therapy. However, cardiac function is governed by four determinants: preload, afterload, rhythm, and contractility. All four require control. Treatment aimed at reducing preload and afterload and improving arrhythmias can achieve cardiac compensation by reducing cardiac work without the need for digoxin therapy or other inotropic drugs.

Advances in the Long-Term Treatment of Obesity

2004 ◽  
Vol 12 (S12) ◽  
pp. 149S-150S ◽  
Author(s):  
Samuel Klein
Keyword(s):  
Term Treatment ◽  
Long Term Treatment ◽  
Treatment Of Obesity

Orlistat in the Long-term Treatment of Obesity in Primary Care Settings.

2001 ◽  
Vol 21 (1) ◽  
pp. 53
Author(s):  
J Hauptman ◽  
C Lucas ◽  
M N Boldrin ◽  
H Collins ◽  
K R Segal
Keyword(s):  
Primary Care ◽  
Term Treatment ◽  
Primary Care Settings ◽  
Long Term Treatment ◽  
Treatment Of Obesity

WCA Recommendations for the Long-Term Treatment of Social Phobia

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S1) ◽  
pp. 40-52 ◽  
Author(s):  
Michael Van Ameringen ◽  
Christer Allgulander ◽  
Borwin Bandelow ◽  
John H. Greist ◽  
Eric Hollander ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Phobia ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Social Performance ◽  
Term Treatment ◽  
Term Therapy ◽  
Long Term Treatment

ABSTRACTWhat is the best approach for treating patients with social phobia (social anxiety disorder) over the long term? Social phobia is the most common anxiety disorder, with reported prevalence rates of up to 18.7%. Social phobia is characterized by a marked and persistent fear of being observed or evaluated by others in social performance or interaction situations and is associated with physical, cognitive, and behavioral (ie, avoidance) symptoms. The onset of social phobia typically occurs in childhood or adolescence and the clinical course, if left untreated, is usually chronic, unremitting, and associated with significant functional impairment. Social phobia exhibits a high degree of comorbidity with other psychiatric disorders, including mood disorders, anxiety disorders, and substance abuse/dependence. Few people with social phobia seek professional help despite the existence of beneficial treatment approaches. The efficacy, tolerability, and safety of the selective serotonin reuptake inhibitors (SSRIs), evidenced in randomized clinical trials, support these agents as first-line treatment. The benzodiazepine clonazepam and certain monoamine oxidase inhibitors (representing both reversible and nonreversible inhibitors) may also be of benefit. Treatment of social phobia may need to be continued for several months to consolidate response and achieve full remission. The SSRIs have shown benefit in longterm treatment trials, while long-term treatment data from clinical studies of clonazepam are limited but support the drug's efficacy. There is also evidence for the effectiveness of exposure-based strategies of cognitive-behavioral therapy, and controlled studies suggest that the effects of treatment are generally maintained at long-term follow-up. In light of the chronicity and disability associated with social phobia, as well as the high relapse rate after short-term therapy, it is recommended that effective treatment be continued for at least 12 months.

Sign in / Sign up

Export Citation Format

Share Document