Sibutramine: a new weight loss agent without evidence of the abuse potential
associated with amphetamines
by
Cole JO, Levin A, Beake B, Kaiser PE, Scheinbaum ML
McLean Hospital,
Belmont,
Massachusetts 02178, USA.
J Clin Psychopharmacol 1998 Jun;18(3):231-6
ABSTRACT
Sibutramine is a serotonin and norepinephrine reuptake
inhibitor that has shown efficacy as a weight loss and weight maintenance
agent. Because of the abuse liability and physical dependence potential
of amphetamines and related antiobesity agents, this study evaluated the
abuse potential of sibutramine and compared it with that of dextroamphetamine
and placebo in recreational stimulant users. Thirty-one male recreational
stimulant users participated in this single-site, Latin square crossover
study that compared the effects of two doses of sibutramine (20 mg and 30
mg) to dextroamphetamine (20 mg and 30 mg) and placebo, using a series of
validated subjective scales or questionnaires. For scales measuring stimulation
and euphoria, there was a greater mean response for dextroamphetamine 30
mg versus 20 mg, with both doses having a significantly greater stimulant
and euphoric effect than placebo at the majority of time points (p <
0.05); responses for both doses of sibutramine were statistically indistinguishable
from placebo at all time points. Responses to "street value" and "most enjoyed
study session" questions confirmed that sibutramine lacks abuse potential;
mean cash value estimates of street value were significantly greater for
both dextroamphetamine doses than for placebo or either sibutramine doses
(p < 0.05), and the rank order of session enjoyment placed both doses
of sibutramine last. Together with the relatively late Tmax of the active
metabolites (3-4 hours), this short-term, single-dose study provides strong
evidence that sibutramine does not have the potential for abuse that is
characteristic of amphetamines and that it is indistinguishable from placebo
in abuse potential.
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