(b) Appetite suppressants with primarily serotonergic effects: There are several drugs for which pediatric trials exist that affect appetite primarily by increasing serotonergic release or inhibiting reuptake,48, 50 including fluoxetine, chlorphentermine, fenfluramine and its stereoisomer, dexfenfluramine.58, 59, 60, 61, 62, 63 None of these drugs are currently FDA approved for weight loss and most have been removed from the US market. Acute studies demonstrate their ability to suppress appetite in obese adults,69 and anorexia is a frequently observed side effect when such medications are used in pediatric patients with attention deficit disorder.70, 71 Because of their adverse effect profile (agitation, insomnia, tachycardia, hypertension and hyperhidrosis), abuse potential72 and the absence of trials showing long term weight loss efficacy, these agents are not recommended or approved for obesity management. Sibutramine was voluntarily withdrawn from use in 2010 when a greater incidence of cardiovascular events was found among adults at high risk for cardiovascular disease who took the drug.. ) Muscleman Sazali bags ninth Asia title in Macau activity club i knew there was a secret to the test
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