fatnews.com

Discussion Forums
NEW!

Discussion Forums

Recent Forum Topics
NEW!

Recent Forum Topics
We welcome your comments, experience, expertise and insight on various topics about weight loss in these discussion forums.

STORE

The Store

SEARCH THIS SITE


Advanced Search

SEARCH THE WEB

Google

CONTACT US

  • Contact Us
  • Submit your suggestions to improve this site
  • Submit an article you would like reviewed
  • Suggest a drug, nutrient or diet you would like reviewed
  • TABLES

    BMI Table for adults
    BMI Table defining childhood obesity
    Glycemic Index Tables

    MEMBERS

    Login
    Register

    MAILING LIST

    CATEGORIES

    (Tip: To find articles about a particular subject, either search for a particular word, click "Category View" above, or select the category you are interested in from the list below.)
    5-HTP (5-Hydroxytryptophan)
    Abilify (aripiprazole)
    Acarbose (Precose)
    Accountability
    ACE Inhibitor
    Acetyl-L-Carnitine
    Acomplia (rimonabant)
    Actonel (risedronate)
    Actos (pioglitazone)
    Adiponectin
    Aging
    AIDS
    Air Conditioning
    Alcohol
    Alcoholism
    Alii (orlistat) - (also see Xenical)
    All-you-can-eat
    Allergies, Food and Brain
    Almonds
    Alpha Lipoic Acid
    Aluminum
    Alzhemier's Disease
    Amantadine (Symmetrel)
    Ambien (zolpidem)
    Amino Acids
    Amitriptyline (See Elavil)
    Amphetamines
    Amylase inhibitors (See Starch Blockers)
    Anafranil (clomipramine)
    Angina (chest pain)
    Animal-based diet
    Antibiotics
    Antidepressants
    Antihistamines
    Antipsychotic drugs
    Anxiety
    Arginine
    Arthritis
    Articles by others
    Artificial sweetners (general)
    Aspartic Acid
    Aspirin
    Asthma
    Attention Deficit Hyperactive Disorder -- ADHD
    Autism
    Avandia (rosiglitazone)
    Axokine
    Bariatric Surgery (See Weight Loss Surgery)
    Behavioral Therapy, Cognitive
    Belviq (lorcaserin hydrochloride)
    Benefits of weight loss
    Benzodiazepines
    Beta Blockers
    Binge Eating
    Bioidentical hormones
    Birth Control Pills
    Blacks
    Blood Donation
    Blood Pressure
    Blood Pressure Drugs
    Blood Pressure Drugs INCREASED Death in Older women
    Blood sugar
    BMI not perfect
    BMI Table
    BMI, Healthiest (Healthiest BMI)
    Body Composition
    Bone Fractures
    Bone mass
    Book - Blue Zones
    Book - Cholesterol Myths (by Uffe Ravnskov, MD, PhD)
    Book - Deadly Medicines and Organised Crime (by Prof. Peter Gøtzsche, MD)
    Book - Deadly Psychiatry and Organised Denial (by Prof. Peter Gøtzsche, MD)
    Book - Good Calories, Bad Calories (by Gary Taubes)
    Book - Malignant Medical Myths
    Book - Our Daily Meds
    Book - The Black Swan
    Book - Why We Get Fat (by Gary Taubes)
    Brain Allergies (See Allergies, Food and Brain)
    Breakfast
    Breast-feeding
    Broda Barnes, MD, PhD (thyroid expert)
    Bromocriptine (Ergoset)
    Bulimia
    Bupropion (See Wellbutrin)
    Byetta (exenatide)
    C-reactive protein
    Caffeine
    Calcium
    Calcium Channel Blockers
    Calorie content of food
    Calorie Density of Food
    Calorie Intake
    Calorie intake, Underreporting
    Calorie Restriction
    Cancer
    Cancer screening (Does it do any good?)
    Cancer treatments
    Cancer, Bladder
    Cancer, Bowel
    Cancer, Brain
    Cancer, Breast
    Cancer, Cervical
    Cancer, Colorectal
    Cancer, Endometrial
    Cancer, Gallbadder
    Cancer, Kidney
    Cancer, Leukemia
    Cancer, Liver
    Cancer, Lung
    Cancer, Multiple Myeloma
    Cancer, Non-Hodgkin Lymphoma
    Cancer, Oesophageal
    Cancer, Oesophageal (adenocarcinoma)
    Cancer, others
    Cancer, Ovarian
    Cancer, Pancreatic
    Cancer, Prostate
    Cancer, Stomach (gastric cardia)
    Cannabis (marijuana)
    Caralluma fimbriata
    Carbohydrates
    Carnitine, L- (L-carnitine)
    Carpal tunnel syndrome
    Celexa (citalorpam)
    Cell Phones
    Cereal
    Chelation Therapy, EDTA
    Chemtrails
    Chewing
    Childhood Illnesses
    Childhood neglect and abuse
    Childhood Obesity
    Chitosan
    Chocolate (cocoa)
    Cholesterol
    Cholesterol drugs
    Cholesterol Hypothesis Skeptics
    Cholesterol Myths
    Cholesterol, HDL
    Chromium
    Chronic Fatigue
    Citrus aurantium
    CLA (Conjugated Linoleic Acid)
    Clozaril (clozapine)
    Cobalt
    Cochrane Collaboration
    Codonopsis Eupolyphaga
    Coffee
    Coffee, Decaffeinated
    Cognitive function
    Commercial Weight Loss Programs
    Computer Use
    Conflicts of Interest
    Congestive Heart Failure
    Constipation
    Contrave (Wellbutrin (bupropion) plus naltrexone)
    Copper
    CoQ10 (Coenzyme Q10, ubiquinol, ubiquinone)
    Cortisol (stress hormone)
    Cost of food
    Costs associated with obesity
    Cravings
    Cymbalta (duloxetine)
    Daniel Amen, MD
    Death, Risk of
    Deaths from obesity
    Definitions
    Dental Amalgams (mercury fillings)
    Depo-Provera (depot-medroxyprogesterone acetate)
    Depression
    Desire to Lose Weight
    DHEA
    Diabetes
    Diabetes drugs
    Diagnosed Overweight by a Doctor
    Dialysis
    Diet drug use
    Diet Pills (General Info)
    Diet soda
    Dietary Counseling
    Diethylpropion (Tenuate)
    Dieting (General)
    Dieting, Intermittent
    Dinitrophenol
    Disability
    Discrimination against obesity
    Diuretics
    Diverticulitis
    Doctor - Abram Hoffer, MD, PhD
    Doctor - Boyd Haley, PhD
    Doctor - Dr. Kailash Chand
    Doctor - H. Gilbert Welch, MD (author of Overdiagnosed and Less Medicine, More Health)
    Doctor - Irving Kirsch, PhD
    Doctor - Jason Fung, MD
    Doctor - Joel Kauffman, PhD (author of Malignant Medical Myths)
    Doctor - John Abramson, MD (author of Overdosed America)
    Doctor - Jonathan Wright, MD (pioneer in natural medicine)
    Doctor - Kimber Stanhope, PhD
    Doctor - Malcolm Kendrick, MD author of "The Great Cholesterol Con"
    Doctor - Marcia Angell, MD
    Doctor - Mary Enig, PhD
    Doctor - Michel de Lorgeril, MD
    Doctor - Peter Gøtzsche, MD
    Doctor - Robert Lustig, MD
    Doctor - Suzanne Humphries, MD
    Doctor - Uffe Ravnskov, MD PhD
    Doctor - William Wilson, MD
    Doctor trends
    Don't fall for this
    Dopamine agonists
    Drug company lies
    Drug Company Money
    Drug Company Salesman
    Drug Company Tactics
    Drug-induced Side Effects
    Dry Skin
    Duodenal Switch (weight loss surgery)
    Eating time of day
    Economic Issues and Obesity
    Education
    Eggs
    Elavil (amitriptyline)
    Elderly
    Elderly, risk of obesity
    Empatic (Zonegran plus Wellbutrin)
    Environmental chemicals
    Ephedrine/Ephedra
    Epigenetics
    Erectile Dysfunction
    Escitalopram (Lexapro)
    Estrogen replacement therapy
    Evening Primrose Oil
    Every Other Day Modified Fast
    Excalia
    Exercise
    Exhaustion
    Fast Food
    Fasting, Intermittent
    Fat Cells
    Fat Intake (Dietary Fat)
    Fat loss
    Fat Oxidation
    Fat Replacers
    Fat, Body (Body Fat)
    Fat, Dietary
    FDA (U.S. Food and Drug Administration)
    Fen-Phen
    Fertility (see Pregnancy)
    Fiber (Dietary Fiber)
    Fiber supplements
    Fidgeting
    Fish
    Fish Oil (omega-3 fatty acids)
    Flaxseed
    Food Allergies (See Allergies, Food and Brain)
    Food Cues
    Food Diary
    Food Intake statistics
    Food preferences associated with obesity
    Food Pyramid
    Food Safety
    Food's effect on appetite
    Foods associated with higher and lower body weight
    Foods Associated with Weight Gain
    Forskolin (from the plant Coleus forskohlii)
    Fosamax (alendronate)
    Fructose
    Fruit
    Fucoxanthin
    GABA
    Gallbadder Disease
    Gallstones
    Garlic
    Gastro-esophageal reflux disease
    General Health Checks
    Genes and genetics
    Geodon (ziprasidone)
    Ghrelin
    Ginger
    Ginseng
    GLA (Gamma Linolenic Acid)
    GLA - Gamma Linolenic Acid
    Glucomannan (konjac root)
    Glucophage (metformin)
    Glutamine (amino acid)
    Glycemic Index
    Glycemic Index Tables
    Glycomacropeptide
    GMO foods (genetically modified organisms)
    Grains
    Grapefruit
    Green coffee bean extract
    Green Tea
    Group Therapy
    Growth Hormone
    Guar gum
    Gut Bacteria
    Gwen Olsen
    Habits associated with obesity
    Habits of being lean
    Hair Loss (caused by weight loss)
    Haldol (haloperidol)
    Hawaiian Diet
    HCG (human chorionic gonadotropin)
    Headaches
    Health Insurance
    Health Risks of obesity
    Heart Attack (myocardial infarction)
    Heart Disease
    Heart Disease, Coronary - Skeptics of the Cholesterol Hypothesis
    Heavy metal toxicity
    Herbal formula, Number Ten
    Herbal formula, PM-F2-OB
    Hibiscus tea
    High Carbohydrate Diet
    High-Fructose Corn Syrup
    High-Protein / Low-Carb Diets
    Histamine levels
    History
    Holiday Weight Gain
    Homocysteine
    Hoodia
    Hop extract, isomerized
    Hunger
    Hydralazine
    Hydrogenated vegetable oil (partially hydrogenated oil)
    Hydroxycitrate (HCA)
    Hypoglycemia
    Hypothyroidism, including Type 2 Hypothyroidism
    IGF-1 (insulin-like growth factor-1)
    Income level
    Infections
    Infertility
    Influenza (Flu)
    Injuries
    Insulin
    Insulin sensitivity
    Interview with Patients
    Interview with Stephen Gullo, PhD
    Interviews with Doctors
    Iodine
    Jenny Craig Weight Loss Program
    Joan Mathews Larson, PhD
    John Ioannidis
    Just for Fun
    Kidney Disease
    Kidney stones
    Kidney Stones
    Konjac root (See glucomannan)
    Krill Oil
    Lap Band Surgery
    Lead (heavy metal toxicity)
    Lean, things associated with being
    Legumes
    Leptin
    Lesbians
    Leucine (amino acid)
    Life Expectancy
    Lipolysis (release of fat from fat cells)
    Liposuction
    Lipozene (see glucomannan)
    Liquid Calories
    Liraglutide
    Longevity
    Lorcaserin (also see Belviq (lorcaserin hydrochloride))
    Low Calorie Diet
    Low Carbohydrate Diets
    Low Fat Diets
    Low Stomach Acid
    Lp(a)
    Ludiomil (maprotiline)
    Luvox (fluvoxamine)
    Magnesium
    Maitake mushroom
    Mammography
    Marijuana (see Cannabis)
    Mark Starr, MD
    Married or Single
    Meal Frequency
    Meal Replacement Shakes
    Measurments of obesity
    Meat, Red
    Mediterranean Diet
    Medium chain triglycerides (MCT's)
    Men, studies about
    Menopause
    Menstruation
    Mercury
    Mercury fillings (Dental amalgams)
    Meridia (sibutramine)
    Metabolic syndrome (also see Insulin Sensitivity)
    Metabolism
    Mifeprex (mifepristone)
    Milk and Dairy
    Mineral aspartates
    Mirapex (pramipexole)
    Mirtazapine (antidepressant Remeron)
    Moban (molindone)
    Monounsaturated fat (Olive Oil and Canola Oil)
    Mortality associated with obesity
    Motivational techniques for losing weight
    Movies
    MSG (monosodium glutamate)
    Multiple Myeloma (See Cancer, Multiple Myeloma)
    Myths, Medical Myths
    N-Acetyl-Cysteine (NAC)
    Naltrexone
    Nasal Blockage
    Nassim Taleb
    Natural Treatments
    Nestatin-1
    Neurontin (gabapentin)
    Niacin (vitamin B3)
    Nicotine
    Night Eating Syndrome
    Night workers/shift workers
    No Dinner Diet
    Nonalcoholic fatty liver disease
    Nortriptyline (See Pamelor)
    Nutrasweet (aspartame)
    Nuts (also see Almonds)
    Obesity Forecasts
    Obesity Guidelines, NIH
    Obesity statistics
    Obesity Statistics, US States
    Obesity, Causes of
    Obesity, Factors associated with
    Oleoyl-estrone
    Olestra
    Olive Oil
    Omega-3 Fatty Acids (fish oil)
    Omega-6 Fatty Acids
    Onions
    Oolong Tea
    Opinion
    Orthomolecular Medicine
    Over-treatment
    Paleo Diet
    Pamelor (nortriptyline)
    Parent's influence on obesity
    Parkinson's Disease
    Paroxetine (antidepressant Paxil)
    PCSK9 inhibitors (cholesterol-lowering drugs)
    Pedometer
    Periactin (cyproheptadine)
    Periodontal Gum Disease
    Personal stories about weigh loss
    Phen-Pro (Phentermine-Prozac or other SSRIs)
    Phendimetrazine (Bontril)
    Phentermine
    Phenylephrine
    Phosphodiesterase type-5 inhibitors, sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)
    Plastic's effect on body weight
    Plate Size
    Pokeweed extract
    Polar Weight Management Program
    Polio Vaccine (Salk Vaccine)
    Polycystic Ovarian Syndrome
    Polyunsaturated Fat
    Port, Sidney (UCLA statistician)
    Portion size, effect on calore intake
    Post-traumatic stress disorder
    Postnatal weight gain (immediately after birth)
    Postpartum depression
    Potassium
    Pramlintide (see Symlin)
    Predicted Weight Loss
    Pregnancy
    Pregnant women, effects on offspring
    Prejudice against obesity
    Prevalence of Obesity
    Prices for drugs
    Prolixin (fluphenazine)
    Prostate, Enlarged
    Protamine
    Protein (general)
    Protein Leverage Theory
    Protein Source
    Protein supplement
    Protein, High, Diet
    Protein, Low, Diet
    Protein, Soy
    Proton pump inhibitors
    Prozac (fluoxetine)
    PSA Test (Prostate Specific Antigen)
    Psychiatric Drugs
    Pu-erh Tea (Chinese Black Tea)
    Pursuing Weight Control
    Pyruvate
    Qsymia (phentermine and topiramate) (formerly Qnexa)
    Quality of Life
    Radiation (background ionizing radiation)
    Rate of Eating
    Raw food diet
    Red Yeast Rice
    Resistant Starch
    Resveratrol
    Rhodiola rosea (Golden root or Arctic root)
    Rice
    Richard Moore, MD, PhD
    Risperdal (risperidone)
    Ritalin (methylphenidate)
    Robert Skversky, MD
    Robert Whitaker (author & journalist)
    Rubidium
    Saccharin (artificial sweetner)
    Saturated Fat
    Sauna
    Scams
    Schizophrenia
    Seizures
    Self-help weight loss
    Self-reported height and weight
    Self-reported intake
    Serentil (mesoridazine)
    Serlect (sertindole)
    Seroquel (quetiapine)
    Serotonin Syndrome
    Serzone (nefazodone)
    Sex and Sexual Activity
    Sexual abuse
    Shift Workers
    Sick Days
    Simmondsin (jojoba plant seed extract)
    Skinny on Obesity video series
    Sleep
    Sleeping pills
    Smoking's effect on weight
    Snacks
    Snoring
    Social Influence
    Sodium Intake
    Soft drinks (Coke, Pepsi, etc.)
    South Beach Diet
    Splenda (sucralose)
    Spouses
    SSRI's
    Starch Blockers (Amylase inhibitors)
    Statin Nation (documentary)
    Statins
    Stearic Acid (in beef and chocolate)
    Stents (coronary artery stents)
    Strattera (atomoxetine)
    Strength Training
    Stress
    Stroke
    Sugar Addiction
    Sugar intake
    Suicide
    Sumatriptan
    Sun Bathing, Benefits of
    Surmontil (trimipramine)
    Symlin (pramlintide)
    Symlin (pramlintide)
    Sympathetic Nervous Activity (SNS)
    Taranabant
    Taste
    Taubes, Gary
    Taxes and Obesity
    Tea
    Television Watching
    Temperature, House
    Tenuate (See diethylpropion)
    Tesofensine
    Testosterone
    Thermogenesis
    Thermography
    Thiomersal (mercury-containing preservative)
    Thorazine (chlorpromazine)
    Thyroid Function
    Thyroid supplement
    Thyroid, Desiccated
    Timeline related to obesity discoveries
    Tofranil (imipramine)
    Tofu (soybean curd)
    Tonsils
    Too much medicine
    Topamax (topiramate)
    TOPS (Take Off Pounds Sensibly)
    Trans Fats
    Trazedone (antidepressant)
    Tricyclic antidepressants
    Triglyceride levels
    Tryptophan
    Underreporting weight
    Urinary incontinence
    Vaccines
    Vegetable-based Diet
    Vegetables
    Vegetables, Raw
    Vegetarians
    Venlafaxine (antidepressant Effexor)
    Ventricular arrhythmias
    Vertical Banded Gastroplasty
    Very-Low-Calorie Diets
    Vibration, Whole Body
    Vinegar
    Virus and Bacteria associated with obesity
    Virus, obesity (adenovirus-36)
    Visual Cues
    Vitamin C
    Vitamin D
    Vitamins
    Waist measurement
    Waist-to-Hip Ratio
    Wansink, Brian (studies done by)
    Water
    Weighing, Self
    Weight cycling (gaining and losing)
    Weight gain
    Weight Lifting
    Weight Loss Expectations
    Weight Loss Programs
    Weight Loss Strategies
    Weight Loss Success (what successful weight losers do)
    Weight Loss Supplements
    Weight Loss Supplements, Adulterated
    Weight loss surgery
    Weight Loss Surgery - Laparoscopic Sleeve Gastrectomy
    Weight Loss, Benefits of
    Weight loss, Rate of
    Weight loss, risks of
    Weight Maintenance
    Weight monitoring
    Weight Perception
    Weight Watchers
    Weight-gaining drugs
    Wellbutrin (bupropion)
    Wine, Red
    Women, studies about
    Work, Lost Days
    Xenical (orlistat)
    YouTube videos
    Zerona laser
    Zetia (ezetimibe)
    Zinc
    Zocor (simvastatin)
    Zoloft (sertraline)
    Zonegran (zonisamide)
    Zyprexa (olanzapine)

    ARCHIVES

    September, 2017
    August, 2017
    July, 2017
    June, 2017
    May, 2017
    April, 2017
    March, 2017
    February, 2017
    January, 2017
    December, 2016
    November, 2016
    October, 2016

    ARCHIVE SUMMARY

    View by Date
    View by Category

    RSS / XML


    RSS 1.0
    RSS 2.0
    RSS Atom

    WEATHER

    Weather around the country
    Home page  >  Article | Previous article | Next article

    QUICKLINKS AND VIEW OPITONS

  • Articles with Recent Comments
  • Recent Forum Topics
  • Summary View
  • Headline View
  • Archive of Quotes
  • Phentermine-Prozac (Phen-Pro): An interview with Dr. Michael Anchors


    Posted by .(JavaScript must be enabled to view this email address)
    Wednesday, September 10, 2003 3:52 pm Email this article
    Michael Anchors, M.D., Ph.D. is the author of the book titled Safer Than Phen-Fen. He is a clinical professor of medicine at Georgetown University and operates a family practice in Maryland.

    This interview was first published in Obesity Research Update, August 1997, Volume 2 Number 8.

    Dr. Anchors can be reached as follows:

    Michael Anchors, MD, PhD
    16220 Frederick Rd Ste 210
    Gaithersburg, MD 20877
    (301) 990-6061
    (301) 990-6064 Fax
    .(JavaScript must be enabled to view this email address)

    Hobbs:      What is the drug combination that you are using for weight loss?

    Anchors:   Phentermine and Prozac (Phen-Prozac).

    Hobbs:      When did you start using Phen-Prozac?

    Anchors:   March 1995.

    Hobbs:      How many patients have you treated with Phen-Prozac?

    Anchors:   About 620.

    Hobbs:      Do you ever use phentermine alone?

    Anchors:   No. Phentermine alone isn’t very effective. Patients lost a little weight at first, but gained it back even when they kept taking it. Phen-Prozac works much better.

    Hobbs:      Did you ever prescribe Fen-Phen?

    Anchors:   No. I considered fenfluramine to have unnecessary risks such as primary pulmonary hypertension (PPH) and possible heart valve damage. In fact, in the book (page 59) I predicted that we would see cases of heart valve damage in some people taking fenfluramine.

    Hobbs:      Does Prozac increase the risk of PPH?

    Anchors:   No. Eli Lilly, the company that manufactures Prozac, has received only 8 reports of PPH in people taking Prozac out of 19 million users worldwide. This is even fewer cases than would be expected in the general population. The reason is that Prozac does not force the release of serotonin like fenfluramine does. It only blocks the reuptake. Prozac is also more than 98% protein-bound in the blood, whereas fenfluramine is much less protein-bound and so is more available to cause trouble.

    Hobbs:      Will you comment on the letter from Bostwick and Brown (1996) regarding a toxic reaction from combining phentermine and Prozac.

    (Reference: Bostwick JM, Brown TM. A toxic reaction from combining fluoxetine and phentermine [letter]. Journal of Clinical Psychopharmacology, 1996 Apr, 16(2):189-90.)

    Anchors:   First of all the phentermine was started at a dose of 30 mg, which should not be done. And second, the “toxic reaction” occurred 8 days after the Prozac was stopped.

    Hobbs:      How does Phen-Prozac compare in to Fen-Phen as far as efficacy?

    Anchors:   I believe they are equally effective.

    Hobbs:      How does Phen-Prozac compare to Redux as far as efficacy?

    Anchors:   I think that Phen-Prozac or Fen-Phen, for that matter, is more effective than Redux. I’ve treated a number of patients who failed to lose weight with Redux, but were successful with Phen-Prozac.

    Hobbs:      How do they compare as far as side effects?

    Anchors:   Phen-Prozac generally causes fewer side effects than Fen-Phen. And Phen-Prozac is better tolerated than either phentermine or Prozac alone.

    Hobbs:      Have you had any problems with anxiety using Phen-Prozac?

    Anchors:   Rarely. It’s probably because I start with a small dose of phentermine and gradually increase it and I only use 10 mg of Prozac.

    Hobbs:      If Fen-Phen didn’t work for someone, is it likely that Phen-Prozac might work?

    Anchors:   I have some patients who did not lose weight with Fen-Phen, but did lose weight with Phen-Prozac. I think it is certainly worth a try.

    Hobbs:      What percentage of your Phen-Prozac patients have lost weight?

    Anchors:   Most of them. Only 10 out of 620 failed to lose when following the program. A few dozen more failed to lose weight because they didn’t take the medicines as prescribed, ate when they weren’t hungry or didn’t exercise.

    Hobbs:      How did you decide to use Phen-Prozac rather than Fen-Phen?

    Anchors:   There were a couple reasons. First, fenfluramine is not covered by most insurance plans, but Prozac is. Second, fenfluramine has a shorter half-life, so it has to be taken two or three times per day, whereas Prozac only has to be taken once per day. Prozac also generally has fewer side effects than fenfluramine.

    Hobbs:      What is the dose of Phen-Prozac that you use?

    Anchors:   30 mg of phentermine plus 10 mg of Prozac. But I always have patients start with only 15 mg of phentermine for the first week or two and then increase it to 30 mg to reduce the initial side effects.

    Hobbs:      Why do you think it is that only 10 mg of Prozac is necessary when combined with phentermine, whereas using Prozac alone seems to require at least 60 mg?

    Anchors:    Only 10 mg is needed for weight loss, although a higher dose is needed to treat depression.

    Hobbs:      Studies indicate that weight loss with Prozac alone only lasts for 6 months or so and then patients return to their previous weight. Have you had any problem with patients regaining a substantial amount of weight using Phen-Prozac?

    Anchors:   No. I have never seen a patient gain weight on Phen-Prozac.

    Hobbs:      What do you do when patients reach their target weight?

    Anchors:   About 25% of patients are able to stop taking the medicines, and the other 75% still need a small dose to maintain their lower weight.

    Hobbs:      What do you mean by a small dose?

    Anchors:   Typically, 15 mg of phentermine plus 10 mg of Prozac every other day for some weeks of the month.

    Hobbs:      Can other serotonin reuptake inhibitors (SSRI) be substituted for Prozac?

    Anchors:   Yes. Phen-Zoloft, Phen-Trazodone, and Phen-Luvox all seem to work.

    Hobbs:      How do you decide whether to use Prozac, Zoloft, trazodone or Luvox?

    Anchors:   If a patient is controlling their depression with one particular SSRI I’ll keep them on that and just add the phentermine. Or if I start a patient on Phen-Prozac and they experience side effects I may switch them to another SSRI.

    Hobbs:      For example?

    Anchors:   Zoloft is a good choice when patients are also taking medications for other conditions because it is less likely to interfere with other drugs. Zoloft also loosens the stool which is useful for patients who experience too much constipation from phentermine.

    If a patient has problems sleeping trazodone is a good choice. It’s also available as a generic so it’s cheap.

    And Luvox is a good choice for patients who experience a decrease in libido from Prozac.

    Hobbs:      What doses do you use?

    Anchors:   When I use Phen-Trazodone I have them take the phentermine in the morning and 50 to 100 mg of trazodone at night.

    When I use Phen-Luvox I have them take 25 to 50 mg of Luvox.

    And with Zoloft I use 25 to 50 mg.

    The dose of phentermine is always 30 mg.

    Hobbs:      Do you ever combine phentermine with 2 SSRIs like Phen-Prozac-Trazodone or Phen-Trazodone-Luvox?

    Anchors:   Yes. Sometimes I combine low dose Prozac with low dose trazodone in depressed patients, because trazodone helps them sleep.

    Hobbs:      Have you tried any other combinations like Phen-Tryptophan or Phen-5HTP (5-hydroxytryptophan)?

    Anchors:   No. I think that tryptophan is capable of causing heart valve disease for the same reason that fenfluramine does.

    Hobbs:      What criteria do you use for trying a patient on Phen-Prozac?

    Anchors:   The usual. I’ll try it only if they: 1) have failed to maintain weight loss by diet and exercise; 2) have a body mass index (BMI) greater than 30 or; 3) a BMI of 27 if they have obesity-related health problems. And, of course, they can’t have any contraindications to the medicines.

    Hobbs:      Are there SSRIs or other antidepressants that don’t work?

    Anchors:   Yes. Elavil√? (amitriptyline) and Pamelor√? (nortriptyline) don’t work because they stimulate appetite. Paxil√? doesn’t work either. Neither does Wellbutrin√? or Serzone√?.

    Hobbs:      What other benefits have you found with Phen-Prozac?

    Anchors:   Many of my patients have said they found it easier to stop smoking or drinking.

    I’ve also found that phentermine is an effective treatment for attention deficit disorder (ADD). I discovered this after some of my Phen-Prozac patients told me that could concentrate better. So I tried substituting phentermine for Ritalin in young obese patients with ADD and I found that phentermine worked just as well an Ritalin and they lost weight. Dr. Rothman previously published a paper on using phentermine for ADD.

    Rothman RB. Treatment of a 4-year-old boy with ADHD with the dopamine releaser phentermine [letter]. Journal of Clinical Psychiatry, 1996 Jul, 57(7):308-9.)

    Anchors:   I’ve also found that Phen-Prozac works for obsessive-compulsive disorder (OCD). After taking Phen-Prozac for a while one of my patients confessed that she previously had a compulsion to buy compact discs and had purchased 10,000 of them! After taking Phen-Prozac her compulsion went away and she lost 94 lbs. Other patients have told me that have stopped using their credit cards compulsively.

    And, as I mentioned before, Phen-Prozac seem to have an easier time stopping addictive behaviors like smoking, drinking and illicit drugs.

    Dr. Michael Anchors on Phen-Prozac (updated in October 2000)

    Hobbs:      How many patients have you treated with Phen-Prozac?

    Anchors:   1058. This is the total of all my patients on “Phen-Pro”, which consists of phentermine plus one of the serotonin reuptake inhibitors (SSRIs). About 70 percent of my patients are on Phen-Prozac, 20 percent of Phen-Zoloft, 10 percent on Phen-Luvox and 10 percent on Phen-Trazodone.

    Hobbs:      Have you tried Phen-Wellbutrin, Phen-Effexor, Phen-Serzone or Phen-Paxil?

    Anchors:   Yes, I’ve tried all of these. Phen-Wellbutrin doesn’t work any better than phentermine alone. That is tachyphylaxis develops after 6 weeks. It makes sense that Wellbutrin would not work because it doesn’t work on serotonin. The 3 times I tried it Phen-Serzone was not tolerated. And in all of the patients I tried Phen-Effexor they developed nausea. But now that slow-release Effexor XR has become available, it might be worth a second look. And Phen-Paxil does not work.

    Hobbs:      How do you decide whether to use Prozac, Zoloft, trazodone or Luvox?

    Anchors:   If a patient is controlling their depression with one particular SSRI I’ll keep them on that and just add the phentermine. Or if I start a patient on Phen-Prozac and they experience side effects I may switch them to another SSRI.

    Hobbs:      For example?

    Anchors:    Zoloft is a good choice when patients are also taking medications for other conditions because it is less likely to interfere with other drugs. Zoloft also loosens the stool which is useful for patients who experience too much constipation from phentermine.

    If a patient has problems sleeping trazodone is a good choice. It’s also available as a generic so it’s cheap.

    And Luvox is a good choice for patients who experience a decrease in libido from Prozac.

    Hobbs:      What doses do you use?

    Anchors:   The same doses that I suggested in Safer Than Phen-Fen, that is 10 or 20 mg of Prozac; 25 or 50 mg of Zoloft; 25 or 50 mg of Luvox; or 25 or 50 mg of Trazodone. Padla’s study showed that higher doses cause less weight loss than lower doses. I’ve confirmed this to be true.

    Hobbs:      Do you ever combine phentermine with two SSRIs like Phen-Prozac-Trazodone or Phen-Trazodone-Luvox?

    Anchors:   Yes. Sometimes I combine low dose Prozac with low dose trazodone in depressed patients, because trazodone helps them sleep.

    Hobbs:      What percentage of your Phen-Prozac patients have lost weight?

    Anchors:   Twenty-eight percent of my patients reached ideal body weight; 50 percent lost a significant amount of weight but plateaued; and the remaining 22 percent did not take the medicine or were lost to follow-up. I’ve only had 14 patients out of 1058 √? just over one percent √? who took the medicine and did not lose weight.

    Hobbs:      What do you do when patients reach their target weight?

    Anchors:   About 25 percent of patients are able to stop taking the medicines, and the other 75 percent still need a small dose to maintain their lower weight.

    Hobbs:      What do you mean by a small dose?

    Anchors:   Typically, 15 mg of phentermine plus 10 mg of Prozac every other day for some weeks of the month.

    Hobbs:      Do patients tend to regain weight after the initial 6 months of weight loss?

    Anchors:   Except in one case, I have NEVER seen a patient regain more than 10 pounds while taking the medicines. The one exception was one of the six people who lost 150 pounds. She regained 70 lbs while taking up to 90 mg of phentermine and low-doses of an SSRI. This is the only time I have ever tried 90 mg of phentermine, but it just didn’t work. I have no idea what’s going on with her. She reached a plateau from the underside! I offered her gastroplasty surgery, but her insurance is foot-dragging, so we are really waiting for other medicines to come out.

    Hobbs:      Have you tried 5-hydroxytryptophan (5-HTP) combined with phentermine?

    Hobbs:      What dietary advice do you give?

    Anchors:   I suggest my patients follow my 10 commandments. They are…

    1. Eat only when hungry, eat slowly and stop when full.

    2. Don’t even buy what you shouldn’t eat.

    3. Get aerobic exercise.

    4. Fill your plate with side-dishes first.

    5. Eat less of foods from land animals.

    6. Choose restaurants with smaller portions.

    7. Eat foods that are spicier and more aromatic.

    8. Reduce alcohol intake.

    9. Drink two big glasses of water with each meal.

    10. Don’t stay up late eating.

    It is also equally important to remove any interfering drugs and behaviors. Follow-up is also very important. I used to have patients come in every month for follow-up, but now I follow-up with a majority of them via email. It works very well. Simply handing patients a prescription without instructions on diet and exercise just doesn’t work.

     

     

     

    Phen-Prozac: Adding 5-HTP helpful about half of the time

    This is an update to the Interview with Dr. Michael Anchors which appeared in Obesity Research Update September/October 2000.

    Dr. Michael Anchors has found that adding 5-HTP to Phentermine-Proac helps about half of plauteaed patients to lose more weight.

    Michael Anchors, M.D., Ph.D. was the first to describe the use of phentermine combined with Prozac (fluoxetine) and other SSRIs in his best-seller Safer Than Phen-Fen (Prima Publishing, 1997). He is a clinical professor of medicine at Georgetown University and has a family practice in Gaithersburg, Maryland. A little over a year ago he started adding 5-hydroxytryptophan (5-HTP) in some of his patients taking Phen-Prozac. Larry Hobbs interviewed Dr. Anchors by email to find out what effect, if any, it has had.

    Dr. Anchors can be reached at:

    Michael Anchors, MD, PhD
    16220 Frederick Rd Ste 210
    Gaithersburg, MD 20877
    (301) 990-6061
    (301) 990-6064 Fax
    .(JavaScript must be enabled to view this email address)

    Hobbs:      How many patients have you treated with Phen-Prozac√?a combination of phentermine and an SSRI?

    Anchors:   1706 patients.

    Hobbs:      How many have reached ideal body weight√?a body mass index (BMI) less than 25?

    Anchors:   521.

    Hobbs:      Has weight regain been a problem?

    Anchors:   No. Only one patient has gained back more than 10 pounds.

    Hobbs:      How often do you use each of these SSRIs or drugs with phentermine and what doses do you use?

    Anchors:     My answers to this question are based on my current practice. Most of the drugs marked 0% were tried previously and did not work.

    Hobbs:      How do you decide which drug to use?

    Anchors:   I use Prozac first unless the patient is already on one of the five other effective SSRIs, in which case I leave the patient on their current SSRIs although I sometimes adjusting the dose downward since higher doses of SSRIs block the effect of phentermine (see Padla in NAASO abstracts November 1997). Prozac works fine for two-thirds of patients. In the other one-third I have to switch to another SSRI such as Celexa, Luvox or Effexor when a patient reports anorgasmia, that is inability to orgasm, or switch them to Trazodone if they report having insomnia.

    Hobbs:      What side effects are most common with each drug?

    Anchors:   The only side-effect specifically traceable to the SSRI is anorgasmia, that is inability to orgasm. It occurs more often in women than men. In those cases I switch them to Celexa or Effexor which are less likely to cause this problem. The SSRI’s seldom have side-effects with the small doses that I use. The side effects that patients report most often√?dry mouth, insomnia, fast heartbeat, sweating, etc.√?are caused by the phentermine, but they are not a problem for most people. Most of these side-effects, if they occur at all, occur to a mild degree during the first ten days as the patient is adjusting to the medication and then go away. That is why it is so important for physicians to start phentermine at a dose of 15 mg per day, and then only after the patients gets used to the medicine to increase it to 30 mg.

    Hobbs:      Do you ever add 5-hydroxytryptophan (5-HTP) to Phen-Pro (Phentermine-Prozac or other SSRI)?

    Anchors:   Yes.

    Hobbs:      In what percent of patients?

    Anchors:   

    Hobbs:      When do you add 5-HTP?

    Anchors:   Whenever a patient’s rate of weight-loss slows down and their hunger increases.

    Hobbs:      Does it help to break plateaus?

    Anchors:   Yes. That’s exactly what it does.

    Hobbs:      How often does it work?

    Anchors:   About half the time.

    Hobbs:      Does it reduce cravings?

    Anchors:   It’s difficult to say. The idea of √?cravings√? means different things to different people.

    Hobbs:      Does 5-HTP help reduce the symptoms of PMS?

    Anchors:   I don’t know. Many patients have reported a reduction in PMS with the initial use of an SSRI and since I don’t add the 5-HTP until later I don’t have a way of separating out the two.

    Hobbs:      Do you know why it is that sometimes 5-HTP doesn’t help?

    Anchors:   I don’t know for sure. Maybe their renewed hunger wasn’t caused by a reduction in serotonin. Or maybe the patient didn’t really have renewed hunger, but instead only claimed renewed hunger to cover for their behavior of eating when they weren’t hungry. I don’t really know.

    Hobbs:      Do patients notice any subjective differences when 5-HTP is added to Phen-Pro?

    Anchors:   A few patients have reported having nausea with the addition of 5-HTP, otherwise they have not reported any other differences.

    Hobbs:      Does it provide better appetite suppression?

    Anchors:   Yes, it definitely does in people who respond.

    Hobbs:      Does it help to reduce night time eating?

    Anchors:   I don’t know. I haven’t asked.

    Hobbs:      Have patients reported any effect improvement in insomnia, headaches, PMS, fibromyalgia?

    Anchors:   No, not that I have been told.

    Hobbs:      What is the average weight loss with Phen-Prozac vs Phen-Prozac-5HTP?

    Anchors:   I don’t know as far as total weight loss because everyone is started on Phen-Prozac and then 5-HTP is added later. The initial weight loss with phen-Prozac ranges from zero to 5.8 pounds per week with the average being about two pounds per week. After six weeks the rate usually settles down to somewhere between zero and three pounds per week with an average of about 1 pound per week. When a person plateaus and has stopped losing weight and I add 5-HTP weight loss returns to about one pound per week.

    Hobbs:      Do patients report any effect on mood with the addition of 5-HTP?

    Anchors:   No. I haven’t had anyone tell me that it has affected their mood.

    Hobbs:      Do patients report any effect on energy or fatigue?

    Anchors:   No.

    Hobbs:      Have you had any reports of daytime sleepiness?

    Anchors:   No.

    Hobbs:      What time of the day do you give it√?before meals or before bedtime?

    Anchors:   I found and patients have reported less nausea when 5-HTP is taken with food.

    Hobbs:      Is 5-HTP any less effective when taken with food?

    Anchors:   No. I’ve found weight loss to be the same whether they take it with food or on an empty stomach.

    Hobbs:      Do you ever vary the dose depending on the response, that is increase the dose if it doesn’t seem to be working?

    Anchors:   I would if it was necessary but the response seems pretty consistent in people who respond. I’ve had only one patient out of more than a hundred say that they found that 100 mg per day had no effect on their appetite, but increasing it to 200 mg was effective.

    Hobbs:      What is the smallest dose that you have found effective?

    Anchors:   100 mg. 50 mg is simply not enough. This is one reason I am confident that the effect from 5-HTP effect is not a placebo effect.

    Hobbs:      What is the largest dose that you have found necessary?

    Anchors:   200 mg.

    Hobbs:      Do you ever vary the dose depending on a woman’s cycle or if a person is under additional stress?

    Anchors:   No.

    Hobbs:      Do you keep patients on 5-HTP continuously?

    Anchors:   Yes, generally I have patient continue to take it, but I also tell them they can stop if they want to and see if their hunger returns at which time they can begin taking it again. However most of my patients have wanted to continue taking it for fear of gaining the weight back.

    Hobbs:      Do you have any patients taking it intermittently only when they feel it is necessary?

    Anchors:   A few, but not many.

    Hobbs:      Have you noticed any difference in response between men and women?

    Anchors:   Yes. Women are much more likely than men to respond to 5-HTP. But this may be because women are more honest with me about the return of hunger. Men are better at denial and rationalizing, and worse at following instructions or deferring to authority.

    Hobbs:      Have you found any difference in the response to 5-HTP depending on which SSRI you used?

    Anchors:   I don’t know. I haven’t looked at this.

    Hobbs:      With the addition of 5-HTP how much more common are: Nausea? Headaches? Sexual dysfunction?

    Anchors:   Nausea is the only problem. I have not had any reports of headaches or sexual dysfunction with 5-HTP.

    Hobbs:      Have you had any suspected cases of serotonin syndrome with the addition of 5-HTP?

    Anchors:   No. And I have carefully watched for this.

    Hobbs:      Have you tried adding carbidopa with 5-HTP as Richard Rothman suggests? If so, was it helpful? And did it cause any additional side effects?

    Anchors:   Initially I only gave 5-HTP with carbidopa. But later I found that 5-HTP alone was more effective, much better tolerated, and much cheaper. Theoretically it seems that 5-HTP-plus-carbidopa should work better, but this was not my experience.

    —END

    Articles on the same subject can be found here:


    COMMENTS

    Please feel free to share your comments about this article.


    Name:

    Email:

    Comments:

    Please enter the word you see in the image below:


    Remember my personal information

    Notify me of follow-up comments?



    © Copyright 2003-2017 - Larry Hobbs - All Rights Reserved.