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    People lost 22 lbs with phentermine vs 18.5 lbs w/ phentermine plus fenfluramine; 8.8 lbs w/placebo


    Posted by .(JavaScript must be enabled to view this email address)
    Tuesday, August 31, 2010 12:58 pm Email this article
    The combination of phentermine plus fenfluramine was all the rage from late-1994 until July 1997 when the Mayo Clinic announced heart valve problems in patients taking fenfluramine (Pondamin) or dexfenfluramine (Redux), and the US Food and Drug Administration (FDA) removed it from the market.

    Fen-Phen, as it was called, was said to be more effective than either drug alone.

    However, a 1984 study showed that phentermine alone caused more weight loss than the combination of the two drugs:
    ( Thank you to Michael Anchors, MD, PhD for pointing this study out to me. ) Study Performed by Michael Weintraub, MD

    Study performed by Michael Weintraub, the author of the Fen-Phen study from 1992 that generated all the interest

    Interesting, the study was performed by by Michael Weintraub, MD, the same person who later published a larger, longer trial of Fen-Phen that was published in 1992, and started the interest in Fen-Phen.

    The craze really took off in Dec 1994 after the discovery of the first obesity.

    This gave people a reason to say, “Look, there is a genetic factor to this. We should treat this with drugs like any other disease.”

     

    Conclusion

    Study conclusion

    “Combining fenfluramine and phentermine capitalized on their pharmacodynamic differences, resulting in equivalent weight loss, fewer adverse effects, and better appetite control,” they researchers concluded, even though weight loss was better with phentermine alone, although the difference was not statistically significant.

     

    Comments

    Comments: Some doctors told me phentermine alone was just as good as phentermine plus fenfluramine

    After fenfluramine was removed from the market, some doctors told me that fenfluramine was absolutely essential, and that the drug would be greatly missed.

    However, other doctors told me that phentermine alone caused just as much weight loss as the combination, however, it just took a little longer to achieve the weight loss.

     

    Phentermine plus 5-HTP

    Some doctors use phentermine plus 5-HTP

    Some doctors started using phentermine plus 5-HTP to work in a similar way to Fen-Phen, that is, phentermine releases noradrenaline, whereas 5-HTP is converted into serotonin in the body.

     

    Articles about phentermine plus 5-HTP

    Articles about giving phentermine with 5-HTP include:

    One patient given phentermine plus 5-HTP plus carbidopa lost 24% in 6 months

    Phentermine (Adipex-P) plus 5-HTP used by 20% of weight loss doctors surveyed

    5-HTP studies reviewed

    —-

    Other research

    Here are some previous findings about 5-HTP.

    A study from Japan found that 5-HTP increases leptin, the hormone that is released by fat cells with reduces appetite and may or may not increase metabolism.
      They also found that 5-HTP did not increase leptin when given with carbidopa.

    One study found 5-HTP was eight times more effective at reducing stress-induced eating in rats than reducing eating in rats that had not been fed.

    Dr. Michael Anchors sometimes adds 100 mg of 5-HTP to patients taking Phen-Pro, the combination of phentermine combined with Prozac or other certain SSRI’s, when the patient seems to have plateaued, or sometimes uses 5-HTP instead of Prozac or an SSRI.
      Dr. Anchors has found that 5-HTP seems to help women more than men. Dr. Dennis Padla, as discussed below, reports the same thing.
      Dr. Anchors has found that 5-HTP works better without carbidopa and is better tolerated alone. Some researchers initially theorized that the opposite would be true.

    Dr. Richard Rothman gives patients 5-HTP in combination with phentermine.
      Dr. Rothman also adds carbidopa, which most other doctors do not.

    Dr. Jay Piatek has found that 5-HTP reduces sweet cravings, and often adds it to patients who are taking phentmerine but still have crave sweets. He has also found that only about 10 percent of men crave sweets and that usually 50 mg per day of 5-HTP is enough, whereas about 80 percent of women crave sweets, and more than 50 mg per day is usually required for them.

    Dr. Piatek has patients “start with 50 mg in the evening between dinner and bedtime.
        “After a week they increase it to 100 mg in the evening if needed.
        “Then after five days, if they continue to be hungry or have sweet cravings, I add 50 mg in the morning in addition to the 100 mg in the evening.
        “I allow them to increase it by 50 mg every five days, if necessary, first increasing the evening dose and then increasing the morning dose to a maximum of 300 mg per day—150 mg in the morning and 150 mg in the evening.
        “I have them adjust the dose until they get a feeling of fullness and eliminate their sweet cravings.”

    Dr. Dennis Padla sometimes adds 5-HTP—50 mg, 100 mg, 200 mg or 300 mg—along with 50 mg of vitamin B6 (to help with conversion to serotonin) to patients who have plateaued taking one of the Phen-Pro combinations—phentermine plus Prozac (fluoxetine) or certain other SSRIs.
      Dr. Padla says it helps about 30-40 percent of the time, however, it may also increase the incidence of some side effects.

    Dr. William Wilson sometimes adds 5-HTP to phentermine and drugs such as Celexa (citalopram) in patients with serotonin deficiency.

    In his book “5-HTP: The Natural Way to Boost Serotonin and Overcome Depression, Obesity, and Insomnia” Naturopathic doctor Michael Murray recommends 50 to 100 mg of 5-HTP three times a day 20 minutes before meals, but says that it varies.

     

    5-HTP : Cheapest Source I’ve Seen

    The cheapest source of 5-HTP I’ve seen is from Beyond-A-Century.com : $0.12 for 100 mg dose

    The cheapest source of 5-HTP is in powder form from Beyond-A-Century.com.

    They are currently selling it for $23.50 for 20 grams (20,000 mg).

    Most doctors using it have their patients take 100 mg per day.

    This means that cost for the powder is $0.12 per day per 100 mg dose as powder.

    REFERENCE

    Weintraub M, Hasday J, Mushlin A, Lockwood D. A double-blind clinical trial in weight control. Use of fenfluramine and phentermine alone and in combination. Arch Intern Med. 1984 Jun, 144(6):1143-48.

    Articles on the same subject can be found here:


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