This Is MS Multiple Sclerosis Knowledge & Support Community

Ok, here I go again... A week before I ended up in the hospital for MS (June 05), I had been taking a weight loss drug called Phentermine. It was very effective. I stopped taking abruptly because I thought its effectiveness was wearing off and I was tired of the head-ache it was giving me every night when I "came down" off of this drug. Next week: I am in the hospital. I told my attending doctors that I was taking this drug, but stopped the week before. They didn't have any concern for that.

Fast forward to now. I started taking phentermine again to see what would happen, I want to lose more weight. Although I have had no more symptoms of MS (yet) I can tell that it is affecting my mood, and it is causing muscle twitching. I started poking around the phentermine.com forum and found that there were several references to vision problems, and numbness in hands or limbs. After a few of those people when to the doctor, they were told they had MS.

Does anyone here think it is possible that this drug could cause brain damage in some people? Would it be possible for anyone else to try to confirm this? I have googled my self to death on it and all i come up with are the cases on the www.phentermine.com forum. Somebody else's opinion would be appreciated, although it may take a little research. If confirmed, I wonder if this really could be a side effect of phentermine that hasn't been realized?

Thanks,
Brock

Just one example of what I am talking about:
http://www.phentermine.com/forums/ultim ... tml#000001

Phentermine Profile:
http://en.wikipedia.org/wiki/Phentermine

Another link of interest:

http://www.phentermine.com/forums/ultim ... tml#000000

Yet another suspect link... I am sure this thread doesn't concern to many, however, if for no other reason I can at least gather my thoughts here... -B


http://www.phentermine.com/forums/ultim ... tml#000010

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Bob,

I know. I have already stopped taking again. In light of the new information I've found. Its not worth messing with. Kind of stupid to try to lose weight like that. Nothing is easy.

Brock

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From the google queen

Psychiatric Symptoms May Signal Brain Damage From Diet Pills
Users of widely prescribed diet pills may suffer irreversible loss of brain serotonin nerve terminals, possibly resulting in symptoms of anxiety, depression, cognitive and sleep problems, suggests the first author of a newly published report on fenfluramine side effects. National Institute of Mental Health researcher Una McCann, M.D., and colleagues, report on their review of 90 animal studies on serotonin neurotoxicity and primary pulmonary hypertension from fenfluramine and its chemical cousin dexfenfluramine, in the August 27 issue of the Journal of the American Medical Association.

An estimated 50 million people have taken the drugs, often in combination with phentermine (hence "fen/phen"), an amphetamine-like diet drug that counteracts the fenfluramines' tendency to induce drowsiness. The study cautions that if the animal findings apply to humans, the brain damage "would be expected to occur in almost everyone taking a dose sufficient to achieve weight loss."

"I think there is cause for concern that people who take fenfluramines are at risk for a host of problems," said McCann, chief of anxiety disorders research in the NIMH Biological Psychiatry Branch, Bethesda, MD. "A dose comparable to that prescribed to reduce weight in humans causes neurotoxicity in monkeys."

"It might be justifiable for someone who is morbidly obese and hence at risk for serious health problems, but not for a person who just wants to lose a few pounds for cosmetic reasons," explained McCann. "Many people who try diet pills quickly regain their weight after they stop taking the drugs, so they might be tempted to continue taking them. We won't know the long-term risks of these drugs until controlled studies are completed in humans."

In one study reviewed, monkeys' brains continued to show signs of damage 17 months after taking a course of the drug. Much like the branches of a tree, neurons contain extensions called axons that transport messenger chemicals like serotonin and form synapses -- connections with other neurons. Fenfluramines damage serotonin-secreting neurons by pruning these axons, which do not grow back in monkeys, although studies show that they do in rodents. And since human brains are more like those of monkeys, any such damage in humans would also likely be permanent, according to McCann.

"However, the neurotoxic potential of fenfluramines in humans has not been systematically evaluated," write the researchers. Moreover, "the functional consequences of brain serotonin neurotoxicity are largely unknown," even though the neurotransmitter is thought to be important "in a variety of brain functions, including cognition and memory and the regulation of mood, anxiety, impulsivity, aggression, sleep and neuroendocrine function."

In fact, McCann cites case reports that some users have experienced psychiatric disorders, which, she points out, tend to be under-diagnosed in clinical practice. Studies also document that fenfluramines increase the risk for developing primary pulmonary hypertension, a rare, but incurable and life threatening illness.

The researchers advise doctors to be vigilant for both behavioral and cardiopulmonary side effects, and that patients be apprised of the risks and benefits of fenfluramines for weight loss.

Also participating in the study were: Lewis Seiden, Ph.D., University of Chicago; Lewis Rubin, M.D., University of Maryland; George Ricaurte, M.D., Ph.D., Johns Hopkins University. The study was supported by the NIMH Intramural Research Program and grants from the National Institute on Drug Abuse (NIDA).

NIMH and NIDA are components of the National Institutes of Health, an agency of the U.S. Department of Health and Human Services.



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Jules Asher
Public Affairs and Science Reports Branch
National Institute of Mental Health
5600 Fishers Lane
Rm. 7-99
Rockville, MD 20857
(301) 443-4536
fax (301) 443-0008.
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Diet Pills Potential Killers
The U.S. FDA recalled the diet pills Redux (sold in the Philippines as Adifax) and Pondimin because of increasing evidence that they can cause damage to the heart and lungs.

I had heard warnings (they turned out to be prophetic) from researchers during a weight management forum I attended in the U.S. in 1996. The researchers were questioning why the FDA had approved the use of Redux for up to a year when, in their opinion, there wasn't enough evidence yet of safe long-term use. One of the scientists went as far as calling the FDA "crazy".

They predicted an increase in the number of cases of primary pulmonary hypertension or PPH (high blood pressure of the lungs) and heart valve problems. It didn't take long for their predictions to come true.

In July 1997, CNN reported that the Mayo Clinic had found evidence of heart disease in 24 women taking either Redux or "fen/phen" (Pondimin in combination with Ionamin). Subsequently, the FDA received reports of 58 more cases.

Old drugs, new combination.
The diet drugs, fenfluramine (Pondimin) and phentermine (Ionamin), have both been around for twenty years but were never very popular because the weight loss effects only lasted for so long as the individual continued to take the pills.

There were also unpleasant side effects. Fenfluramine can cause dry mouth, drowsiness, and diarrhea. Phentermine, meanwhile, can cause dry mouth, nervousness, constipation, and insomnia.

In 1992, Michael Weintraub, a medical doctor doing research at the University of Rochester, discovered that by combining the two drugs, the side effects were lessened and weight loss results were increased. Fenfluramine makes you feel full and reduces cravings for carbohydrates while phentermine suppresses your appetite.

After Weintraub's findings were published, sales for both fenfluramine and phentermine increased dramatically. In fact, the company that manufactures fenfluramine admitted in an interview with Idea Today, a magazine for fitness professionals, that they could not keep up with the demand in spite of operating their production lines 24 hours a day!

The "fen/phen" craze was off and running. Fen/phen weight loss clinics sprouted almost overnight in major American cities. I once counted nine ads for clinics offering the fen/phen treatment in a single issue of the Los Angeles Times.

Redux.
Redux was the brainchild of Richard Wurtman, a neurologist at M.I.T. who likened it to a "super Prozac". It is the first diet pill in 23 years to be approved by the FDA. Redux or Adifax are brand names for dexfenfluramine, a variation of fenfluramine.

It is ironic that the FDA, which is usually very conservative about approving new drugs, would approve Redux when many scientists tried to block approval citing evidence that it could increase pulmonary risk. A major European study that was published in The New England Journal of Medicine found that the risk of primary pulmonary hypertension increased by 30 times in people who took the drug for as little as three months.

Dexfenfluramine had been available in Europe since 1985. After the controversial European study was published, sales in Europe plummeted by 80%. A little too late for the many people who now had an often fatal disease.

PPH is characterized by a tightening of the blood vessels of the lungs. The constricted blood vessels force the heart to work so hard at pumping blood that eventually it fails. The statistics are dismal -nearly half of all PPH patients die from heart failure within four years.

The National Task Force on the Prevention and Treatment of Obesity, an organization that includes 14 of the most prestigious researchers in the management of obesity, also cautioned against the routine use of these diet pills. They discovered that there were only 200 people who had taken the drugs for more than two years. Under the circumstances, the task force felt it was inappropriate to declare the drugs safe for long term use.

Brain damage.
Primary pulmonary hypertension is not the only health risk associated with the use of both Redux and fen/phen. Dexfenfluramine and fenfluramine cause changes in brain cells to occur. There is some controversy as to whether these changes can be defined as brain cell damage. Definite cases of brain damage have been found in laboratory animals given the drugs but not in humans. Dr. George Ricaurte, a neurologist at the John Hopkins School of Medicine says that while scientists don't know whether dexfenfluramine produces the same brain damage in humans, they are concerned that it may.

Lewis Seiden, a neuropharmacologist at the University of Chicago cautions that damaged brain nerve cells may not be apparent for many years. So there is a possibility that the people who are currently taking Redux, Adifax or fen/phen may not notice changes in their behavior or functioning till many years from now.

Use and abuse.
Both Redux and the fen/phen treatments were originally designed to be used only as a last resort with obese people whose lives were being threatened by their excess weight.

Unfortunately, because of the public's obsession with being thin and unscrupulous medical personnel, these drugs have become available even to people who only need to lose ten or twenty pounds.

Last year, I found myself sitting beside a woman at a luncheon party who showed off her Adifax pill as the latest thing in weight control. This woman was by no means obese. When I told her about the warnings I had heard about dexfenfluramine, she retorted that since it was doctor prescribed it couldn't possibly be harmful. I wonder what she thinks about it now.

Teagan Clive, a writer for Muscle and Fitness Magazine was able to get a prescription for fen/phen from a weight loss clinic in the U.S. after she claimed she wanted to lose 15 pounds. She had just modeled for a fitness photo layout.

Diet pills not worth the risk.
The sad truth about Redux and fen/phen is that they are only effective while treatment is going on. Once the drugs are stopped, 95 % of the people regain all the lost weight within five years. This is one case where the risks definitely outweigh the benefits!

http://tinajuanfitness.info/articles/art092597.html

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You want to loose weight do it the easy way. Didn't say yummy(at first) but did say easy. This is all considering you are not gluten sensitive not sensitive to these particular foods. Hard to plan a meal for someone who's diet I don't know.
Breakfast get a high fiber bran cereal. I like all bran bud as it's 18 grams I believe of fiber in 1/2 cup. Now don't go mad at first build up John and I strive for 38-50 grams of fiber per day. Use 1/2 cup of that then add a non sugared cereal like raisin bran or rice crispies or corn flakes(idea is one of the plain ones) to that add a 1 TBS of ground flax but only if you keep it frozen as otherwise it goes rancid to quick and will play havoc with a free radical attack. Toss in 1/2 -1cup fresh pineapple or grapes or berries. Have a decalf coffee and a 4 oz of juice or milk.
Snack on any fruit in between meals or veggies
Lunch any fresh veggies use a low fat cottage cheese(if dairy isn't a problem for you)and in that mix a touch of garlic some turmeric, celery seed and any other spice you like or use plain yogurt for a change. a dense toast I like farmer's rye make a sandwich with tuna or salmon or meats just not cold cuts they will kill ya(an opinion don't freak). Add tomato, onion, hot peppers you get the idea all the crunchy veggies you can sneak in. Also try making a bean salad if legumes aren't a problem or tomato sprinkled with a tad of low fat feta and balsamic vinegar and don't forget the turmeric and it should have it's own shaker by the end of the week. Just to good for you to miss. Vitamin D3 in my opinion also acts as an appetite suppressant but that's something you need to feel comfortable taking I'm no doctor.Remember tinned tomatoes heat them with some hot peppers if you like them and add onion and celery and spinach and such you can eat as many as you want but to many will give cankers as they are acidic. We can eat a tin 3 or 4 days a week no problem. Plain soup broth with veggies you've added also fills you up. I bit high sodium but if you are not sodium sensitive worth a go. If you like thicker soups cook squash,carrot leek and such and blend it for the broth then add the other stuff.
Main courses and keep in mind I don't believe in dietary cholesterol from good sources as problematic so shrimp is great as well as sea scallops,crab,lobster,salmon,mackerel,tuna(I know mercury flags are going off so only a couple helpings of tuna per wk)trout, escargots(Absolutely NO BUTTER on any) use lemon or lime or shrimp sauce for a garnish. Hot pepper,garlic we use allot of although some are a tad timid on garlic as it boost the immune system. Turkey breast is a great lean protein and we even like a nice lean spiral ham or once a week John has lean beef or pork or maybe lamb. Only once a week. The other days are seafood or Turkey or chicken.All the vegetables you can eat I don't care if you eat them raw or cooked just eat them. Eat all day snack all night on veggies. We use red hot sauce for a garnish or hot mustard or even a no fat sour cream mixed with garlic and pepper. Wild rice is great as well as barley and whole wheat or whole grain noodles but only a 1.5 cup of those per day. One or the other. Bread no more than 2 slices of a dense bread. Need to snack on something crunchy get your cereal out. Also sauerkraut is great and a good probiotic yogurt to keep your gut flora stable.The first 2 weeks is tough but once the fat and sugar are out of your system you will not miss them Try it for 2 weeks you will not believe how well it works. I'm here if you need help

PPH Lawsuits: What is the problem with Fen Phen?
Pondimin (also known as fenfluramine), and Redux (also known as dexfenfluramine), are prescription diet drugs that were distributed through doctors and weight loss clinics. When Pondimin and/or Redux were taken in combination with Phentermine, it was popularly referred to as Fen-Phen. Fenfluramine [fen] and Phentermine [phen], were separately on the market since the 1970s.

Physicians became interested in combining the medications following the 1992 publication of a University of Rochester study conducted by Dr. Michael Weintraub wherein he described long-term successful weight loss results when combining the two medications. Soon after that, millions of people were presecribed the Phen-Fen combination.

The “Fen" (fenfluramine) had always been known to have an appetite suppressing effect, but had the undesirable side effect of making people sleepy. The gist of combining the drugs was to counterbalance this sleepiness by adding “Phen" (phentermine), a mild stimulant. The drugs were then marketed under the catch phrase "fen-phen".

Fen-phen refers to the combination of fenfluramine and phentermine. Phentermine has also been used in combination with dexfenfluramine (dexfen-phen). Fenfluramine (fen) and phentermine (phen) are prescription medications that have been approved by the FDA for many years as appetite suppressants for the short-term (a few weeks) management of obesity.

The two drugs were around a long time before they were used together. Phentermine was approved in 1959 and fenfluramine in 1973. Dexfenfluramine (Redux) was approved in 1996 for use as an appetite suppressant in the management of obesity.

Recently, some physicians have prescribed fenfluramine or dexfenfluramine in combination with phentermine, often for extended periods of time, for use in weight loss programs. Use of drugs in ways other than described in the FDA-approved label is called "off-label use." In the case of Fen-Phen and dexfen-phen, no studies were presented to the FDA to demonstrate either the effectiveness or safety of the drugs taken in combination. (Source: FDA)




Contact An Attorney: Do I have a PPH lawsuit?

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PHENTERMINE
Generic Name: phentermine (FEN ter meen)
Brand Names: Adipex-P, Fastin, Ionamin, Obenix, Obephen, Oby-Cap, Oby-Trim, Panshape M, Phentercot, Phentride, Pro-Fast HS, Pro-Fast SA, Pro-Fast SR, Teramine, Zantryl





What is the most important information I should know about phentermine?
• Use caution when driving, operating machinery, or performing other hazardous activities. Phentermine may cause dizziness, blurred vision, or restlessness, and it may hide the symptoms of extreme tiredness. If you experience these effects, avoid hazardous activities.
• Phentermine is habit forming. You can become physically and psychologically dependent on this medication, and withdrawal effects may occur if you stop taking it suddenly after several weeks of continuous use. Talk to your doctor about stopping this medication gradually.
• Do not crush, chew or open any "once-daily" phentermine tablets or capsules. Swallow them whole.




What is phentermine?
• Phentermine is a sympathomimetic amine, which is similar to an amphetamine. It is also known as an "anorectic" or "anorexigenic" drug. Phentermine stimulates the central nervous system (nerves and brain), which increases your heart rate and blood pressure and decreases your appetite.
• Phentermine is used as a short-term supplement to diet and exercise in the treatment of obesity.
• Phentermine may also be used for purposes other than those listed in this medication guide.




Who should not take phentermine?
• You cannot take phentermine if you
· have heart disease or high blood pressure;
· have arteriosclerosis (hardening of the arteries);
· have glaucoma;
· have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days; or
· have a history of drug or alcohol abuse.
• Before taking this medication, tell your doctor if you have
· problems with your thyroid,
· an anxiety disorder,
· epilepsy or another seizure disorder, or
· diabetes.
• You may not be able to take phentermine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.
• It is not known whether phentermine will harm an unborn baby. Do not take phentermine without first talking to your doctor if you are pregnant.
• It is also not known whether phentermine passes into breast milk. Do not take phentermine without first talking to your doctor if you are breast-feeding a baby.




How should I take phentermine?
• Take phentermine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Phentermine is usually taken once or twice a day before a meal on an empty stomach.
• Do not take phentermine in the evening because it may cause insomnia.
• Do not crush, chew or open any "once-daily" phentermine tablets or capsules. Swallow them whole.
• Never take more of this medication than is prescribed for you. Too much phentermine could be very dangerous to your health.
• Store phentermine at room temperature away from moisture and heat.




What happens if I miss a dose?
• Take the missed dose as soon as you remember. However, if it is almost time for your next dose or if it is already evening, skip the missed dose and take only your next regularly scheduled dose. A dose taken too late in the day will cause insomnia. Do not take a double dose of this medication.




What happens if I overdose?
• Seek emergency medical attention.
• Symptoms of a phentermine overdose include restlessness, tremor, rapid breathing, confusion, hallucinations, panic, aggressiveness, nausea, vomiting, diarrhea, an irregular heartbeat, and seizures.




What should I avoid while taking phentermine?
• Use caution when driving, operating machinery, or performing other hazardous activities. Amphetamine may cause dizziness, blurred vision, or restlessness, and it may hide the symptoms of extreme tiredness. If you experience these effects, avoid hazardous activities.
• Do not take phentermine late in the day. A dose taken too late in the day can cause insomnia.




What are the possible side effects of phentermine?
• If you experience any of the following serious side effects, stop taking phentermine and seek emergency medical attention:
· an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
· an irregular heartbeat or very high blood pressure (severe headache, blurred vision); or
· hallucinations, abnormal behavior, or confusion.
• Other, less serious side effects may be more likely to occur. Continue to take phentermine and talk to your doctor if you experience
· restlessness or tremor,
· nervousness or anxiety,
· headache or dizziness,
· insomnia,
· dry mouth or an unpleasant taste in your mouth,
· diarrhea or constipation, or
· impotence or changes in your sex drive.
• Phentermine is habit forming. You can become physically and psychologically dependent on this medication, and withdrawal effects may occur if you stop taking it suddenly after several weeks of continuous use. Talk to your doctor about stopping this medication gradually.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.




What other drugs will affect phentermine?
• You cannot take phentermine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days.
• Changes in insulin and other diabetes drug therapies may be necessary during treatment with phentermine.
• Phentermine may reduce the effects of guanethidine (Ismelin). This could lead to an increase in blood pressure. Tell your doctor if you are taking guanethidine.
• Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin). These drugs may decrease the effects of phentermine.
• Drugs other than those listed here may also interact with phentermine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.




Where can I get more information?
• Your pharmacist has more information about phentermine written for health professionals that you may read.



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• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.


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Melody,

Thank you for this information! That's actually pretty scary. I was only taking Phentermine, not fenfluramine. Believe it or not, there is a doctor in the city I live in that will openly prescribe Phentermine if you want to lose weight. Regardless of whether your are morbidly obesese or not.

I am sure it is possible that Phentermine alone can cause problems. I really shouldn't be trying to cut corners by taking this risk. Its just not worth it. I will give your advice a try with respect to dieting, it sounds like a tasty diet actually. I was on the BBB diet for a while after I got diagnosed, and it was actually great. I ate a lot of salmon, and other fish and vegetables. I lost weight, and felt great, I just got complacent.

What are some causes of protein in CSF? Can brain damage cause protein to show up in CSF? Is the level of protein in CSF patients alway elevated? or only during an exacerbation/live disease activity?

Thanks again for your research and advice to both you and Bob, it is very good information.

Brock

viper498 wrote:Melody,



What are some causes of protein in CSF? Can brain damage cause protein to show up in CSF? Is the level of protein in CSF patients alway elevated? or only during an exacerbation/live disease activity?



Brock

I can honestly say I'd never heard of it. seems a bit in depth for just googling. Someone here should have an answer with luck.

Thats a test they use to "help" diagnose someone with MS. They test the Cerebral Spinal Fluid of a patient to see if it has protein in it. That is supposed to tell them something, but I am very confused as to how relevant that may be in diagnosis.

Brock