Mancini Marcio C, Halpern Alfredo
Endocrinology and Metabology Division, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP.
Arq Bras Endocrinol Metabol. 2006 Apr;50(2):377-89. doi: 10.1590/s0004-27302006000200024. Epub 2006 May 23.
This review offers an overview of physiological agents, current therapeutics, as well as medications, which have been extensively used and those agents not currently available or non-classically considered anti-obesity drugs. As obesity - particularly that of central distribution - represents an important triggering factor for insulin resistance, its pharmacological treatment is relevant in the context of metabolic syndrome control. The authors present an extensive review on the criteria for anti-obesity management efficacy, on physiological mechanisms that regulate central and/or peripheral energy homeostasis (nutrients, monoamines, and peptides), on beta-phenethylamine pharmacological derivative agents (fenfluramine, dexfenfluramine, phentermine and sibutramine), tricyclic derivatives (mazindol), phenylpropanolamine derivatives (ephedrin, phenylpropanolamine), phenylpropanolamine oxytrifluorphenyl derivative (fluoxetine), a naftilamine derivative (sertraline) and a lipstatine derivative (orlistat). An analysis of all clinical trials - over ten-week long - is also presented for medications used in the management of obesity, as well as data about future medications, such as a the inverse cannabinoid agonist, rimonabant.
本综述概述了生理制剂、当前的治疗方法以及已被广泛使用的药物，还有那些目前尚未上市或非传统意义上被视为抗肥胖药物的制剂。由于肥胖——尤其是中心性分布的肥胖——是胰岛素抵抗的一个重要触发因素，因此其药物治疗在代谢综合征的控制方面具有重要意义。作者对抗肥胖管理疗效的标准、调节中枢和/或外周能量稳态的生理机制（营养素、单胺和肽）、β-苯乙胺药理衍生物（芬氟拉明、右芬氟拉明、苯丁胺和西布曲明）、三环衍生物（马吲哚）、苯丙醇胺衍生物（麻黄碱、苯丙醇胺）、苯丙醇胺氧三氟苯基衍生物（氟西汀）、萘替林衍生物（舍曲林）和脂抑素衍生物（奥利司他）进行了广泛综述。还对用于肥胖管理的药物进行了为期十周以上的所有临床试验分析，并给出了有关未来药物的数据，如反向大麻素激动剂利莫那班。
