Central Nervous System Medications

Medications approved for adults include:

• Lorcaserin
• Phentermine
• Phendimetrazine
• Diethylpropion
• Phentermine plus extended release topiramate

Medications approved for children and adolescents include:

• Amphetamine sulfate (for children over 11 years old)
• Phentermine or diethylpropion (for children over 16 years old only)

These medications act on your brain to suppress your appetite. Lorcaserin is approved for long-term use. Phentermine, phendimetrazine and diethylpropion are only recommended for short-term use (a few weeks).

Possible side effects include:

• Lightheadedness
• Dry mouth
• Headache
• Constipation or diarrhea
• Nausea
• Nervousness
• Sleeplessness
• Restlessness
• Elevated blood pressure
• Heart problems

Also:

• Lorcaserin
  • Fatigue
  • Back pain
  • Cough
• Phentermine and amphetamine sulfate:
  • Difficulty urinating
  • Rash
• Phentermine plus extended release topiramate
  • Numbness or tingling of skin
  • Change in taste
  • Depression

Fat Absorption Blockers

Orlistat:

• Xenical (prescription)
• Alli (over-the-counter)

Approved for use in children and adults over 11 years old. Taken at a dose of 120 milligrams (mg), 3 times a day, Xenical prevents ingested fat from being absorbed by blocking digestive enzymes. About 30% of the fat you eat will remain in your bowels. In some, the fat is excreted by the body between bowel movements as an oily discharge. It is recommended for long-term use (up to about 2 years). Orlistat is also available in a 60 mg over-the-counter form, called Alli.

Possible side effects include:

• Staining of underwear
• Gas
• Pressure to empty bowels
• Leakage of stool
• Increased frequency of bowel movements
• Severe liver damage (rarely)

Glucagon-Like Peptide-1 (GLP-1) Inhibitors

• Liraglutide

Liraglutide is used for chronic weight management if you have at least one other weight-related complication. It works by making you feel less hungry or fuller faster while eating. The medication is given as a daily injection. Dosage is slowly increased until you are up to 3 mg a day.

Possible side effects may include:

• Nausea
• Constipation
• Diarrhea
• Abdominal pain
• Headache
• Increased heart rate
• Serious side effects may include an increased risk of pancreatitis.

Monoamine Oxidase Inhibitors (MAOI)

• Naltrexone-Bupropion

Used for chronic weight management in combination with a reduce calorie diet and regular exercise. The pill is a combination of 2 drugs. It works by making you feel less hungry or fuller faster while eating. The medication is extended release tablet taken by mouth. Dosage is slowly increased from one table to 2 tablets a day.

This medication is not recommended in those with a history of poorly controlled high blood pressure, or a history of seizures, eating disorders ( anorexia or bulimia), opioid dependency, or alcohol and drug withdrawal. If you are already taking bupropion for other reasons, do not take this medication.

Possible side effects include:

• Lightheadedness
• Constipation
• Diarrhea
• Nausea or vomiting
• Dry mouth
• Sleeplessness
• Increased heart rate
• Elevated blood pressure
• Serious side effects may include liver damage

NOTE: This medication may increase the risk of suicidal thoughts or actions. If you have these thoughts or actions, call for emergency medical services right away.