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Sanorex (mazindol)

Sanorex (mazindol): Sanorex, approved in the 1970s, is a sympathomimetic amine that suppresses appetite. It is rarely prescribed due to concerns about its potential for abuse and side effects, including high blood pressure, dry mouth, and constipation.

Sanorex or mazindol was never widely prescribed in the US but is Japan's most popular weight loss medication.
Era of Discovery


Mechanism of Action

Suppresses appetite

History of Use in the United States

Approved in the 1970s

Benefit of Weight Loss Agent or Medication

Weight loss due to appetite suppression

Possible Side Effects

High blood pressure, dry mouth, constipation

Current Regulatory Status in US

Rarely prescribed

Sanorex: The Lesser Known Weight Loss Medication

Mazindol, more commonly known by its trade name Sanorex, is a lesser-known medication in the arena of weight loss. Similar to other weight loss medications, its history, mode of action, safety profile, and continued use paint a nuanced picture.

Mazindol's History and Initial FDA Approval

Mazindol was first developed in the early 1970s and received FDA approval for the short-term treatment of obesity in 1973. It was marketed under several trade names, the most well-known being Sanorex. However, compared to other weight loss drugs like phentermine and fenfluramine, mazindol has always been somewhat in the shadow, receiving less attention in clinical practice and the pharmaceutical market.

Mode of Action

Mazindol's primary mechanism of action is as a sympathomimetic amine, which works to suppress appetite. It inhibits the reuptake of norepinephrine and dopamine in the brain, similar to amphetamines, thus stimulating the central nervous system and reducing appetite. However, mazindol also has a unique property of acting as a serotonin reuptake inhibitor, but to a much lesser degree than its action on norepinephrine and dopamine. This balanced mechanism may offer a unique therapeutic window, but it also means mazindol comes with its share of side effects.

Safety Profile and Concerns

As with most weight loss medications, mazindol carries a risk of side effects. These can include restlessness, nervousness, elevated blood pressure, and elevated heart rate. The appetite-suppressing effects of mazindol can wane over time as the body becomes accustomed to the medication, leading to a plateau in weight loss. In rare cases, mazindol has been associated with more serious side effects like pulmonary hypertension and heart valve disease, though these are much less common than with drugs like fenfluramine.

Current Availability and Usage

Mazindol was voluntarily withdrawn from the U.S. market by its manufacturer in 1999, not due to safety issues, but economic ones. However, it is still available in other countries and used off-label in the U.S. Its lower profile compared to other weight loss medications means that its use is relatively niche.

In summary, mazindol's role in weight loss treatment has been more subdued compared to other drugs. Its history is less fraught with controversy, and its continued use suggests that, for some patients and physicians, it provides a viable option for the management of obesity. As with all weight loss medications, the key is in finding the right balance between efficacy, side effects, and individual patient factors.

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