China
Africa
Explore chapters and articles related to this topic
Medications That May Be Useful in the Management of Patients with Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
Fenfluramine may cause drowsiness. Avoid concomitant consumption of alcohol. These drugs should generally be taken on an empty stomach; mazindol may be taken with meals to reduce gastrointestinal irritation.
Sympathomimetic Amines: Actions and Uses
Published in Kenneth J. Broadley, Autonomic Pharmacology, 2017
Amphetamine was found to promote weight loss when used in patients suffering from narcolepsy (prolonged bouts of sleepiness). Dexamphetamine (DexedrineR) has been used in the treatment of obesity, the weight loss being due to suppression of appetite rather than an effect on energy expenditure. Its effect is short-lived since tolerance develops and there are risks of hypertension and sleep disturbances. Amphetamine and related agents [phentermine (Ionamin, Duramine, FastinUS), diethylpropion (Tenuate DospanR), pheadimetrazine (PlegineUS), benzphetamine (DidrexUS), methamphetamine (DesoxynUS)] have psychostimulant properties and have potential for abuse and habituation. They have therefore been largely replaced by non-stimulant derivatives such as fenfluramine (PonderaxR) and its dextro isomer, dexfenfluramine (AdifexR). Whereas amphetamines are indirectly acting sympathomimetic amines releasing noradrenaline from nerve endings, fenfluramine releases 5-HT and is sedative rather than stimulant; in fact depression is a potential adverse effect. Mazindol (TeronacUK, MazanorUS) is a tricyclic antidepressant, structurally unrelated to amphetamine, which is an inhibitor of neuronal uptake. It supresses appetite and will interact with antihypertensives (eg neurone blockers).
Pulmonary hypertension induced by drugs and toxins
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Kim Bouillon, Yola Moride, Lucien Abenhaim, Marc Humbert
Mazindol is a sympathomimetic amine, similar to amphetamine (see Fig. 29.2). We found only a single case report of PAH diagnosed 12 months after discontinuing mazindol that had been taken for 10 weeks.44
Reviewing the role of emerging therapies in the ADHD armamentarium
Published in Expert Opinion on Emerging Drugs, 2021
Ann C. Childress, Nathalie Beltran, Carl Supnet, Margaret D. Weiss
MPH is the most widely used prescription medication for ADHD and is frequently misused by high school and college students [48,156,157]. Although LDX could be said to have abuse-deterrent qualities as a prodrug with no activity of the parent compound until metabolically activated, it is a DEA Schedule II drug [158]. Several IR AMPH abuse-deterrent formulations are in development and will be a welcome addition to available treatments. AR-19 (racemic AMPH) is closest to being approved by the FDA in the U.S. The abuse-deterrent d-MPH formulation KP484, which is an ER prodrug of dMPH, is earlier in development and the DURECT ER MPH has not been studied in the U.S. A combination MPH plus naltrexone is also in development, but its potential indication is ADHD + substance use disorder. Mazindol was previously labeled as a DEA Schedule IV drug. Its abuse potential is unclear. It is unknown what scheduling it will receive should it be approved for the treatment of ADHD.
Advances in pharmaceutical treatment options for narcolepsy
Published in Expert Opinion on Orphan Drugs, 2018
Tatsunori Takahashi, Sakai Noriaki, Mari Matsumura, Chenyu Li, Kayo Takahashi, Seiji Nishino
EDS is defined as ‘irresistible sleepiness in a situation when an individual would be expected to be awake, and alert’ [24]. Although non-pharmacological treatments (i.e. avoiding sleep deprivation and maintaining a regular sleep pattern) may help to control EDS [15], almost all patients require pharmacological therapies, mostly stimulant medications [25]. Milder stimulants with low efficacy and potency (e.g. modafinil and armodafinil, Schedule IV controlled substance) are tried first. Sodium oxybate (Schedule III controlled substance) is approved for both EDS and cataplexy and is also the first line medication for both NT1 and NT2 patients. Based on a study by Black J et al. [26], the combination therapy of sodium oxybate and modafinil demonstrated an increase in daytime sleep latency while sodium-oxybate alone was as efficacious in treating EDS as the previously administered modafinil. This result indicates additive effects and the combination therapy should be considered as an alternative approach when the monotherapy is insufficient. Amphetamine-like compounds are also used, and these include methamphetamine, d-amphetamine, methylphenidate (Schedule II controlled substances), and mazindol (a Schedule IV controlled substances) [17]. Patients with EDS are usually started on a low dose which is then increased progressively to achieve satisfactory results. Pemoline is another mild sympathomimetic stimulant which selectively blocks dopamine reuptake and only weakly stimulates dopamine release [27]. However, this drug has been withdrawn from the market in most countries due to its potential fatal hepatotoxicity [27,28].
Update on treatment for idiopathic hypersomnia
Published in Expert Opinion on Investigational Drugs, 2018
Elisa Evangelista, Régis Lopez, Yves Dauvilliers
In two retrospective series, dextro-amphetamine has been reported to improve EDS in IH, as assessed by a reduction in ESS score [6,27]. However, because of its potentially serious side effects, especially on cardiovascular system and psychiatric area, the French consensus considered this drug as last-line therapy in IH. In a multicentric retrospective trial, mazindol provided an improvement of EDS with reduction of 4.8 ± 4.7 points of ESS score in patients with IH refractory to conventional stimulants with a good risk-benefit ratio in 84% patients [31]. Mazindol is a potent tricyclic non-amphetamine stimulant that was available in France but no longer marketed currently.