Meridia

isadoraworkman

Just a comment
I have often seen folks talk about diet pills on MFP, and it always makes me sad. I don't usually comment because it is such an emotional issue for me. My father died in the 1970's - his heart was adversely affected by the diet pills his doctor prescribed to him. He had a massive heart attack and died in front of his family (I was just seven years old). Just because a doctor prescribes it doesn't mean it is safe, and there are no quick fixes. I am passing along an article about Meridia...also previously thought of as 'safe'.


The Associated Press, Updated: October 8, 2010 11:38 AM

Diet pill pulled from market for heart risk
WASHINGTON - Abbott Laboratories says it is withdrawing its diet pill Meridia in the U.S. and Canada, almost a year after studies showed the drug increases the risk of heart attack and stroke in patients with a history of heart disease.

Meridia has been available in both countries for more than a decade. Abbott says it made the decision at the request of the Food and Drug Administration. Earlier in the day, Health Canada, the nation's health department, announced the drug would come off the market there.

European regulators pulled the product off the market in January citing data showing that patients who had heart disease were more likely to have heart attacks or stroke while taking the drug.

ActionJackson

Thanks for the article. I have taken Merida in the past and have just started to take it again. I am of the camp that all medication has side effects whether it be chemo or aspirin. Benefits and risk must always be weighed. I am wondering what is the exact mechanism that causes damage to the heart or the heart-attack/stroke. Do they know that? Every time I hear about it, the FDA speaks in generalities. Is it just the drug or is it just the drug in combination of being overweight. Just like overweight people are statistically more likely to die while doing any activity including exercising, sleeping or defecating. Being overweight adversely affects the heart for years. The longer one is overweight, the more damage is done. Eating right and exercise is the only way to go. How do you get there?

Diet drugs are methadone-like bridge and not meant to permanently replace behavior changes. Yes weight loss drugs are a crutch for the weak willed like myself. Likewise I consider anti-depressants a crutch for postpartum depression. There is a considerable mental component to over-eating that some of us need the diet pill crutch to get over the hump. Since I have started augmenting my diet with pills, I have maintained 1200 cals or less daily. I was taking Adipex but laws in my state limit it to 12 weeks. Merida was my doctors post Adipex recommendation.

dgroulx

i have a doctor of pharmacy degree. These meds are supposed to be prescribed only in those with a BMI of over 30, which is the catagory of extremely obese. People who need to lose only a few pounds get their physicians to write for these drugs. Now the drugs are used in a population that the drug was never meant to be used in.

For Meridia, the recent study was called SCOUT. This was a trial to see if Meridia could improve cardiovascular outcomes in obese people at high risk. The people in the study were 1) over 55, 2) had existing cardiovascular disease , 3) a history of coronary artery disease, peripheral arterial occlusive disease, or stroke, AND/OR type 2 diabetes with additional risk factors (high blood pressure, smoker, high cholestorol, etc). and 4) had a RECENT HISTORY OF cardiovascular events.

So the study only enrolled people who were going to die of cardiovascular disease. In this group, 10.1% in the Meridia group had a cardiovascular event. The placebo group had 8.3%.

This means in people with heart disease, Meridia does not improve the outcome and has a 1.9% chance of making it worse.

The FDA recommends that physicians look at their patients and re-evaluate whether they should be on Meridia. Meridia does not cause cardiovascular problems in those without the disease.

For those who want to know the mechanism of action: Meridia blocks the neuronal uptake of norepinephrine, serotonin, and a small amount of dopamine. Blocking norepinephrine decreases your appetite. I take Wellbutrin which also blocks norepinephrine and dopamine. Most people on Wellbutrin also lose weight.

Dana

ActionJackson

Thanks dgroulx for your response. I extra appreciate those who post more than conjecture.

You back up what I've always thought. I am already high risk because I am overweight. I started pills with at 53 BMI. Thank goodness I still have a healthy heart despite my age and the years of food abuse. However, it does seem like Abbott has folded and will pull the drug regardless. I figure Wellbutrim will be my back up plan.

@dgroulx, the mechanics of Meridia I want to know about is how it supposedly causes heart damage. For instance can it cause arterial plaque build up to break free or does it do phen phen like damage to heart valves.

I lost over 10 BMI already and will stop all diet pills once I reach 30 BMI.

dgroulx

There is no direct connection to the heart to cause damage. The neurotransmitter norepinephrine is similar to epinephrine which is a pressor used to raise blood pressure. By increasing norepinephrine, it must be enough to increase blood pressure enough in those which high blood pressure already. Dopamine is also a pressor. The trial was created to see if there was a benefit. There was not. You can be sure that any of the other drugs that raise norepinephrine will not start a clinical trial.

I'm sure the drug is safe for those without cardiovascular disease. No doubt, there will be a bunch of law suits like there was for Vioxx. The drug company won those law suits by the way, because the people already had a heart attack. You can't really prove that a drug caused another one.