Mazindol 1mg tablets

The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global evaluation of Cochrane resulted in 19 studies with a high level of bias and six with unclear risk. Due to the lack of information in primary studies, direct meta-analyses were conducted only for amfepramone and mazindol. Compared to placebo, amfepramone resulted in higher weight loss in the short-term (<180 days; mean difference (MD) -1.281 kg; p<0.05; I2: 0.0%; p=0.379) and long-term (≥180 days; MD -6.518 kg; p<0.05; I2: 0.0%; p=0.719). Only studies with long-term follow up reported efficacy in terms of abdominal circumference and 5-10% weight reduction. These results corroborated the finding that the efficacy of amfepramone is greater than that of placebo. Treatment with mazindol showed greater short-term weight loss than that with placebo (MD -1.721 kg; p<0.05; I2: 0.9%; p=0.388). However, metabolic outcomes were poorly described, preventing a meta-analysis. A mixed treatment comparison corroborated the direct meta-analysis. Considering the high level of risk of bias and the absence of important published outcomes for anti-obesity therapy assessments, this study found that the evaluated drugs showed poor evidence of efficacy in the treatment of overweight and obese patients. Robust safety data were not identified to suggest changes in their regulatory status.

Abstract licence: CC BY

INTRODUCTION: The prevalence of obesity has increased worldwide over the past decades. Regional variations exist in the relationship between body mass index (BMI), body fat, and health risks: Asians typically have a lower BMI than people of European descent, but a higher risk of obesity-related comorbidities. However, there is a paucity of evidence for anti-obesity medications (AOMs) in East Asian populations. In this study, we aimed to systematically review evidence regarding the safety and efficacy of AOMs among adults with obesity disease in East Asia, and to assess the feasibility of conducting an indirect treatment comparison (ITC) between the semaglutide and mazindol trials. METHODS: The Embase, MEDLINE, and ICHUSHI databases were searched via the Ovid SP platform for randomized controlled trials, in English or Japanese, reporting data on semaglutide or mazindol therapy with placebo or diet and exercise as comparators. The potential risks of bias in conducting a population-adjusted ITC were determined based on the heterogeneity of potential effect modifiers and variations in study design. RESULTS: ), total cholesterol, and systolic blood pressure] among Japanese and South Korean people with obesity disease. Mazindol also proved beneficial in reducing body weight and total cholesterol compared with placebo in Japan. Both semaglutide and mazindol were associated with higher rates of adverse events and treatment discontinuation than placebo. An ITC between the two studies was not deemed feasible based on the potential risks of bias. CONCLUSIONS: Semaglutide and mazindol are associated with significant body weight reduction among people with obesity in East Asia. Further research based on label indications and up-to-date real-world data among East Asian people with obesity would help determine additional clinical benefits.

Abstract licence: CC BY-NC

Objectives: Obesity poses major perioperative challenges in gynecologic malignancies, particularly endometrial cancer, and increases surgical complexity and risk. Although robot-assisted hysterectomy (RAH) and bilateral salpingo-oophorectomy are preferred for early-stage cases, the obese patients make it limit their feasibility. Preoperative weight loss may improve outcomes; however, the pharmacological options remain understudied. This study explored the feasibility of a preoperative mazindol-based weight-loss program in severely obese patients. Materials and Methods: A retrospective case series study was conducted on four women (body mass index [BMI] ≥35 kg/m²) who were suspected of having stage 1A endometrial cancer based on preoperative magnetic resonance imaging between January 2021 and July 2024. The patients received nutritional counseling and mazindol (1.0 mg/day) before undergoing surgery. The effect of mazindol was indexed by each patient's weight loss before surgery, and surgery-related parameters included the time of surgery, the amount of blood loss, and the presence of surgical complications. Results: Patients experienced a median weight reduction of 13.7 kg (range, 9.1-17.4 kg), with a corresponding decrease in BMI. Operative time was 247.5 min, with a console time of 214 min and blood loss of 75 g. The Trendelenburg angle was 18°-19°, which facilitated adequate surgical visualization. No adverse effects or postoperative complications were observed. Conclusion: Preoperative administration of mazindol resulted in significant weight loss, enabling safer RAH with reduced surgical complexity. This suggests that mazindol may be a viable option for weight reduction in obese patients absolutely requiring gynecologic surgery for malignant diseases.

Abstract licence: CC BY-NC-SA

This study analyzed 97 pharmaceuticals in samples of surface water, as well as influent and effluent from various wastewater treatment plants (WWTPs), during winter 2022 and spring 2023. Approximately 40% of the tested compounds were detected, at amounts ranging from below the methods' detection limits to 5623 ng/L (2-hydroxyibuprofen in surface water) and 12,664 ng/L (caffeine in wastewater). Twelve compounds (acetaminophen, ampicillin, azithromycin, caffeine, fluoxetine, gemfibrozil, 2-hydroxyibuprofen, ibuprofen, ketoprofen, mazindol, naproxen, and salicylic acid) were detected with a 100% frequency in both surface water and wastewater samples. The observed high detection frequency of pharmaceuticals within the nonsteroidal anti-inflammatory drugs/analgesics, antibiotics, and psychiatric drug classes aligns with their high consumption. Caffeine was both the compound with the highest concentration and the most prevalent compound detected. Seasonal differences were observed, with higher concentrations detected during winter. Six of the eleven targeted metabolites and degradation products were detected in at least one sample. Risk quotient assessment revealed potential ecological risks, particularly for atorvastatin, caffeine, carbamazepine, and venlafaxine, exceeding risk thresholds for various trophic levels. The studied WWTPs showed limited removal efficiencies, with some compounds presenting higher concentrations in effluent than in influent, emphasizing the need for enhanced treatment to mitigate micropollutant risks.

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(1) Background: The number of severely obese patients worldwide is rapidly increasing. Recently, novel therapeutic approaches, such as bariatric surgery or GLP-1 receptor agonists, have emerged, bringing about a paradigm shift in this field. However, these therapies sometimes face challenges, such as peri-surgical complications or supply shortages. Mazindol, which is an appetite suppressant approved decades ago in Japan, remains a valuable option. In this study, we investigated the effectiveness of mazindol in reducing body weight in 147 patients, and we examined the factors influencing said effectiveness. (2) Methods: The patients were divided into four groups based on the treatment cycles they underwent: 1 cycle, 2 cycles, 3–5 cycles, and over 6 cycles. We compared the changes in body weight before and after the treatment among these four groups. Additionally, we sought to identify the factors correlated to the effectiveness of mazindol. (3) Results: The change in body weight was more pronounced in the group which underwent 3–5 cycles compared to the groups which underwent 1 cycle and 2 cycles; this change was also more pronounced in the group which underwent over 6 cycles compared to those which underwent 1 cycle. Furthermore, we observed a significant correlation between the initial body weight and the extent of body weight change. (4) Conclusions: Mazindol demonstrated effectiveness in reducing the body weight of patients in a cycle-dependent manner.

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This study investigated the sex-specific effects of commonly prescribed appetite suppressants on body weight and the manifestation of motor side effects, specifically stereotypy. Employing video recordings and DeepLabCut (DLC) for precise behavioral quantification, we analyzed stereotypy, defined as purposeless, repetitive motor behaviors, in male and female rats. Under control (saline) conditions, male rats exhibited a greater propensity for weight gain compared to females. However, in contrast, female rats demonstrated greater and more homogenous weight loss than males following the administration of diethylpropion and tesofensine. Phentermine and mazindol induced comparable weight loss in both sexes, whereas cathine elicited weight reduction exclusively in males. 5-HTP and d-amphetamine administration only prevented weight gain relative to controls. Analysis of motor side effects revealed that drugs primarily targeting dopamine pathways - specifically, phentermine, mazindol, diethylpropion, cathine, and d-amphetamine - induced pronounced stereotypies, particularly head-weaving, in both sexes. Interestingly, tesofensine elicited head-weaving behavior exclusively in female subjects, albeit to a lesser extent than that observed with other dopaminergic agents; conversely, tesofensine was most frequently associated with orolingual dyskinesia. Male subjects treated with these same drugs exhibited an unexpected effect: spontaneous ejaculations, potentially attributable to the combined effects on dopamine and serotonin signaling in brain regions regulating sexual function. Network analysis and Markov transition matrices revealed distinct behavioral profiles associated with head-weaving, which emerged as the dominant attractor state, suggesting potential mechanistic differences among these drugs. Collectively, this study provides a valuable database characterizing the behavioral side effects of appetite suppressants.

Abstract licence: CC BY

Abstract This study investigated the sex-specific effects of commonly prescribed appetite suppressants on body weight and the manifestation of motor side effects, specifically stereotypy. Employing video recordings and DeepLabCut (DLC) for precise behavioral quantification, we analyzed stereotypy, defined as purposeless, repetitive motor behaviors, in male and female rats. Under control (saline) conditions, male rats exhibited a greater propensity for weight gain compared to females. However, in contrast, female rats demonstrated greater and more homogenous weight loss than males following the administration of diethylpropion and tesofensine. Phentermine and mazindol induced comparable weight loss in both sexes, whereas cathine elicited weight reduction exclusively in males. 5-HTP and d-amphetamine administration only prevented weight gain relative to controls. Analysis of motor side effects revealed that drugs primarily targeting dopamine pathways – specifically, phentermine, mazindol, diethylpropion, cathine, and d-amphetamine – induced pronounced stereotypies, particularly head-weaving, in both sexes. Interestingly, tesofensine elicited head-weaving behavior exclusively in female subjects, albeit to a lesser extent than that observed with other dopaminergic agents; conversely, tesofensine was most frequently associated with orolingual dyskinesia. Moreover, one of the most potent forms of stereotypy—backward locomotion, here referred to as “moonwalking”—was sporadically observed only following the administration of phentermine, diethylpropion, cathine, and mazindol, with diethylpropion inducing it most frequently. Male subjects treated with these same drugs exhibited an unexpected effect: spontaneous ejaculations, potentially attributable to the combined effects on dopamine and serotonin signaling in brain regions regulating sexual function. Network analysis and Markov transition matrices revealed distinct behavioral profiles associated with head-weaving, which emerged as the dominant attractor state, suggesting potential mechanistic differences among these drugs. Collectively, this study provides a valuable database characterizing the behavioral side effects of appetite suppressants.

Abstract licence: CC BY-NC