Sibutramine acts by increasing serotonin and nor adrenaline levels in the brain. The serotonergic action, in particular, is thought to influence appetite. Recognized side-effects are dry mouth, headache, constipation and insomnia. It may increase the blood pressure, and is therefore contraindicated in patients with arterial hypertension, or others in whom a rise in blood pressure would be harmful (e.g. patients with angina). Pulmonary hypertension, a problem in some other anorectics, is not a recognized side-effect.
A study is ongoing into reports of sudden death, heart failure, renal failure and gastrointestinal problems. Despite petitions, the drug has not been banned by the FDA, but was part of a Senate hearing in 2005.
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