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Sibutramine is not considered a drug - just a potent substance, the use of which requires compulsory medical supervision. He is appointed exclusively to those who have not been helped by other measures of weight correction. It was assumed that he, like all normalizing drugs, would help reduce the risk of cardiovascular diseases among lovers of a "snack", and at first he even gave the desired result. However, with long-term use, its effect on heart and vascular function was worse than atherosclerosis itself, which led to the need to limit the use of "Reduxin".
The work of the central nervous system is based on the generation and transmission of electrical impulses from one neuron to another by means of processes of different length and branching - dendrites and axons. Transmit such impulses help neurotransmitters - intermediates, facilitating or inhibiting the passage of the signal, as well as preserving for a while the path by which it passed (so that the "answer" of the cortex could go where the "question" came from). They accumulate in the nerve cells to be released into the space between them as the signal passes through this area.
Temporary "bridges" that mark the path of a particular signal are called synapses. And neurotransmitters own a significant part of the hormones, including serotonin and norepinephrine. These two substances can be re-captured - first allocated to create a synapse with the tip of the nerve cell, which transmits the signal to its "neighbor", and then re-absorbed into it. Sibutramine is an inhibitor of exactly the reuptake of norepinephrine and serotonin. It prevents their absorption into the process of the nerve cell after the neurotransmitters have already separated from it and have created a synaptic connection.
Forms of release
Sibutramine is a part of not only Reduxin, but also:
- "He is ostracized";
- "The Green Bomb";
Reduxin also has "intraspecific" variations - a common way of avoiding prescription restrictions on over-the-counter sales. The "official" version is called "Reduxin" and is sold in packs of ten capsules, in a dosage of 10 mg (blue capsules) or 15 mg (blue capsules). But besides her, there are also "Reduxin Light" and "Reduxin Met".
- Reduxin Light. It is registered as a dietary supplement (not considered a medicine), does not contain sibutramine and is sold without a prescription. The similarity of its name with anorexigene "Reduxin" is the advertising process of the manufacturer. At the heart of Reduxine Light lies one of the isomers of linoleic acid, which has an antitumor effect, but does not affect the recruitment / reduction of fat or muscle mass (proven by a number of independent studies in the United States). And the positive feedback about "Reduxine Light" is explained either by the placebo effect or by all the same advertising.
- Reduxin Met. A mixed preparation, each package containing 30 capsules of sibutramine at a dosage of 15 mg and 60 metformin tablets at 850 mg. Metformin is a protivodiabetic drug - biguanide (a derivative of guanidine - a component of goat's medicinal), which blocks the synthesis of glucose in the liver. It is used separately, in the stage of pre-diabetes and diabetes mellitus, in combination with insulin compensation. Both components of the agent should be taken simultaneously. "Reduxin Met" is nephro- and hepatotoxic due to the presence of metformin, therefore it is sold only on prescription.
Talking about what "Reduxin" is more effective for losing weight, you can only summarize: "Reduxin Light" has no weight-reducing effect. And the use of "Reduxina Met" with weight loss is topical if weight gain leads to an increase in insulin resistance and / or sugar level in the patient's blood.
Sibutramine was developed from the very beginning as an antidepressant. Then he became one of many drugs, reoriented to treat very different diseases, including "helping" the diet. Until 2008 Reduxin was appointed from:
- — переедания, вызванного психогенными травмами, антипода анорексии; bulimia - overeating caused by psychogenic trauma, antipode anorexia;
- — которая часто сопровождается тягой к перееданию из-за наличия прочной рефлекторной взаимосвязи между насыщением и чувством комфорта, благополучия; depression - which is often accompanied by a craving for overeating due to the presence of a strong reflex relationship between satiety and a sense of comfort, well-being;
- — всех его случаев, включая те, что возникают при гормональном сбое временного характера (беременность, послеродовые изменения фона у женщин, климакс у обоих полов), а также эндокринных патологиях наподобие сахарного диабета; obesity - all of its cases, including those that occur during a temporary hormonal failure (pregnancy, postpartum changes in the background in women, menopause in both sexes), as well as endocrine pathologies like diabetes;
- — сравнительно редкого нарушения, которое выражается в пониженном артериальном давлении вместо типичного для большинства повышенного АД; hypotension - a relatively rare disorder, which is expressed in a lowered arterial pressure instead of the typical for the majority of elevated blood pressure;
- — атеросклероза и его осложнений в виде гипертонии, ишемической болезни сердца, инфаркта и инсульта. cardiovascular diseases - atherosclerosis and its complications in the form of hypertension, ischemic heart disease, heart attack and stroke.
Sibutramine significantly interferes with the central nervous system. This property - its main harm in some pathologies, accompanied by a set of extra pounds. Bulimia and depression, as psychiatric pathologies with a physiological "continuation", disappeared from the list of prescriptions of the drug among the first, passing into contraindications. "Reduxin" was a bad antidepressant because of a pronounced "pullback" in insomnia, increased anxiety, suicidal thoughts after a period of serotonin euphoria caused by his admission.
Among the ways of obesity, in which its use is permissible, everything is eliminated, except for overeating. The increase in the "Reduxin" speed of blood flow, vascular tone, heart rate and body temperature was initially perceived as a positive property that promotes the absorption of glucose from food and losing weight. But it turned out that his long reception also accelerates the deterioration of the cardiovascular system and the development of atherosclerosis, brings complications closer. And an overdose of "Reduxina" can cause arrhythmia and cardiac arrest.
Such damage to the heart and blood vessels is comparable to the long-term consequences of atherosclerosis, although initially stimulation of their activity suggested a decrease in its rate. Currently, the reception of "Reduxin" is contraindicated under the following conditions.
- With cholelithiasis. Because of the increased tonus and peristalsis of all CNS-controlled organs, including the gallbladder. The use of "Reduxin" in gallstones can provoke their displacement.
- With liver and kidney pathologies. With their obesity, cirrhosis, hepatitis, urolithiasis, nephritis, renal failure. Splitting and assimilation of sibutramine, as well as other medicines, is carried out mainly by the liver, and its excretion by the kidneys. The accumulation of its metabolites in the blood can lead to inadequate strong "acceleration" of the central nervous system with an equally pronounced subsequent inhibition of it.
- With organic obesity. For example, provoked by diabetes, hypothyroidism (a decrease in the production of thyroxine and triiodothyronine by the thyroid gland).
- With neurological disorders. With Tourette's syndrome, tics, neurasthenia.
- In combination with mental illness. For example, with paranoia, manic-depressive psychosis.
- With epilepsy and schizophrenia. By origin, they are closer to neurological disorders, but directly affect the psyche, and therefore more studied in psychiatry. In the practice of therapy, "Reduxin" recorded one case, when it led to the development of psychosis in a patient with schizoaffective disorder.
- With developed atherosclerosis. Signs of which are hypertension, ischemic heart disease, stroke and myocardial infarction.
- With pathologies of the heart and blood vessels. With heart diseases, arrhythmias, varicose veins and deep vein thrombosis. "Reduxin" narrows the blood vessels and can lead to a violation of the heart rhythm, because its reception in the presence of thrombi can result in their clogging of vessels of different diameters.
- With glaucoma. Due to increased arterial and capillary pressure in the treatment of sibutramine.
- With prostate adenoma. And also with precancer, cancer, endometriosis, ovarian cysts and fibromioma. The drug-induced activation of blood circulation in such tumors can activate their growth and malignancy (turning into cancer).
- During pregnancy. And breastfeeding. Losing weight when planning pregnancy, in general, the idea is dubious. To conceive and successfully conceive a child, a woman needs a stable estrogen background, and the accumulation and metabolism of female sex hormones occurs in the fat cells of the body. This means that before conception it is wiser for a woman to gain a few extra pounds than throw them off.
"Reduxin" is also not recommended for children and adolescents, the elderly, especially those suffering from senile dementia or Alzheimer's disease. It is not suitable for the prevention of obesity or other diseases, and is strictly prohibited for use in alcoholism and / or drug addiction. Simultaneous use of sibutramine with alcohol does not affect the dynamics of alcoholic intoxication or hangover. But this incompatibility concerns all antidepressants, neuroleptics and drugs regulating the work of the central nervous system.
The list of side effects of "Reduxin" is not less than the list of its contraindications. The drug can provoke:
- sleep disorders;
- dry mouth;
- unreasonable anxiety, nervousness;
- suicidal thoughts;
- cramps of limbs;
- changes in taste perception;
- back pain;
- increased sweating and hot flashes;
- hypertension, right up to the crisis;
- acceleration of the pulse and contractions of the heart;
- loss of appetite, right up to anorexia;
- acute constipation;
- nausea and vomiting;
- increased hemorrhoidal bleeding.
Instructions for use "Reduxin"
To drink "Reduxin" for weight loss should be once a day, before meals or after. Taking any medications after a meal is more preferable because of their irritating effect on the digestive tract and the risk of developing a drug gastritis during their use on an empty stomach. The daily dosage of "Reduxin" tablets is individual and can be adjusted in accordance with the body's response to therapy. Schemes of obesity therapy are as follows.
- Standard. Most often, patients are prescribed 10 grams of sibutramine per day.
- Poor tolerance. If there are side effects or general deterioration of the well-being, the dosage may be reduced to 5 g per day, and the patient should be transferred to the medication only after eating.
- Low productivity. If the patient loses less than 5% of the current weight per month on the Reduxine, the dose is increased to 15 mg per day. Officially, this is the limit of the allowable daily dose of the drug. And if the speed of losing weight still leaves much to be desired, it is more reasonable to cancel it than to increase the dosage further.
The use of "Reduxin" should also be discontinued if, after a period of weight loss, the patient began to receive it (that is, with continued use of the remedy).
The "Reduxin" has fewer more secure analogues. Among the "candidates" with a clear composition and principle of action, the following means can be singled out.
- Orlistat. The active substance in the Orsotene composition with the same low efficiency as in the Reduxin (5% of the total body weight per month is not much). Orlistat blocks the digestion and absorption of vegetable and animal fats from food. It can become an effective means of controlling the diet and weight in lovers of fatty foods, especially those rich in hybrid fats - made on the basis of spread or margarine (shortbread, puffs, and other baking from factory production).
- Metformin. The same as in the Reduxina Met. It is sold separately under the names "Siofor", "Glukofazh". The effect of it on weight loss is significantly higher than that of sibutramine or orlistat, due to inhibition of glucose synthesis in the liver. To diabetics, it helps to control the blood sugar level, and to those who lose weight - the amount of carbohydrates digested by the body from food. Its only drawback is a side effect on several organs of the digestive tract, including the liver, which rarely passes after its cancellation.
- Non-absorbable fillers. Fiber or a drug called "Porciola". Vegetable fiber is not digested and not digested - because the intestine and seeks to withdraw it as soon as possible, which leads to the normalization of the stool. When taken with food, it takes part of the volume of the stomach and intestines, speeding up saturation with its own zero calorie. Its administration is prohibited for gastritis, duodenitis and peptic ulcer due to high irritating properties. A "Porciola" consists of the same indigestible gellant - a carbomer of polyacrylic acid. The principle of its action is similar to cellulose. Reception "Porcioly" allows you not to overeat and do not irritate the foci of inflammation / ulceration, if any. But this drug also has laxative properties, causes increased gas formation and dysbacteriosis with prolonged admission. Although both side effects are reversible immediately after the withdrawal of the remedy.
The deficit in the market of licensed and effective means for weight loss is explained by the fact that there are no such drugs without side effects. And all of them are created for cases when the benefit of their direct action exceeds the potential harm. The desire to improve your figure and weight indicators, if they are not catastrophic, is not from this number. The optimal method in such situations is the equalization of the caloric content of the daily ration with the expenditure of incoming carbohydrates. And to take for this purpose tablets "Reduxin" for weight loss or any drug with a similar effect, medicine considers reckless.