Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

Poulton, Alison; Hibbert, Emily; Champion, Bernard; Cook, Traci L.; Alais, David; Coulshed, D.

doi:10.3389/fendo.2015.00014

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…Titration works well in ADHD where the aim is to improve the functional deficits. Even in obesity there is often scope for improvement in mood and motivation and in our research we have found dose titration possible using adverse effects on mood as an indication for dose reduction (Poulton et al, 2015 ). Therefore, with correct use the psychotropic effects could have the potential to assist with the lifestyle changes that are vital for weight control.…”

Section: Psychotropic Effects Of Drugs Developed For Obesitymentioning

confidence: 73%

“…Indeed there is no clearly apparent logical reason why dexamphetamine is used for treating ADHD while phentermine has been retained for obesity, which raises the question of whether this was simply an accident of history. Ongoing research in our group is examining the effects of dexamphetamine for treating obesity (Poulton et al, 2015 ). We suggest that the prejudice against the stimulants for treating obesity is perhaps misplaced and favors surgery and new drug development.…”

Section: Discussionmentioning

confidence: 99%

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Stimulants for the Control of Hedonic Appetite

et al. 2016

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The focus of this paper is treatment of obesity in relation to the management of hedonic appetite. Obesity is a complex condition which may be potentiated by excessive reward seeking in combination with executive functioning deficits that impair cognitive control of behavior. Stimulant medications address both reward deficiency and enhance motivation, as well as suppressing appetite. They have long been recognized to be effective for treating obesity. However, stimulants can be abused for their euphoric effect. They induce euphoria via the same neural pathway that underlies their therapeutic effect in obesity. For this reason they have generally not been endorsed for use in obesity. Among the stimulants, only phentermine (either alone or in combination with topiramate) and bupropion (which has stimulant-like properties and is used in combination with naltrexone), are approved by the United States Food and Drug Administration (FDA) for obesity, although dexamphetamine and methylpenidate are approved and widely used for treating attention deficit hyperactivity disorder (ADHD) in adults and children. Experience gained over many years in the treatment of ADHD demonstrates that with careful dose titration, stimulants can be used safely. In obesity, improvement in mood and executive functioning could assist with the lifestyle changes necessary for weight control, acting synergistically with appetite suppression. The obesity crisis has reached the stage that strong consideration should be given to adequate utilization of this effective and inexpensive class of drug.

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Section: Psychotropic Effects Of Drugs Developed For Obesitymentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Stimulants for the Control of Hedonic Appetite

et al. 2016

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“…Mindfulness-based approaches and psychotherapy targeting the management of food craving have been effective in some studies, but there seems to be a large interindividual response variance [Potenza and Grilo, 2014]. These problems highlight the need to better understand the psychological and neural determinants of craving to develop new, successful strategies for this growing epidemic [Goldman et al, 2013;Potenza and Grilo, 2014;Poulton et al, 2015]. These problems highlight the need to better understand the psychological and neural determinants of craving to develop new, successful strategies for this growing epidemic [Goldman et al, 2013;Potenza and Grilo, 2014;Poulton et al, 2015].…”

Section: Introductionmentioning

confidence: 99%

“…The available pharmacological treatments for obesity are relatively ineffective and expansive, and have their drawbacks [Suplicy et al, 2014]. These problems highlight the need to better understand the psychological and neural determinants of craving to develop new, successful strategies for this growing epidemic [Goldman et al, 2013;Potenza and Grilo, 2014;Poulton et al, 2015].…”

Section: Introductionmentioning

confidence: 99%

Oxytocin enhances cognitive control of food craving in women

Striepens

Schroter

Stoffel‐Wagner

et al. 2016

Human Brain Mapping

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In developed countries, obesity has become an epidemic resulting in enormous health care costs for society and serious medical complications for individuals. The homeostatic regulation of food intake is critically dependent on top-down control of reward-driven food craving. There is accumulating evidence from animal studies that the neuropeptide oxytocin (OXT) is involved in regulating hunger states and eating behavior, but whether OXT also contributes to cognitive control of food craving in humans is still unclear. We conducted a counter-balanced, double-blind, within-subject, pharmacological magnetic resonance imaging experiment involving 31 healthy women who received 24 IU of intranasal OXT or placebo and were scanned twice while they were exposed to pictures of palatable food. The participants were instructed either to imagine the immediate consumption or to cognitively control the urge to eat the food. Our results show a trend that OXT specifically reduced food craving in the cognitive control condition. On the neural level, these findings were paralleled by an increase of activity in the middle and superior frontal gyrus, precuneus, and cingulate cortex under OXT. Interestingly, the behavioral OXT effect correlated with the OXT-induced changes in the prefrontal cortex and precuneus. Collectively, the present study provides first evidence that OXT plays a key role in the cognitive regulation of food craving in women by strengthening activity in a broad neurocircuitry implicated in top-down control and self-referential processing. Hum Brain Mapp 37:4276-4285, 2016. © 2016 Wiley Periodicals, Inc.

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“…Locus of control is an important characteristic in relation to obesity as, by definition, it indicates whether an individual believes that his or her environment and choices are under his or her control. An example of this is the treatment of obese individuals with dexamphetamine (for a psychotropic effect on motivation) coupled with a basic behavioural intervention which was shown to be effective for weight loss with no significant complications reported [ 19 ]. Further work by Levy et al has used stimulant medication (mainly amphetamine) in a female cohort of obese individuals with attention deficit hyperactivity disorders; significant weight lost was observed and suggested to be a result of positive effects of treatment on self-directedness, persistence and behavioural change as regards diet compliance [ 20 ].…”

Section: Developmental Programming and Disorders Of Energy Balancementioning

confidence: 99%

Early Life Nutrition and Energy Balance Disorders in Offspring in Later Life

Reynolds

Gray

et al. 2015

Nutrients

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The global pandemic of obesity and type 2 diabetes is often causally linked to changes in diet and lifestyle; namely increased intake of calorically dense foods and concomitant reductions in physical activity. Epidemiological studies in humans and controlled animal intervention studies have now shown that nutritional programming in early periods of life is a phenomenon that affects metabolic and physiological functions throughout life. This link is conceptualised as the developmental programming hypothesis whereby environmental influences during critical periods of developmental plasticity can elicit lifelong effects on the health and well-being of the offspring. The mechanisms by which early environmental insults can have long-term effects on offspring remain poorly defined. However there is evidence from intervention studies which indicate altered wiring of the hypothalamic circuits that regulate energy balance and epigenetic effects including altered DNA methylation of key adipokines including leptin. Studies that elucidate the mechanisms behind these associations will have a positive impact on the health of future populations and adopting a life course perspective will allow identification of phenotype and markers of risk earlier, with the possibility of nutritional and other lifestyle interventions that have obvious implications for prevention of non-communicable diseases.

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Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

Cited by 9 publications

References 26 publications

Stimulants for the Control of Hedonic Appetite

Stimulants for the Control of Hedonic Appetite

Oxytocin enhances cognitive control of food craving in women

Early Life Nutrition and Energy Balance Disorders in Offspring in Later Life

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