2010, volume 83, nr. 2

The central and peripheral regulation of appetite: theoretical bases and therapeutic use II.

The first part of this review aimed the actual theoretical aspects of the appetite regulation, while this second part comprises the management of obesity, emphasizing the new therapeutic possibilities, used also in type 2 diabetes mellitus. The android obesity frequently induces metabolic syndrome and insulin resistance, leading to cardiovascular complications, prediabetes or type 2 diabetes, and increases cancer incidence. Within the medications used for the management of obesity, the atypical antidepressants, interfering with recaptation of 5-HT and/or NA (SSRI, SNRI), as sibutramine, venlafaxine, bupropione, fluoxetine, citalopram are frequently prescribed. Metformin has been used for many decades, nowadays more and more often, and orlistat has also been used for a few years. From the newer drugs applied for the treatment of obesity and reduction of insulin resistance, some antiepileptics (topiramate, zonisamide), thiazolidindiones, ghrelin antagonists (e.g. in Prader–Willi syndrome), endocannabinod antagonists (rimonabant), incretin-mimetics (exenatide and liraglutide), inhibitors of dipeptidyl-peptidase-4 (sitagliptine, vildagliptine) that prevent the inactivation of GLP-1, oxyntomoduline and the amylin-mimetic pramlintide are worth mentioning.

 

Keywords: sibutramine, metformin, thiazolidindiones, rimonabant, incretin-mimetics, dipeptidyl-peptidase-4 inhibitors, oxyntomoduline and pramlintide