Noradrenergic Drugs

Noradrenergic drugs are those that are intended to influence norepinephrine, which is a chemical neurotransmitter or some other related chemicals. By manipulating noradrenergic neutrons, noradrenergic drugs affect the activity of the brain and the central [Page 507]nervous system (CNS) and it is possible that this will lead to positive health outcomes. One such outcome is the suppression of appetite for food which leads to feelings of satiety and reduction in intake of food. The consequence, necessarily, is weight loss in the short term or medium term.

Several problems, of course, exist with the use of such drugs as a form of sustainable weight-loss regimen. These include the possible side effects of the extended use of drugs having a significant impact upon the higher functions of the body and the difficulty in sustaining weight loss simply by eating less—this tends to become counterproductive in the long term (after perhaps six months or longer, depending on individual characteristics of the patient) without behavior modification and physical exercise regimen examination. However, owing to the powerful forces giving rise to obesity in the adult populations of so many countries, it is unrealistic to imagine that cures for the condition can occur in large numbers. Nevertheless, palliation (long-term weight reduction to a less unhealthy body state) is a reasonable and achievable outcome in a large number of cases and, consequently, drug use continues to be a useful tool for medical practitioners.

Early manifestations of noradrenergic drugs included amphetamines and related drugs, which exhibited the desired appetite-suppressant qualities but which also produced euphoric effects which led to a potential problem with abuse. The use of narcotics such as amphetamines and, more recently, cocaine as a suppressor of appetite and, hence, means of maintaining a very low weight, persists in the various entertainment industries of the Western world and helps to explain the prevalence of extraordinarily and unhelpfully slender fashion models. There is no clinical need for the use of drugs of this type in combating obesity, but their effectiveness, or perceived effectiveness, has led to the acquisition of a bad reputation for noradrenergic drugs in all their various manifestations.

A second generation of antiobesity drugs included products such as fenfluramine and fluoxetine, which had similar effects as those of the amphetamine family of pharmaceuticals but largely avoided the abuse problems. These drugs influenced the creation and absorption of serotonin in different ways so as to create the appetite suppressant effect, and this has been shown to be effective to the medium term (approximately 16 weeks, although this length varies significantly in the case of individual cases). These drugs tend to work along the interface between depression (or at least stimuli giving rise to symptoms of depression in some people) and food ingestion—food provides a respite from depressive effects in the short term and promoting well-being in various ways—consequently has a tendency to reduce obesity in many patients. However, these drugs are typically not noradrenergic in nature.

The complexity of many drugs and their impact upon the equally complex actions of the human body are such that what was once popular as a means of medication becomes unpopular as new evidence is unearthed but those same drugs are suggested for treating different conditions. At the same time, understanding of the nature and treatment of side effects is continually developing and this has the effect of making once-disregarded treatments viable once more. Research continues with noradrenergic drugs to determine whether the early weight-loss aspects can still be employed or whether different effects can be successfully deployed.

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