A retrospective review of California poison control system data of sibutramine exposures.
BACKGROUND
Sibutramine is a centrally acting neurotransmitter reuptake inhibitor used for the treatment of obesity. In doses of 10-15 mg/day, sibutramine has been shown to promote modest weight loss; however, the literature devoted to characterizing overdoses and abuses of sibutramine is limited.


METHODS
We queried and retrospectively reviewed the California Poison Control System database between January 1998 and August 1, 2008. This was an observational case series.


RESULTS
A total of 62 cases were identified. Forty-four (71%) of our study subjects were females. Twenty-three patients (37%) were between 8 months and 2 years of age; 17 patients (27%) were between 31 and 50 years. The doses ranged from 2.5 to 75 mg. A total of 27 patients (44%) were referred to a medical center. In general, medical outcomes were minor. Twenty-five (40%) patients had no effects reported; 30 patients (48%) reported minor effects; and three patients (5%) had moderate effects. There were no major effects or deaths reported. In 58 (94%) patients, the ingestion was unintentional. Thirty-two (52%) cases resulted in the recommendation of observational therapy only as their management strategy. Of the patients who did experience adverse effects, cardiovascular side effects were the most common. In particular, tachycardia (nine patients, 14.5%) was the most notable, followed by chest pain (four patients, 6.5%). Six patients (10%) reported central nervous system side effects. Gastrointestinal side effects occurred in four patients (6.5%). The dose ingested did not appear to correlate with the clinical effects observed.


CONCLUSIONS
Sibutramine ingestion resulted in no serious effects or deaths on our retrospective case series. Mild to moderate effects that were rarely reported included tachycardia, chest pain, agitation, irritation, dizziness, vertigo, nausea, and vomiting.
Minns
Alicia Bethany
AB
Department of Emergency Medicine, Division of Medical Toxicology, University of California, San Diego, California 92103-8925, USA. abminns01@yahoo.com
Ebrahimi
Shirley
S
Te
Lena
L
Ly
Binh
B
Clark
Richard F
RF
Cantrell
F Lee
FL
D000293:Adolescent; D000328:Adult; D001067:Appetite Depressants / Q000506:poisoning*; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003503:Cyclobutanes / Q000506:poisoning*; D019992:Databases as Topic; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014179:Neurotransmitter Uptake Inhibitors / Q000506:poisoning*; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D001067:Appetite Depressants; D003503:Cyclobutanes; D014179:Neurotransmitter Uptake Inhibitors; C058254:sibutramine