title: Addiction potential of phentermine prescribed during long-term treatment of obesity.
abstract: OBJECTIVE
  To investigate if phentermine treatment induces phentermine abuse, psychological dependence (addiction) or phentermine drug craving in overweight, obese and weight loss maintenance patients. To investigate whether amphetamine-like withdrawal occurs after abrupt cessation of long-term phentermine treatment.
  
  
  METHODS
  Clinical intervention trial with interruption of phentermine treatment in long-term patients.
  
  
  METHODS
  269 obese, overweight or formerly obese subjects (age: 20-88 years, BMI: 21-74 kg m(-2)) treated with phentermine long-term (LTP, N=117), 1.1-21.1 years, or short-term (ATP, N=152), 4-22 days, with phentermine doses of 18.75-112.5 (LTP) and 15-93.75 (ATP) mg per day.
  
  
  METHODS
  Module K of the Mini International Neuropsychiatric Interview modified for phentermine (MINI-SUD), Severity of Dependence Scale (SDS), 45-item Cocaine Craving Questionnaire-NOW (CCQ-NOW) modified for phentermine (PCQ-NOW), and Amphetamine Withdrawal Questionnaire (AWQ) modified for phentermine (PWQ).
  
  
  RESULTS
  MINI-SUD interviews were negative for phentermine abuse or psychological dependence in all LTP patients. SDS examination scores were low for all LTP and ATP patients, indicating they were not psychologically dependent upon phentermine. PCQ-NOW scores were low for all LTP and ATP patients, indicating neither short-term nor long-term phentermine treatment had induced phentermine craving. Other than an increase in hunger or eating, amphetamine-like withdrawal symptoms did not occur upon abrupt phentermine cessation as measured by sequential PWQ scores.
  
  
  CONCLUSIONS
  Phentermine abuse or psychological dependence (addiction) does not occur in patients treated with phentermine for obesity. Phentermine treatment does not induce phentermine drug craving, a hallmark sign of addiction. Amphetamine-like withdrawal does not occur upon abrupt treatment cessation even at doses much higher than commonly recommended and after treatment durations of up to 21 years.
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Hendricks
authors.affiliation: Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: M
authors.initials: M
authors.lastname: Srisurapanont
authors.affiliation: Department of Endocrinology, Metabolism & Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Schmidt
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Haggard
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Souter
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Mitchell
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: De Marco
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hendricks
authors.affiliation: Center for Weight Management, Roseville, CA, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Istratiy
authors.affiliation: Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA, USA.
authors.forename: F L
authors.initials: FL
authors.lastname: Greenway
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001067:Appetite Depressants / Q000008:administration & dosage* / Q000009:adverse effects; D016739:Behavior, Addictive / Q000139:chemically induced; D004334:Drug Administration Schedule; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D010645:Phentermine / Q000008:administration & dosage* / Q000009:adverse effects; D019966:Substance-Related Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D001067:Appetite Depressants; D010645:Phentermine