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Stimulants for the Control of Hedonic Appetite

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 a...

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Autores principales: Poulton, Alison S., Hibbert, Emily J., Champion, Bernard L., Nanan, Ralph K. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843092/
https://www.ncbi.nlm.nih.gov/pubmed/27199749
http://dx.doi.org/10.3389/fphar.2016.00105
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author Poulton, Alison S.
Hibbert, Emily J.
Champion, Bernard L.
Nanan, Ralph K. H.
author_facet Poulton, Alison S.
Hibbert, Emily J.
Champion, Bernard L.
Nanan, Ralph K. H.
author_sort Poulton, Alison S.
collection PubMed
description 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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spelling pubmed-48430922016-05-19 Stimulants for the Control of Hedonic Appetite Poulton, Alison S. Hibbert, Emily J. Champion, Bernard L. Nanan, Ralph K. H. Front Pharmacol Pharmacology 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. Frontiers Media S.A. 2016-04-25 /pmc/articles/PMC4843092/ /pubmed/27199749 http://dx.doi.org/10.3389/fphar.2016.00105 Text en Copyright © 2016 Poulton, Hibbert, Champion and Nanan. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Poulton, Alison S.
Hibbert, Emily J.
Champion, Bernard L.
Nanan, Ralph K. H.
Stimulants for the Control of Hedonic Appetite
title Stimulants for the Control of Hedonic Appetite
title_full Stimulants for the Control of Hedonic Appetite
title_fullStr Stimulants for the Control of Hedonic Appetite
title_full_unstemmed Stimulants for the Control of Hedonic Appetite
title_short Stimulants for the Control of Hedonic Appetite
title_sort stimulants for the control of hedonic appetite
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843092/
https://www.ncbi.nlm.nih.gov/pubmed/27199749
http://dx.doi.org/10.3389/fphar.2016.00105
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