Pronunciation: dye-eth-ill-PROH-pee-on

Chemical Abstracts Service Registry Number: 90-84-6. (Hydrochloride form 13480-5)

Formal Names: Adiposan, Amfepramone, Anfamon, Apisate, Bonumin, Brendalit, Dietic, Dietil-Retard, DIP, Dobesin, Frekentine, Lineal-Rivo, Linea-Valeas, Lipomin, Liposlim, Magrene, Moderatan, M-Orexic, Nobesine, Nulobes, Prefa-mone, Propion, Regenon, Regibon, Slim-plus, Tenuate, Tenuate Dospan, Tepanil Informal Names: Blues

Type: Stimulant (anorectic class). See page 15 Federal Schedule Listing: Schedule IV (DEA no. 1610) USA Availability: Prescription Pregnancy Category: B

Uses. Humans find the drug's effects similar to those of dextroamphetamine but at a weaker level. One experiment found dextroamphetamine 6 to 11 times stronger than diethylpropion when given orally, 10 to 20 times stronger when given by subcutaneous injection. Although diethylpropion was created in the 1920s, this amphetamine derivative was not marketed for weight loss until around 1960. The drug then achieved great popularity. Over 30 million persons around the globe had taken the drug by 1978. That year 1.5 billion prescriptions were written, but the number dropped to just one-fourth that amount by 1988 as the medical world became more aware of the drug's drawbacks.

Occasional short-term usage rather than continual use has been recommended. The compound breaks up sleep and interferes with dreaming but has fewer stimulant effects than some other anorectics. Users feel less fatigue than with fenfluramine, and undesirable effects of diethylpropion disappear faster than those of fenfluramine when the drug is stopped. Studies of weight loss patients using diethylpropion found only trivial impact on heart rate or blood pressure, and the compound is considered a good choice for patients with high blood pressure.

Diethylpropion has been used experimentally to reduce craving for cocaine, with some success. Some researchers question that finding, however, pointing out that craving for cocaine diminishes in a hospital setting regardless of whether patients receive diethylpropion or a placebo. In a two-week study, former crack cocaine users receiving diethylpropion showed no change in tests of thinking abilities. That result is interpreted as meaning that short-term use of diethylpropion may cause no measurable harm to brain function.

Another experimental use of the drug has been for relief of arthritis pain. Patients experienced increase of comfort but no increase in ability to use affected joints.

Drawbacks. Minor unwanted actions may include dizziness, dry mouth, and constipation. In a study of 132 patients taking the drug, about 3% had experiences such as euphoria, muscle tremors, or trouble with sleeping. Assorted scientific reports indicate the drug rarely has untoward physical effects; the medical literature mentions an addict who ingested 30 to 100 times the recommended amount each day without major impact. Exceptions to the drug's relative safety do occur. Diethylpropion is suspected of being involved in a case where someone suffered minor strokes (transient ischemic attacks), is suspected of contributing to a case of heart trouble, and is known to cause heart trouble if an overdose is taken. A rare affliction ascribed to the drug is overdevelopment of the vestigial male mammary glands.

The drug may bring on psychosis, especially when taken along with a mon-oamine oxidase inhibitor (MAOI, found in some antidepressants and other medicine). One user felt under assault from persons using mental telepathy; another heard voices; another thought a television set was observing her; another began worrying about someone using the "evil eye" to kill a child. In some cases those problems ceased after the diet drug stopped; in others the affliction reappeared. A therapist reporting on the latter type of cases suspected that the persons would have developed psychosis regardless of whether they used diethylpropion. The typical sufferer is a female 25 to 40 years old, leading a troubled life with a history of mental instability and drug abuse. Drugs abused by these women often include amphetamines, an important factor because a former amphetamine abuser who later takes another stimulant can quickly shift back into the old abuse mode. Often such persons begin taking diethylpropion to help them lose weight but afterward continue taking it for pleasurable psychic effect. That special group's experience, however, is not commonplace among users in general.

Abuse factors. The drug's amphetamine-type effects are strong enough to have produced an illicit market for diethylpropion in the 1960s, but large surveys determining levels of abuse for various drugs yielded no mention of diethylpropion during the drug's peak of popularity in the mid-1970s. In that era analysis of 5,204 street drug samples found 1 containing diethylpropion. Because the compound is described as producing effects resembling those of amphetamine, diethylpropion is not recommended for persons who have suffered from psychological illness or drug abuse. Binge abusers report that pleasant sensations can be obtained for one to three days, but then nervousness and restlessness predominate if dosing continues. Tolerance develops to the drug's stimulant actions.

Drug interactions. Experiments with mice show that alcohol and diethylpropion produce more locomotor activity than either drug alone. Researchers in Brazil speculate that combining the two substances may increase other stim ulation sensations, perhaps explaining why using alcohol and anorectic drugs together is allegedly so popular in that country. How popular is that practice? In the latter 1980s the total distribution of diethylpropion and other anorectics was compared to Brazil's population, yielding enough drugs to supply a daily dose to about 1.4% of the population that could afford to buy it, which is the same as saying 0.7% of that wealthier population could be taking two doses a day. The percentage of users becomes one third of those totals if doses are divided among the entire population rather than just among those with enough money to buy the drugs. By using a survey other researchers measured use of anorectics as totaling 1.3% of the population in one area of southern Brazil in 1994, confined mostly to women from higher classes using the drugs under medical prescription. Those percentages lump together usage of diethylpropion with other anorectics, so usage of diethylpropion would be a fraction of those percentages. And recreational usage of diethylpropion together with alcohol would be smaller yet.

Cancer. The drug's potential for causing cancer is unknown.

Pregnancy. Tests with rabbits, mice, and rats produced no birth defects. A case in which a pregnant woman taking diethylpropion gave birth to a malformed infant raised fear that it may cause fetal damage, but studies of pregnant women taking the drug attribute no birth defects to it. Nonetheless, potential for human birth defects is unknown. The drug passes into breast milk.

Additional scientific information may be found in:

Bolding, O.T. "Diethylpropion Hydrochloride: An Effective Appetite Suppressant."

Current Therapeutic Research: Clinical and Experimental 16 (1974): 40-48. Carney, D.E., and E.D. Tweddell. "Double Blind Evaluation of Long Acting Diethylpropion Hydrochloride in Obese Patients from a General Practice." Medical Journal of Australia 1 (1975): 13-15. Carney, M.W.P., and M. Harris. "Psychiatric Disorder and Diethylpropion Hydrochloride." Practitioner 223 (1979): 549-52. Cohen, S.D. "Diethylpropion (Tenuate): An Infrequently Abused Anorectic." Psycho-

somatics 18 (1977): 28-33. "Diethylpropion Psychosis." Medical Journal of Australia 2 (1970): 1052-53. Glazer, G. "Long-Term Pharmacology of Obesity 2000: A Review of Efficacy and

Safety." Archives of Internal Medicine 161 (2001): 1814-24. Hoffman, B.F. "Diet Pill Psychosis: Follow-up after 6 Years." Canadian Medical Association Journal 129 (1983): 1077-78. Silverman, M., and Ronald O. "The Use of an Appetite Suppressant (Diethylpropion Hydrochloride) during Pregnancy." Current Therapeutic Research: Clinical and Experimental 13 (1971): 648-53.

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