Sibutramine was also well tolerated, although it may cause dry mouth, anorexia, and insomnia, and should be used with caution in patients at risk for cardiovascular disease.
* Clin Ther 2003 Jan;25(1):58-80 -- Weight management and current options in pharmacotherapy: Orlistat and sibutramine. -- Leung WY, Neil Thomas G, Chan JC, Tomlinson B.

Sibutramine increases norepinephrine and serotonin levels in the CNS and should not be taken with many antidepressants because of the risk of increased norepinephrine and serotonin levels. Its use is also contraindicated in patients with cardiovascular disease.
* Am J Health Syst Pharm 2001 Jul 15;58(14):1301-8 -- Pharmacologic options for the treatment of obesity. -* Campbell ML, Mathys ML.

Sibutramine should be used with caution in patients with a history of hypertension and should not be used in those with uncontrolled hypertension and concomitant cardiovascular disease.
* Ann Pharmacother 1999 Sep;33(9):968-78 -- Sibutramine : a serotonin-norepinephrine reuptake-inhibitor for the treatment of obesity. -- Luque CA, Rey JA.

A small increase in heart rate and blood pressure also occurs and persists for as long as treatment is continued, which, therefore, requires monitoring.
* Obes Rev 2000 Oct;1(2):127-39 -- An assessment of the safety and efficacy of Sibutramine , an anti-obesity drug with a novel mechanism of action. -- Nisoli E, Carruba MO.

The use of Sibutramine in those under the age of 16 and those over the age of 65 has not been tested.
* Int J Obes Relat Metab Disord 2001 Dec;25 Suppl 4:S2-7 -- When, for whom and how to use sibutramine? -- Astrup A, Toubro S.

To maximize the benefits of Sibutramine , it is important that patients receive adjunctive diet and lifestyle therapy.

* Int J Obes Relat Metab Disord 2002 Dec;26 Suppl 4:S29-33 -- Sibutramine : its mode of action and efficacy. -- Finer N.

Treatment with the drug decreases visceral fat, improves lipid levels, decreases glycosylated haemoglobin and decreases uric acid concentrations. Sibutramine is effective in achieving weight loss in patients with type 2 diabetes but weight loss occurs more slowly than in non-diabetic patients. The criteria for predicting response to treatment in uncomplicated patients may not be appropriate to those with type 2 diabetes. Furthermore, it is important to set realistic goals for weight loss in type 2 diabetes to avoid the risk of denying effective treatment to patients.

* Int J Obes Relat Metab Disord 2002 Dec;26 Suppl 4:S34-7 -- Metabolic benefits associated with Sibutramine therapy. -- Krejs GJ.

Sibutramine can interact with a number of prescription and over the counter medications. Consult with your physician before using other drugs, herbs and supplements.

Not recommended if you are pregnant, planning to be or breastfeeding.