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Multidisciplinary Approach to Obesity Management: A Case Report

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Published on: May 30, 2025

Clinical experience using appetite suppressants and SSRIs.

W Alan Rader¹, G Michael Steelman, Eric C Westman

¹Duke University Medical Center, Durham, NC 27704, USA.

The Journal of the Oklahoma State Medical Association

|September 10, 2008

Summary

Sympathomimetic appetite suppressants combined with selective serotonin reuptake inhibitors (SSRIs) did not cause serotonin syndrome in 1174 bariatric patients. Monitored use by trained physicians is deemed justifiable.

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Area of Science:

Pharmacology
Bariatric Medicine
Neuroscience

Background:

Anecdotal reports suggest a risk of serotonin syndrome when combining sympathomimetic appetite suppressants with selective serotonin reuptake inhibitors (SSRIs).
Concerns exist regarding the safety profile of these drug combinations in weight management.
Bariatric physicians utilize these medications in clinical practice.

Purpose of the Study:

To investigate the incidence of serotonin syndrome in patients using a combination of sympathomimetic appetite suppressants and SSRIs.
To assess the safety of this drug combination in a bariatric patient population.

Main Methods:

A survey was conducted among bariatric physicians regarding their clinical experience.
Data was collected on patients prescribed both sympathomimetic appetite suppressants and SSRIs.
The primary outcome assessed was the occurrence of serotonin syndrome.

Main Results:

No cases of serotonin syndrome were reported among 1174 patients receiving the combined medication regimen.
Physicians monitored the use of these medications in their clinical practice.

Conclusions:

The monitored co-prescription of sympathomimetic appetite suppressants and SSRIs in bariatric patients appears safe, with no observed cases of serotonin syndrome.
The use of this combination by trained practitioners under supervision is justifiable.
Further research may explore long-term safety and efficacy.