Lorcaserin

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Contents

Introduction

A selective 5-hydroxytryptamine 2C agonist developed to treat obesity as an appetite suppressant[1]. The extra weight loss compared to placebo weight reducing diet is about 2kg in a 100kg patient at 3 years, that is 4kg in total.

Clinical Use

Indications

  • Obesity

Administration

Oral 10mg bd

Clinical Issues

Contra-indications

(Based on clinical trial exclusions)

  • Heart failure (EF <20%)
  • Severe valvular heart disease
  • Severe renal failure
  • Severe hepatic failure

Cautions and Interactions

  • Increased risk of severe hypoglycaemia in diabetics on oral hypoglycaemics.
  • May aggrevate pre existing depression

Side effects

Special advice

Pharmacology

Might work in schizophrenia. Fifteen times more selective at 5-HT(2C) than 5-HT(2A) and 100 times more selective at 5-HT(2C) than 5-HT(2B). In rats at high doses it induces tumours. Three year follow up suggests good cardiovascular safety. It probably has a side effect profile that helps with stress incontinence but no issues with urinary retention are reported.

References