Phenmetrazine is a sympathomimetic stimulant that was historically prescribed as an appetite suppressant to aid in weight loss. It works by stimulating the central nervous system, which can increase heart rate and blood pressure, and decrease appetite.

Historical Context and Use
Introduction and Popularity: Phenmetrazine was introduced in the 1950s and was marketed under brand names such as Preludin and 4-meo pv9. It gained popularity due to its effectiveness in reducing appetite and aiding weight loss.
Mechanism of Action: Phenmetrazine increases the release of norepinephrine and dopamine in the brain, which suppresses appetite and increases energy expenditure.
Usage: It was primarily prescribed for short-term use due to concerns about dependence and potential side effects.
Risks and Concerns
Side Effects: Common side effects included increased heart rate, elevated blood pressure, insomnia, anxiety, and dry mouth. Severe side effects could involve cardiovascular issues and potential for abuse and dependence.
Addiction and Abuse: Phenmetrazine has a high potential for abuse due to its stimulating effects, leading to its classification as a controlled substance in many countries.
Withdrawal: Abrupt cessation after prolonged use could result in withdrawal symptoms such as fatigue, depression, and increased appetite.
Regulatory Status
Withdrawal from Market: Due to the risks associated with its use, including the potential for abuse and the development of safer alternatives, phenmetrazine was gradually withdrawn from the market. By the 1970s, it was largely replaced by other appetite suppressants and weight loss medications that were considered to have a better safety profile.
Modern Alternatives
Current Medications: Today, safer and more effective medications are available for weight management, such as:
Phentermine: Similar in action but with a lower risk profile.
Orlistat: Works by reducing fat absorption in the intestines.
Liraglutide: A GLP-1 receptor agonist that helps regulate appetite and food intake.
Non-pharmacological Approaches: Emphasis on lifestyle changes including diet modification, increased physical activity, and behavioral therapy.
Conclusion
While phenmetrazine was once a common medication for weight loss, its use is no longer recommended due to its potential for abuse and the availability of safer alternatives. Patients seeking help for weight management should consult healthcare providers to explore the most appropriate and safe options tailored to their needs.