Ok I have been doing my research on the use of "Phen-Pro" which is the combination of phentermine and a low dose of one of the following: Prozac, Zoloft, Celexa, Lexapro, trazadone or Effexor. The second medicine is necessary because phentermine used alone stops working after a few weeks. The second medicine makes phentermine work longer and better. Although the second medicine is also an antidepressant, its use in the phen-pro combination has nothing to do with depression.
I have found a doctor within an hour of my home that does prescribe Phen Pro and for as long as you need it. Many Phen Pro doctors have prescribed it for up to 10 years when needed.
Here is some VERy interesting info I found.
The Eli-Lilly Funded Phen-Pro Study
For years Dr. Anchors and others begged the Eli Lilly company, manufacturer of Prozac, to fund a study of phen-pro.
In January 1999 Eli Lilly finally funded a small study in which independent data collectors were sent to the offices of Drs. Michael Anchors in Maryland, Linda Brunson in Virginia and Dennis Padla in Michigan. The collectors collected the data on ALL patients on phentermine-Prozac and the data was analyzed by Keith Selander, an independent statistician.
The results, shown in the following graph, show that 117 patients on phentermine alone did not lose weight whereas 711 patients on phen-pro lost about 15% (average) of their total body weight in 9 months. This is far better than the results for Meridia or Xenical.
During 1992-1997 fenfluramine was often added to phentermine to enhance the anorexiant action of phentermine, but in 1997 fenfluramine was withdrawn from the U.S. market after being linked to cardiac valvulopathy. Even in the heyday of the “phen-fen” combination, a minority of physicians used the phentermine-fluoxetine combination instead of phen-fen, and the number of these physicians grew dramatically after fenfluramine was withdrawn. In spite of this, phentermine-fluoxetine combination received little attention from the media. There has been no published association between phentermine or fluoxetine and cardiac valvulopathy.
In January 1999 the Eli Lilly Company, maker of fluoxetine, funded a retrospective trial of phentermine-fluoxetine, which we report here.
Percent weight loss versus time in obese patients on phentermine alone versus phentermine-fluoxetine combination
Professional data collectors were sent to the offices of Drs. Anchors, Padla and Brunson to collect data, using a standard protocol, from the charts of all obese patients (BMI > 30) treated with phentermine alone or the phentermine-fluoxetine combination. The doctors, practicing in different states without knowledge of each other during the time-period of the study, prescribed generic phentermine 30 mg with or without fluoxetine 20 mg per day. In addition, they recommended a low-calorie diet and exercise, with few specifics. The follow-up interval varied from every 2 weeks to 3 months. The data were analyzed by independent statistical consultant Keith Selander, and James Rochon MD of John Hopkins University provided valuable advice and oversight.
117 patients on phentermine alone lost 3.7 + 6.6% (mean + SD) of their body weight, mostly within the first 6 weeks of therapy, and then regained their weight. 711 patients on phentermine-fluoxetine combination lost 11.6 + 9.6% of their weight with no noticeable tendency to regain; 20% of the cohort reached ideal body weight during the 18 months of the trial. There were no significant adverse events. Over 100 echocardiograms on the study subjects showed no evidence of cardiac valvulopathy.
Clinical experience suggests that the addition of fluoxetine, and some other SSRI drugs as well3, may enhance and extend the anorexiant action of phentermine. At a time when so many Americans are obese and so few effective anorexiants are available, a double-blind placebo-controlled trial of phentermine-fluoxetine is long overdue.
Michael Anchors, MD, PhD
Georgetown University School of Medicine
Dennis Padla, MD
St. Joseph MI
Linda Brunson, MD
Dr. Anchors' Presentation to the Florida State Medical Board
On February 2, Dr. Anchors attended the meeting of the Florida State Board of Medicine seeking to get the board to repeal its regulation, unique in the nation, banning phen-pro. Here is a copy of Dr. A's speech
Good morning, colleagues, ladies and gentlemen. Thank you for your rapid response to my letter of December 1 and the opportunity to address you. I am seeking to strike paragraph 2 from Rule 64B8-9.012 of the Florida Administrative Code. The whole Rule 64B8 deals with the manner in which weight-loss doctors, i.e. bariatricians, in Florida treat their patients. It is my understanding that the rule was put in place in 1997 to deal with the problem of large "pill-mill" phen-fen type clinics dispensing medications without properly qualifying patients, examining or instructing them. Rule 64B8 shut down that abuse. But one part of the rule, paragraph #2, has lost its relevance as a result of subsequent research and clinical experience. Its existence hinders the ability of Florida bariatricians to combat obesity, and it puts true physicians in legal jeopardy. Paragraph #2 states...
Physicians in Florida are prohibited from prescribing, ordering, dispensing, or administering any weight loss enhancer that is both a serotonergic and anorexic agent unless the drug has been approved by the Food and Drug Administration (FDA) specifically for use in weight loss management. Selective serotonin re-uptake inhibitors (SSRIS) that have not been approved by the FDA for weight loss may not be prescribed, ordered, dispensed, or administered for such purposes.
I would like to strike out this entire paragraph, leaving the rest of the rule intact. It would be appropriate to do it today, but I don’t expect that. The cautious approach is to appoint a committee to consult with me, my colleagues, and my critics, to determine the truth of my claims and report back to the board.
I am Dr. Michael Anchors. I was raised in Jacksonville, Florida. My MD degree is from the University of Miami, Coral Gables and my PhD in biochemistry from Harvard Medical School. I did research at UCLA and the NIH for seven years. I have been in the private practice of internal medicine in Maryland for 16 years. I am on the adjunct faculty of Georgetown Medical School. I published letters regarding the “phen-pro” combination of phentermine and Prozac in Archives of Internal Medicine and in my book Safer Than Phen-Fen [Prima Press, 1997] I own the patent on phen-pro, though I have never charged for it. I have appeared on ABC, NBC, Fox and CNN News, "Montel", "Hard Copy" and "Good Morning, America", in "Newsweek" magazine, radio and newspapers.
I will not benefit financially from my effort here today; my book is no longer in print and my patent is near the end. I am here today only because some Florida physicians and obese patients who wish to use phen-pro asked me to seek the elimination of paragraph #2.I’ll be the first to admit that medicines are not the most important part of weight control. The most important job is to tell people that overeating is destroying America. Obesity is the first or second most common preventable cause of death, but Americans have no respect for it. Television suppresses the story in order to sell food commercials, and most physicians have even given up. Meanwhile, 300,000 people die from obesity each year.
The simple truth of the matter is that doctors who use safe diet pills get more people to lose weight and keep weight off than doctors who do not; and the phen-pro combination is the most effective medical plan available. Since March 1995, I have treated 1972 obese patients with the result that 548 reached ideal body weight. Fifteen lost 100 lb, four lost 150. Diabetics saw their diabetes go away (two in January, four last year). Hundreds who would have had diabetes, never will.
There are FDA-approved diet pills, Meridia and Xenical, but they are less effective. Eli Lilly, the manufacturer of Prozac, financed a large retrospective study of phen-pro [828 patients], sending a statistician and data collectors to my office, to Dennis Padla's in Michigan and Bonny Lee's in Virginia, to collect all the data from the charts of all the patients on phen-pro. The study will be published in Obesity Research Update. I have given you a copy.
I am not alone in prescribing phen-pro. Hundreds of doctors around the country prescribe it, too. I have brought letters from doctors in other states. These are not slouch doctors. Richard Atkinson is president of the American Obesity Association. Richard Rothman chief of psychopharmacology at the NIDA. Steve Van Ore former president of the Arkansas Bariatric Society. Alan Schulman prominent gastroenterologist & past president of Shady Grove Hospital. There are so many I can’t name them all.
Let’s consider paragraph #2 specifically. The scientific rationale for the paragraph is unclear. It may have been a misunderstanding of the cases of heart valve disease seen in 1997. The important thing for you to know is that ALL the cases of heart valve disease and primary pulmonary hypertension (PPH) associated with phen-fen were due to the fenfluramine part of the combination alone, NOT the phentermine part, NOT Prozac, and NOT the combination of medicines. Lucien Abenhaim, who originally published the association between fenfluramine and PPH, wrote in the New England Journal of Medicine in 2000 that Prozac was protective–-it prevented PPH and heart valve disease. Doctors Una McCann at Johns Hopkins, Rothman at the N.I.H and Raiteri in Genoa, Italy, are in agreement. I have the scientific references. Please listen closely . . .
There has not been a single case of heart valve disease associated with Prozac or phentermine, despite intense scrutiny by the FDA and a zillion lawyers.
- Not one malpractice case has been filed against a phen-pro doctor.
- No manufacturer of phentermine or Prozac has paid out a penny in settlements or damages.
- There is not a single scientific theory left standing by which Prozac or phentermine could cause heart valve disease.
If you are waiting for the FDA to approve phen-pro, you will never see it happen, because no pharmaceutical company will ever ask the FDA. Prozac and phentermine are generic drugs. No company has a sufficient financial interest.
But Florida allows doctors to prescribe medicines off-label. The FDA itself has written, and I quote, “The FDA recognizes that off-label use of drugs by prescribers is often appropriate and may represent the standard of practice.” Consider that Prozac itself is regularly used for anxiety, PMS, ADD, premature ejaculation, irritable bowel syndrome and autism--none of these are FDA-approved indications. Florida allows Prozac to be prescribed off-label for all those indications. Why not for obesity? If there is no scientific reason why not, then why not?
Posted by: Michael Anchors MD PhD on Aug 07, 03 | 4:10 pm |
Michael Anchors was issued a U.S. Patent on Phen-Pro, patent number 5,795,895, on August 18, 1998.
This patent includes all use of the combination of phentermine and an SSRI drug for the treatment of obesity.
For the good of the public at large, Dr. Anchors is happy to allow private physicians, in routine medical practice, to use phen-pro free of charge. Larger commercial enterprises and all multidoctor or multiclinic enterprises must seek written permission from Dr. Anchors.
So with that being said is anyone here using the Phen Pro method? I am going to see the doctor DR Anchor told me to go see that within an hour of my area. I seriously hope this helps me. I have almost lost all effects of Phen alone. I have lost a total of 29 lbs on Phen in 2 months but I lost the first 18-20 in the first month so not as big difference in the second month. I just want to know the opinions from you guys and gals on the Phen Pro method??