Korean J Biol Psychiatry.  2022 Apr;29(1):22-31. 10.22857/kjbp.2022.29.1.004.

Phentermine and Phendimetrazine-Induced Psychotic Disorder and Bipolar Disorder: A Case Series

• Kim SY
• Kim TS
• Kim DJ
• Chae JH
• Lee CU
• Joo SH

• KMID: 2528450
• DOI: http://doi.org/10.22857/kjbp.2022.29.1.004

Abstract

Objectives
Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses.
Methods
In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized.
Results
All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia.
Conclusions
These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.

Keyword

Substance-induced psychoses; Substance-related disorders; Phentermine; Phendimetrazine