Aminorex
An anorectic marketed in central Europe in the mid-1960s that was withdrawn after it triggered an epidemic of primary pulmonary hypertension. It is a landmark cautionary tale linking serotonergic appetite suppressants to fatal pulmonary vascular disease, and a structural relative of the later fenfluramines.
01 Overview
Aminorex (2-amino-5-phenyl-2-oxazoline) was sold as Menocil in Switzerland, Austria and Germany from 1965. Within a few years epidemiologists documented a roughly 20-fold rise in primary (pulmonary arterial) hypertension that tracked its sales, and it was withdrawn in 1968.
The episode established the association between serotonin-releasing anorectics and pulmonary hypertension that would later recur with fenfluramine/dexfenfluramine. Aminorex is now controlled and of historical and toxicological interest; a related compound (4-methylaminorex) appears as an illicit stimulant.
02 Mechanism
A serotonin and noradrenaline releaser structurally related to amphetamine; the serotonergic action on pulmonary vasculature is implicated in the pulmonary hypertension it caused.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Historical anorectic dose | 10–15 mg/day | Oral | Marketed dose before withdrawal; no longer used clinically. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Appetite suppressionEffective hunger suppression, the basis for its brief market success. | short-term weight loss | Clinical | |
| StimulationWakefulness and increased energy. | amphetamine-like | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Primary pulmonary hypertensionProgressive pulmonary arterial hypertension leading to right heart failure; the epidemic that caused withdrawal. | Life-threatening | Rare but often fatal | Observational | |
| Insomnia and anxietyOverstimulation typical of releasers. | Moderate | Common | Clinical |