Mazindol
A tricyclic anorectic that suppresses appetite by inhibiting noradrenaline and dopamine reuptake. Historically prescribed for short-term weight loss, it has been withdrawn in many markets but is under renewed study for narcolepsy and ADHD. Carries cardiovascular, insomnia and dependence considerations.
01 Overview
Mazindol is an imidazoisoindole anorectic that, unlike amphetamine-type agents, is not a classic amphetamine but a reuptake inhibitor. It was widely used for obesity in the past and has largely been withdrawn from general weight-loss use, but a controlled-release form is being investigated for narcolepsy and ADHD.
It produces appetite suppression and modest weight loss short-term. Side effects include dry mouth, insomnia and cardiovascular stimulation, and it retains dependence potential (Schedule IV where scheduled). It is contraindicated with MAO inhibitors and in significant cardiac disease.
02 Mechanism
Inhibits reuptake of noradrenaline and dopamine (and to a lesser degree serotonin), increasing central catecholamine signalling to suppress appetite and promote wakefulness.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Therapeutic (historical anorectic) | 1–3 mg/day | Oral | 1 mg three times daily or 2 mg once daily before a meal; short-term use. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Appetite suppression and weight lossReduces appetite as a short-term adjunct to diet. | Modest short-term weight loss | Clinical | |
| Increased wakefulnessPromotes wakefulness; under investigation for narcolepsy. | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Insomnia and dry mouthDifficulty sleeping and dry mouth are frequent. | Mild | Common | Clinical | |
| Cardiovascular stimulationRaised heart rate and blood pressure; palpitations. | Moderate | Common | Clinical | |
| Dependence potentialDependence can develop, hence short-term historical use. | Moderate | Uncommon | Clinical |