Weight-Loss Pharmacotherapy Beyond Incretins: Patient Selection, Safety, and Real-World Decision-Making - Episode 3
Sympathomimetic agents and baseline safety assessment in obesity pharmacotherapy
Dr Cristancho reviews the targeted role of sympathomimetic agents and outlines essential cardiovascular, psychiatric, and drug–drug interaction assessments before initiating non-incretin medications.
This segment positions sympathomimetic agents as targeted tools for select patients with severe hyperphagia and without major cardiovascular or psychiatric contraindications. Dr Cristancho notes their rapid onset and generally shorter approved duration of use, which necessitate structured monitoring.
Clinicians should avoid or use extreme caution with stimulant-based therapies in patients with established cardiovascular disease, uncontrolled hypertension, or significant psychiatric comorbidity. In such populations, alternative non-incretin options with more favorable safety profiles may be preferable.
Baseline evaluation must encompass cardiovascular history and vitals, mental health screening, and a full review of concomitant medications. Dr Cristancho underscores that this front-loaded risk assessment is essential not only for sympathomimetics but for all centrally acting and non-incretin weight loss agents.
