Talk:Lorcaserin

Presentation of information

I agree with Liturgie de Cristal that the way information is presented in this article gives the reader the impression of bias in favor of this drug's efficaciousness. That is mainly due to how much of the article is devoted to Arena's actions in relation to the drug rather than the drug itself. Few other pharmacology articles are written in this way. It may be due to a simple lack of information about the drug, but the frequent mentions of Arena's actions rather than the drug's own properties are not very useful. This is especially clear in the "future prospects" section of the article. Statements such as "Arena is taking care to demonstrate [12] that lorcaserin does not cause heart valve damage" belong in an article about Arena, and should be rephrased as "Lorcaserin has been demonstrated to not cause heart damage..." (assuming this is actually true.

Interestingly, Liturgie de Cristal is actually the original author of this Arena-centric presentation. If you go back and read her original edits, you'll see that she wrote it in an obscenely anti-Arena biased tone. I agree that the article should be focused on the molecule itself and mention of Arena should be only related to inventorship and discovery, but I don't have the time or energy to rewrite the entire thing in a more scientific and appropriate tone. It needs it though. —Preceding unsigned comment added by Leftcoaster scab (talk • contribs) 01:31, 5 November 2009 (UTC)

Just a few comments here ...

I have zero interest in the success or failure of this drug. I do however have great interest in a well informed public. People seeking information about lorcaserin (or any other subject) should find factual information, good and bad.

I'm well aware that lorcaserin is a touchy subject for investors. If the drug is approved, it's likely to be a gigantic money-maker just as fenfluramine was. Arena estimates that sales will net $1 billion per year. I believe this is the reason that the lorcaserin entry is being brutally edited.

The Wikipedia entry must not be turned into a lorcaserin advertisement for the purpose of generating investor interest and, later, boosting sales. There are numerous references pointing to Arena's own documents, that should suffice. Liturgie de cristal (talk) 23:38, 16 October 2008 (UTC)

From a brief overview of the literature, my impression is that 5HT2C agonists are likely to have useful anorectic effects, but most likely accompanied by dose-limiting side effects which may cause these drugs to be unsuitable for some patients. Of course you could make the same criticism of CB1 inverse agonists such as rimonabant, and so we must be careful to try and keep this article as unbiased as possible, as it is inevitable that lorcaserin will have both good and bad aspects which should both be covered evenly. Meodipt (talk) 02:32, 17 October 2008 (UTC)

I find it odd that Arena is performing heart tests on the trial participants when the 5HT2C receptors "are located almost exclusively in the brain". Not sure if this was a requirement forced upon Arena by the FDA because of the fenfluramine debacle, or if it was a PR ploy by Arena so that it could distance itself from the fenfluramine debacle. --Liturgie de cristal (talk) 01:37, 11 September 2009 (UTC)

Yes, Liturgie de cristal, the company and FDA agreed that 7500 total participants in the phase III trials would rule out a 20% or greater increase in Valvulopathy. I gave the article a thorough updating. Seems this article hasn't been updated in almost 2 years. They have completed 2 of the phase III trials and submitted their NDA (which I forgot to write about..maybe later). Anyway I added a section for the Phase III trial results, and updated the previous section which mainly discussed the Phase IIb trial and the fact that the drug monitoring board did not halt the phase III trial. It was hard to walk around the line separating the company and the drug given the actions of the company in recent weeks. Monkeshine (talk) 23:02, 10 June 2010 (UTC)monkeshine

I'm re-reading and seeing that some of what I added had been touched upon earlier in the article. In addition I wonder whether I should delete or at least minimize the emphasis on side effects like depression given that the phase III program appears to show no increase. It raises the question whether all 5H2C agonists necessarily increase depression. This is a serious issue as it inhibited the approval of other obesity drugs, and I do not want to rely solely on Arena's PRs but there is scant other information at this time. However, I would prefer to rely on the evidence of over 7000 people in a double-blind placebo controlled study than on in-vivo or limited studies performed on other 5H2C agonists. I would appreciate input on how to approach that before I edit, if anyone is still interested. There are now 2 sections on "side effects" but the one I added comes from the large phase III trials which has to be more reliable than any other evidence at this point Monkeshine (talk) 21:32, 11 June 2010 (UTC)monkeshine

I am deleting large portions of the 'side effect' section. Someone wants to add a whole lot of irrelevant information to this article and I think it has to do with rivalry between loyalists or investors in companies developing competing medicines. It may be true that some 5H2c agonists elicit certain side effects, but Lorcaserin itself was studied in phase iii trials including over 8000 people, and I think it is unfair to attribute effects seen in other drugs' small phase i or phase ii trials to this specific drug unless they were actually shown to appear in the phase iii trials. If someone wants to start a new article about 5H2c agonists in general by all means. But it doesn't belong here imo. To add it here is akin to writing about how the DC-10 airplane crashed a lot in the 1970s in the Boeing 777 article. True they are both airplanes but each is a different design and in a different place in time. Also, lorcaserin is not an approved drug so discussing who should and should not take it is likewise erroneous. If the FDA approves the drug they will write a label with restrictions, if any, and then those recommended restrictions can be added to the article. During the phase iii trials, if I recall correctly, only people with severe mental door eating disorders were excluded, so it would appear that this drug has appeal to a broad population if it were to be approved but I think we have to wait for the FDA before discussing labeling restrictions. Monkeshine (talk) 04:21, 26 June 2010 (UTC)monkeshine

The article is practically an add

I would have suggested deleting the page entirely, it's practically an add for the drug mashed up with some "PDR-esque" information. My first thought was "written by the company that owns the patent". However, maybe this drug does deserve its own article - now that it's clear it causes cancer: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/09/15/BU521FDLBC.DTL —Preceding unsigned comment added by 24.130.82.154 (talk) 06:31, 16 September 2010 (UTC)

I agree that it is written overly enthusiastic. However,

1. Whether the drug deserves an article has got nothing to do with its side effects. Articles that don't present a neutral view should be fixed, not deleted.
2. Please don't make the opposite mistake yourself – making the drug appear more dangerous than can be concluded from data is just as WP:POV as making it appear less dangerous. "It's clear it causes cancer" is wrong; it is associated with cancer in animal studies. --ἀνυπόδητος (talk) 10:57, 16 September 2010 (UTC)
3. I know you are interested in a well-informed public and accuracy, so I wanted to point out that there is actually NO LINK between lorcaserin and tumors or cancer in rats. I watched the entire AdCom panel meeting yesterday, and the FDA did not say there was a link. The FDA said they did not know what caused the tumors but wanted more information proving lorcaserin does not. Just thought you might want to make the distinction since the meaning is quite different.Sean9106 (talk) 17:15, 17 September 2010 (UTC)

Structural question

The structural diagram shows a bond going away from the viewer. However, the atom at the end of that bond is not identified, and thus it is probably a hydrogen. Yet, that carbon looks like it should have two hydrogens bonded to it. If that is the case, there was no reason to show the direction of one bond. Jamesdbell8 (talk) 14:03, 1 July 2012 (UTC)

Corners, branches and ends in skeletal formulae that don't show an atom are carbons (see e.g. Ethanol, Ethyl acetate). Hydrogens (at least those bonded to carbons) aren't shown at all, not even their bonds. Cheers, ἀνυπόδητος (talk) 15:47, 1 July 2012 (UTC)

JAMA IM

Good article in JAMA Internal Medicine, on the cautious side:

http://archinte.jamanetwork.com/article.aspx?articleID=1828746
Special Communication | February 2014
The New Weight-Loss Drugs, Lorcaserin and Phentermine-TopiramateSlim Pickings? ONLINE FIRST
Steven Woloshin, MD, MS1; Lisa M. Schwartz, MD, MS1
JAMA Intern Med.
Published online February 10, 2014.
doi:10.1001/jamainternmed.2013.14629

The drugs have been associated with serious harms: Both drugs’ labels include warnings about memory, attention, or language problems and depression; for lorcaserin, the label also warns of valvular heart disease and euphoria; and for phentermine-topiramate, the label warns of metabolic acidosis, increased heart rate, anxiety, insomnia, and elevated creatinine levels. Neither medication is marketed in Europe because of safety concerns.

--Nbauman (talk) 04:48, 13 February 2014 (UTC)

Therein is revealed the objectivity of American medicine.

The days of bat urine with a dash of cocaine or laudanum/morphine in America, that is, Snake Oil, being marketed to naive helplessly ignorant civilians, as the "Miracle Elixir", etc., then little girls with toothaches chopping up and dismembering their mothers upon ingestion of the "wonder elixir", never really left in this country and the game is essentially the same today, only surface details differing, modern managerial bureaucracy being draped over the whole sordid mess mendaciously, for the American mind believes managerial bureaucratic formalism and governmental monopolization is identical to an actual solution or responsible action: the "solution" in America after the carnage of deaths related to "Ph/Fen-phen" was, naturally, every party to regress into hysterical, insincere moral panic, and the local body overseeing medicinal substance as interfacing public health, the FDA, to morally attitudinize, superficially halt the mayhem incoherently and temporarily, only to greedily await its meretricious reinvention by some future company, for, after, all, racketeering cannot succeed without kickbacks and so forth. — Preceding unsigned comment added by 2602:304:B34B:A940:3084:E56D:C81C:CAAC (talk) 03:48, 20 December 2019 (UTC)