New antiobesity agents: lorcaserin (Belviq) and phentermine/topiramate ER (Qsymia)

Cardiol Rev. Jan-Feb 2014;22(1):43-50. doi: 10.1097/CRD.0000000000000001.


Obesity is a risk factor for a wide range of conditions, including cardiovascular disease. Although lifestyle modifications remain the cornerstone for the management of obesity, pharmacologic agents may be a helpful addition to patients who have comorbidities and do not respond adequately to diet and exercise. Lorcaserin and phentermine/topiramate ER are 2 long-awaited agents, approved in 2012 for obesity management, 13 years since orlistat received US Food and Drug Administration approval in 1999. Lorcaserin is a serotonin agonist, whereas phentermine/topiramate is a combination of a sympathomimetic agent and an antiepileptic drug; both these agents have been shown to reduce weight significantly and improve cardiovascular and metabolic parameters, such as blood pressure, lipids, and HbA1C. This article reviews the pharmacology and clinical efficacy and safety of each of these agents. The differences among the three available agents for long-term management of obesity will also be examined.

Publication types

  • Review

MeSH terms

  • Anti-Obesity Agents / therapeutic use*
  • Anticonvulsants / therapeutic use
  • Appetite Depressants / therapeutic use
  • Benzazepines / therapeutic use*
  • Body Mass Index
  • Comorbidity
  • Drug Approval
  • Drug Combinations
  • Fructose / analogs & derivatives*
  • Fructose / therapeutic use
  • Humans
  • Obesity / drug therapy*
  • Phentermine / therapeutic use*
  • Serotonin / metabolism
  • Sympathomimetics / therapeutic use
  • Topiramate
  • Treatment Outcome
  • United States
  • United States Food and Drug Administration


  • Anti-Obesity Agents
  • Anticonvulsants
  • Appetite Depressants
  • Benzazepines
  • Drug Combinations
  • Sympathomimetics
  • Topiramate
  • Fructose
  • Serotonin
  • lorcaserin
  • Phentermine