Which appetite medication should be used with caution in patients with anxiety?

• A. Metformin
• B. Orlistat
• C. Phentermine/topiramate with caution
• D. Liraglutide

Answer: (C)

Stimulant components used for appetite control can ramp up the body's stress response, leading to increased anxiety, restlessness, insomnia, and a faster heartbeat. The combination that includes a stimulant fits this risk most directly, so it should be used with caution in patients who have anxiety. The other medications work through different mechanisms and don’t carry the same stimulant-related anxiety risk: metformin is primarily a diabetes drug that can cause slight weight changes but isn’t an appetite suppressant; orlistat acts in the gut to block fat absorption and tends to cause GI side effects rather than anxiety; liraglutide is a GLP-1 receptor agonist with effects like nausea and weight loss, but it doesn’t have the same stimulant-driven anxiety concerns.