Which statement about Phentermine is true?

• A. Start with 7.5-15 mg/day and increase only if no results
• B. It should not be prescribed for someone with hx of psych dz or substance abuse
• C. It should be used with SSRIs for better results
• D. It is safe for patients with a history of substance abuse

Answer: (B)

Phentermine is a stimulant-like appetite suppressant. Its action increases catecholamines in the brain, mainly norepinephrine, which helps reduce appetite but can also provoke or worsen psychiatric symptoms and carry a risk of misuse. Because of these stimulant effects, it should not be prescribed to someone with a history of psychiatric disorders or substance abuse. In such individuals, the medication can trigger mood disturbances, anxiety, insomnia, or psychosis and may destabilize substance-use recovery, making safer alternatives preferable.

Other options in the list would either misstate how the drug should be started or suggest unsafe combinations; for example, using it alongside SSRIs or assuming it’s safe in people with a history of substance abuse. The key point is the contraindication in psychiatric or substance-use history due to the stimulant nature of the drug.