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Eph3.8
Ephedrine – Forschung
Überwiegend Mechanismus / Beobachtung
6 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Ephedrine sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus mittelwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 1992–2003 mit einer typischen Studiengröße von 167 Teilnehmenden.
Basierend auf 6 Studien · 1 Meta-Analyse · 3 RCTs · 377 Teilnehmende insgesamt
Konfidenz
Mittlere Konfidenz
Nach Outcome
Weight & fat lossEphedrine + Koffein bewirkt in RCTs einen moderaten kurzfristigen Fettverlust — etwa 0,9 kg/Monat mehr als Placebo · Wochen (kurzfristig)
Überwiegend Mechanismus / Beobachtung6 Studien
Psychiatric & CNS effects
Überwiegend Mechanismus / Beobachtung4 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung4 Studien
Cardiovascular harm
Überwiegend Mechanismus / Beobachtung3 Studien
Ältere Forschungsbasis
Neueste Studie von 2003 · Neueste Meta-Analyse: 2003
199219972003
1Meta-Analyse2003
Ephedrine and ephedra promote modest short-term weight loss (approximately 0.9 kg/mo more than placebo) in clinical trials ... Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations.
Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, et al. · JAMA (2003)
The defining meta-analysis (RAND, 52 controlled trials + 65 adverse-event case reports) — the evidence base behind the FDA ban
Ephedrine/ephedra produced ~0.9 kg/month more weight loss than placebo; no trial assessed beyond 6 months and evidence for athletic performance was insufficient
Safety data from 50 trials showed a 2.2- to 3.6-fold increase in the odds of psychiatric, autonomic, or gastrointestinal symptoms and heart palpitations
The ephedrine/caffeine combination is effective, while caffeine and ephedrine separately are ineffective for the treatment of human obesity.
Astrup A, Breum L, Toubro S, Hein P, Quaade F · International journal of obesity and related metabolic disorders (1992)
Pivotal double-blind RCT: 180 obese patients on a 4.2 MJ/day diet given ephedrine/caffeine (20/200 mg), ephedrine (20 mg), caffeine (200 mg), or placebo three times daily for 24 weeks
The ephedrine+caffeine combination produced significantly greater weight loss than placebo from week 8 to 24 (16.6 vs 13.2 kg, P=0.0015) — modest but real
Ephedrine alone and caffeine alone were NO better than placebo — the synergy between the two is the entire effect (the rationale for the ECA stack)
3RCTn=167 · medium study2002
In this 6-month placebo-controlled trial, herbal ephedra/caffeine (90/192 mg/day) promoted body weight and body fat reduction and improved blood lipids without significant adverse events.
Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, et al. · International journal of obesity and related metabolic disorders (2002)
Six-month randomized double-blind placebo-controlled trial of a herbal ma-huang/kola-nut supplement (90/192 mg/day ephedrine alkaloids/caffeine) in 167 subjects
Herbal treatment beat placebo for weight (-5.3 vs -2.6 kg, P<0.001), body fat, and lipids (lower LDL, higher HDL) — reproducing the modest fat-loss signal
Heart rate rose (4 vs -3 bpm) and there were small blood-pressure changes, dry mouth, heartburn, and insomnia; cardiac arrhythmias were not increased in this trial
Ten events resulted in death, and 13 events produced permanent disability ... The use of dietary supplements that contain ephedra alkaloids may pose a health risk to some persons.
Haller CA, Benowitz NL · The New England journal of medicine (2000)
Mandatory counter-evidence: FDA-commissioned review of 140 adverse-event reports for ephedra-alkaloid supplements (1997–1999)
62% of cases were judged definitely, probably, or possibly related; 47% involved cardiovascular symptoms and 18% the CNS
Hypertension was the most frequent effect, followed by palpitations/tachycardia, stroke (10), and seizures (7); 10 deaths and 13 permanent disabilities
Ephedrine-caffeine compared with placebo preserved fat-free mass and enhanced fat loss, which could be accounted for both by anorexia (75%) and by increased thermogenesis (25%).
Astrup A, Toubro S, Christensen NJ, Quaade F · The American journal of clinical nutrition (1992)
Mechanistic account of how ephedrine/caffeine drives fat loss: acute stimulation of thermogenesis plus appetite suppression
Roughly 75% of the weight effect was attributable to reduced food intake (anorexia) and ~25% to increased thermogenesis — not pure 'fat burning'
Ephedrine+caffeine preserved fat-free mass while enhancing fat loss; caffeine and ephedrine separately had no effect