"I've been drinking Slimline for 20 days and I've lost 5 kg, I feel great, my appetite is reduced, I drink a lot more water and eat healthier, which is much easier when you have no appetite..."
"My husband lost 17 kg from one box (36 pills), he lost 36 kg in those 13,5 days, but he continued to lose weight even after he stopped taking the pills, and I had an excess of 7 kg from childbirth (then I had a 7-month-old baby, I breastfed the baby until the 6th month, my milk stopped and my cycle started, but the other kg) I managed to lose all 7 kg."
"I am using Slim Line Soft Gel tablets for the third time, the third and very successful time! Look, baby, just order them nicely and start getting your body back, a renewed sense of self-satisfaction and enjoy your child and the time spent with him... Every time I lost 10 kg in a month and 20 days! The feeling is immeasurable! The last time, now after the second birth, after 8 months of breastfeeding, I reached 90 kg, at the age of 38, but I did not despair, because I was sure of the tried and tested tactics."
These are just some of the testimonials that can be found on internet forums, and refer to the experiences of women who drank Slim Line slimming capsules. The preparation is supposedly 100 percent natural, and according to what is written on the box, it contains only exotic plants: Job's tears, bamboo sprouts, lotus flower and the like... What the women who swallowed these capsules did not know is that they lose weight solely because they enter the body take the antidepressant fluoxetine. In our market it is sold under the names flunisan and flunirin, and globally it is known as prozac (the commercial name under which it was first produced in the USA).
SEARCH FOR THE SECRET MOLECULE: Associate Professor Ljubodrag Vujisić
Fluoxetine in supposedly natural slimming capsules was discovered by experts of the Laboratory for Instrumental Analysis of the Faculty of Chemistry in Belgrade solely thanks to personal initiative. Namely, one of the employees at the faculty heard that her friend was drinking this preparation, the composition seemed suspicious to her, so she bought a box and brought it to the laboratory for analysis. The process of uncovering the miraculous green capsule took almost two months, because scientists did not know exactly what they were looking for. When they finally found fluoxetine, they sent the capsules to the Institute of Public Health in Belgrade, where their findings were confirmed. Docent Ljubodrag Vujisić from the Faculty of Chemistry explains to "Vreme" what the whole procedure looked like.
"How to find out what is really in the diet products is the question of all questions, not only on our but also on world markets. There are two ways to find a substance that someone wants to abuse. One is to put a known substance with some pharmacological effect in the product, but not declare that substance. Another is to put in new substances, such as designer drugs. These are slightly modified substances used to avoid targeted analyses. So, for example, you can cheat the methods for determining the use of doping."
Vujisić explains that the existing methods do not detect the new substance, although it has a similar, perhaps even stronger, and most often completely untested effect. The path to the market is simple, especially here, because such substances are not declared as drugs, but as dietary supplements and nutritional supplements. According to the rules in force in Serbia, supplements are checked only for bacteriological correctness and the presence of heavy metals. So, if there are no bacteria and heavy metals, you get confirmation that the product is safe and it goes on sale. For everything else, the manufacturer or distributor is simply taken at their word, that is, it is assumed that what is written on the declaration is completely true.
Vujisić says that our laboratories are good and detect various substances, however, the worst cases are when chemists do not know what they are looking for, and suspect that it is a fraud. "We are an accredited laboratory and therefore competent because we are accredited for samples of unknown origin, which is our narrow specialty. But we can't do everything at all times either. Therefore, the substance is the most difficult to identify, and once this happens, the institutions can introduce it into some rulebook, and develop a method to determine its presence. Specifically, after our discovery, it is logical to expect that similar products will be tested for the presence of fluoxetine," says Vujisić.
Furthermore, he explains how they came to the discovery that Slim Line slimming capsules contain exactly fluoxetine, i.e. the popular Prozac: "First, the substances that are present should be isolated. Here we were talking about a gelatinous substance, because we are talking about gel capsules, and some oily material that we separated chemically. We separated the watery part from the oily part, and from that watery part we were able to use nuclear magnetic resonance to get to the molecular structure of the ingredient. By comparing with the literature and databases, we determined that it was Prozac, because, fortunately for us, it is a very well-known substance. Then we came up with a standard substance, compared the data and it agreed. When you get information like this, you simply cannot keep it quiet, so the first thing we did was to send a request to the Institute for Public Health in Belgrade, to ask what we should do now. They responded very expeditiously, took samples and confirmed our findings with analysis."
CLASSIC ONLINE SCAM: Slim Line capsules, now officially certified as anything but 100 percent natural, are imported from China. It is imported into Serbia by the company Slim Line, along with a bunch of other dietary supplements, powders, drinks and cosmetic products. According to the data of the Agency for Business Registers, the headquarters of this company is located in Belgrade, in Branka Krsmanovića Street, and it is registered for retail trade through mail or the Internet. In other words, Slim Line products can only be obtained by ordering and home delivery. However, if Slim Line is just trading these capsules, the question is who makes them, and the answer is two clicks away with a computer mouse. China is the promised land when it comes to online commerce. A simple search of China's most popular shopping sites, such as AliExpress and Alibaba, turns up hundreds of thousands of weight loss products. Prices range from one cent to thirty dollars per box or kilogram (!), but you should pay attention to the conditions of purchase. It can be seen from them that the minimum possible order is usually 300.000 tablets or two kilograms of product, so it is clear that they are intended for wholesale trade.
This is where we get to the multiple robbery. First, someone buys a box of capsules with suspicious contents, pays for it, say two dollars, and then resells it in Serbia for more than 5000 dinars. Second, the same substance, only registered as a medicine against depression and other mental disorders, which has passed complicated and rigorous controls, costs between 250 and 300 dinars in pharmacies. The most important thing of all is that no pharmacist can dispense this same substance, which mostly women naively order and pay fabulously, without a prescription or, for those treated in private health institutions, without a doctor's report. At the same time, every purchase of antidepressants is registered, that is, the pharmacist records the type and date of dispensing of the drug, the name of the patient and the doctor who prescribed the drug. In order to prevent possible abuses, the date of purchase is also written on the back of the medical report, so that during the next purchase, the pharmacist has an insight into the fact that the patient last bought the medicine within a reasonable period of time (most often 30 days, because antidepressants are generally packed in boxes of 30 tablets).
WHAT IS PROZAC?: Most of the women who wrote on internet forums about their experience with Slim Line capsules did not use this product for more than a month continuously. Those who continued using it for longer or ordered it again after a break report a halt in weight loss. Some suspect that the manufacturer has changed the composition of the capsules, which is why they are no longer effective. The real cause, however, is of a completely different nature: in most of those who take it, fluoxetine at first really causes a loss of appetite and a slight feeling of euphoria, which these women misinterpret as an influx of energy. However, after long-term use, the opposite happens: appetite increases, body mass increases or weight stagnates. In general, when it comes to antidepressants and body weight, everything is a lottery. From the same SSRI drug (selective serotonin reuptake inhibitors), one person can really lose weight, another can gain weight, and a third can experience no change at all.
Fluoxetine, or Prozac, is the product of seventeen years of research by the American pharmaceutical company Eli Lilly. Research on this substance began in 1970, and in 1977, Eli Lilly submitted an application to the US Food and Drug Administration (FDA). However, the USA is not the first country where Prozac appeared on the drug market, it was Belgium that approved the distribution of this antidepressant in 1986. Only a year later, Prozac became available to Americans. The appearance of Prozac in the history of pharmacy represented a revolution, as it was the first drug from the group of SSRI antidepressants. Before him, the so-called tricyclic and tetracyclic antidepressants were used, which caused a whole spectrum of side effects or those that were completely opposite to what was expected.
Prozac, like other drugs from the SSRI spectrum, is used to treat severe depressive episodes and a number of disorders such as panic disorder, obsessive-compulsive disorder, and bulimia and anorexia as eating disorders. The fact that SSRI antidepressants are safer than earlier generations of these drugs does not mean that they are completely safe. On the contrary, anyone who has had the opportunity to at least open the instructions for use of one of the SSRI antidepressants, knows that it is almost a meter and a half long, and that the longest part is the one devoted to possible side effects and health consequences. Women who drank Slim Line to lose weight, almost as a rule, report dryness of the mouth, but they also interpret this as a positive effect that allegedly forces them to drink more fluids. However, this is the most common, albeit temporary side effect of Prozac. Given that nausea, dizziness and lightheadedness are common side effects, it is not impossible that users of Slim Line capsules experienced these symptoms as well, but did not associate them with the product.
While a typical medical tablet of fluoxetine contains 20 milligrams of this substance, Slim Line capsules contain twice as much. Ljubodrag Vujisić from the Faculty of Chemistry in Belgrade says that the prescribed dose is between nine and ten milligrams, and that the recommended dose on the box is one capsule per day. However, this does not absolve anyone because it is quite reasonable to assume that the users, convinced that they were swallowing a purely herbal preparation, took far more than the recommended dose. This theory is also supported by testimonies in which mostly women claim that they lost even ten kilograms in a month.
SERIOUS CONSEQUENCES AND ABSTINENCE CRISIS: Psychiatrists consulted by "Vreme" regarding this topic generally agree that people who do not suffer from mood disorders should not take antidepressants. The dangers of these drugs are numerous. One of the rarest, but most difficult, is the possibility that a healthy person becomes anxious due to abuse of these drugs, and anxiety is a prelude to depression. Also, the possibility of suicidal thoughts is not excluded. In addition, all the side effects that have been identified so far can also affect healthy people.
Of the internal organs, the liver is in the greatest danger. Moreover, the American scientific monthly "Digestive Diseases and Science" in one of its issues from 2012 brings an article in which it is said that five percent of all liver damage recorded in the USA comes precisely as a result of the use of antidepressants. Prozac, Zoloft and Celexa are mentioned among the most common causes of chemical damage to the liver - all three are antidepressants from the SSRI spectrum and all are available in Serbia. They work by suddenly raising the level of liver enzymes (transaminases) and causing serious disturbances in the function of this organ. Here, too, we are dealing with the luck factor: in some patients, transaminases remain at a normal level even after years of drug use, while in some, it can cause a sharp jump in liver transaminases already at the beginning of therapy, even in small doses. Among the other horrible side effects of fluoxetine, i.e. Prozac, kidney damage, possible epileptic seizures, rashes, allergies, psychomotor restlessness (shaking or involuntary twitching), bone fractures in patients over 50 years old, mania and heart rhythm disorders should be singled out. In diabetics, hypoglycemia may occur during the administration of fluoxetine, and hyperglycemia may occur in the case of sudden cessation of therapy.
Stopping antidepressants abruptly is the birthplace of numerous new problems. When prescribed for the treatment of mood disorders and taken under the supervision of a physician, the discontinuation of therapy is gradual. The doctor usually first prescribes a month of taking half of the previous dose, then for the next month, the patient takes that half every other day, and then the drug is stopped completely. In the instructions for use of fluoxetine, which is available on our market, it is stated that in clinical studies, side effects after discontinuation of therapy occur in approximately 60 percent of patients, and 17 percent of people had severe side effects. The most commonly reported reactions are dizziness, sensory disturbances, sleep disturbances (including insomnia and nightmares), asthenia, restlessness or anxiety, nausea or vomiting, tremors and headache. In general, these symptoms are mild to moderate, but in some patients they can be severe. They usually occur during the first few days after stopping treatment. Symptoms usually disappear on their own within two weeks, although in some patients they can last for two to three months or longer.
All these consequences can affect those who take fluoxetine under constant medical supervision, which was not the case with those who drank Slim Line capsules, because they did not even know what they were drinking. Whether and what consequences they had, we cannot know, except anecdotally, from what is written on internet forums. However, even there the opinions are completely polarized, so there is either complete enthusiasm or strong opposition to any slimming means. Let's also add that enthusiasm should be taken with a grain of salt because there is always the possibility that it is a hidden advertisement. In addition, Slim Line capsules are intensively discussed on the two most visited Internet forums: ana.rs and coolinarika.com, whose target group is primarily women, who are often desperate to lose weight, so they reach for dubious solutions.
PLAYING WITH LIVES: Teenage girls are particularly sensitive to physical appearance and (real or imagined) fatness. This is where we get to the part where we are talking about seriously playing with lives. During puberty, the body's biochemistry and hormonal levels are quite different than in adulthood. There is no antidepressant in the world that does not have a special warning for children and adolescents. The use of SSRI antidepressants in teenagers carries with it a higher risk of suicide than in adults. fluoxetine domestic instructions states: "In clinical trials, suicidal behavior (suicide attempt and suicidal ideation) and hostility (predominant aggression, oppositional behavior, and anger) occurred more frequently in children and adolescents treated with antidepressants than in those receiving placebo. Fluoxetine should be used in children and adolescents aged 8 to 18 years only for the treatment of moderate to severe episodes of major depression, and should not be used in other indications. If, according to clinical needs, a decision was made to treat with fluoxetine, the patient must be carefully monitored for the possible appearance of suicidal symptoms. In addition, only limited information is available regarding the long-term safety of fluoxetine in children and adolescents, including effects on growth, puberty, cognitive, emotional, and behavioral development."
Further, it mentions a nineteen-week clinical trial in which children and adolescents treated with fluoxetine observed slowed growth and weight gain, and the possibility of delayed puberty is not ruled out: "During clinical trials on children, mania and hypomania were often reported." Due to the possibility of these conditions, regular monitoring is recommended. Fluoxetine should be discontinued in any patient who enters a manic phase. It is important that the doctor who prescribes the medicine carefully discusses the relationship between the benefits and the risks of the treatment with the child/young person and/or his parents," reads the domestic instructions for fluoxetine.
Suicidal behavior (suicide attempts and suicidal thoughts) and hostility were observed more frequently in clinical trials in children and adolescents treated with antidepressants compared to those receiving placebo. Manic reactions, including mania and hypomania, were also reported (in 2,6 percent of fluoxetine-treated patients and none in the placebo-control group) and in most cases were the reason for discontinuation of therapy. These patients had no previous episodes of hypomania or mania. In pediatric clinical practice, there were also isolated cases of side effects that potentially indicated delayed puberty or sexual dysfunction.
WHAT NOW: After the fraud was exposed, the distributor Slim Line Club withdrew Slim Line capsules from the offer. All other products are still available to consumers, and what is in them is still unknown. Ljubodrag Vujisić says that the Faculty of Chemistry does not work within institutions that are in charge of controlling these and similar products, except in exceptional situations, at the request of the Ministry of Interior or some other institution. This is not the first fraud discovered at the Faculty of Chemistry (see box "Caught in the act"), but according to Vujisić, the problem of both obsolescence and worn-out equipment is now emerging: "The instruments with the help of which we found this were acquired in 2007, and they are very sensitive. Think of one of the smartphones you bought in 2007, and which you use extensively. Of course, after ten years, he works much worse."
As for the further investigation, the matter is now in the hands of the Institute for Public Health and competent inspections. After the Institute for Public Health confirmed the analyzes of the Faculty of Chemistry, the results were forwarded to the distribution company Slim Line, which responded with a letter. In that document, it says that they have the manufacturer's documentation and that according to that specification it is clear that these capsules should not contain fluoxetine. "The mentioned series was immediately withdrawn from sale and it has not been on our market for almost a month," states the letter signed by the director of the Slim Line company, Dragan Borisic: "After the last import, which passed the regular controls of the competent institutions, it was subsequently determined that the batch contains the substance fluoxetine. Please note that this is a product that is registered and entered in the database of the Ministry of Health of Serbia, and there are certificates of quality for every previous import. We also have a confirmation from the manufacturer that the product does not contain the above-mentioned substance." Apart from withdrawing the disputed batch from the market, Slim Line also says that they are ready to submit all documentation on slimming capsules to the authorities.
There is always the possibility that the distributor himself did not know what was in the product he was trading. This, however, does not change the fact that God knows how many people have been misled and put in danger, that they unknowingly took a substance that should never be drunk without a doctor's supervision and that, most importantly, is not intended for weight loss at all. Also, the fact that the capsules were sold at ten times the purchase price raises serious doubts about the honorable intentions of the distributor. Additional bitterness is caused by the fact that you can import anything to the Serbian market, call it a nutritional supplement or a supplement, make sure that there are no bacteria and heavy metals, and there you are on free sale, and there may even be mouse killer inside.
Epidemiological studies indicate an increased risk of developing cardiovascular deformities of the fetus in the case of fluoxetine use in the first trimester of pregnancy. All available data indicate that cardiovascular deformities in newborns of mothers exposed to fluoxetine occur in every two out of a hundred cases.
Epidemiological data indicate that the use of SSRIs in pregnancy, especially in late pregnancy, may increase the risk of developing pulmonary hypertension in newborns. The recorded risk is 5 cases per 1000 pregnancies. In the general population, this risk is 1 to 2 cases per 1000 pregnancies. Although fluoxetine can be used during pregnancy, caution is required, especially during late pregnancy and immediately before the onset of labor, as the following adverse effects have been reported in infants: irritability, tremors, hypotonia, prolonged crying, difficulty in sucking and falling asleep. More recent studies indicate that infants whose mothers are breastfed while on fluoxetine therapy have slowed development.
In men, fluoxetine has a bad effect on sperm quality, but the condition improves after stopping the therapy.
Prim. Dr. Vesna Pantić Palibrk, head of the Food Safety Control Unit of the City Institute for Public Health, emphasizes that an undeclared pharmacologically active substance must not be present in any drug/product, not even in a dietary one. "Of course, such a substance must not be present in a dietary product, but the essence of the story is that pregnant women and nursing mothers should not take any preparations on their own without consulting a doctor, and we, as an institution, insist on this." The baby's health is a priority. What needs to be emphasized is that herbal is not the same as healthy and that should be kept in mind." Pregnant women who want to lose weight believe that herbal preparations are healthy by definition, but this is not always the case because what the mother takes into the body can be risky. per child who is fed with mother's milk, even if it is of vegetable origin. "Many medicines are obtained from plants, but in every medicine there is a warning about side effects for pregnant women, women in labor and nursing mothers, chronically ill patients," says Dr. Palibrk, pointing out that the Slim Line case means that the control system of dietary products must not die, that a chain must be established to detect unscrupulous manufacturers and counterfeit products. "Extensive chemical analysis is very expensive, sibutramine in dietary supplements is controlled since it was the case with green coffee, but fluoxetine (prozac) is something new." is taking prozac, Dr. Pantić Palibrk says that manufacturers of counterfeit preparations act "subtly" in order not to reveal the fraud. "There is no magic pill for weight loss, the only way is a controlled diet and physical activity."
The Laboratory for Instrumental Analysis of the Faculty of Chemistry, where the antidepressant was found in the slimming agent, has saved thousands of lives with its research. Among the more famous cases, there is the discovery of acetic anhydride in a tanker intercepted by the border police, while the driver claimed to be transporting ordinary vinegar. Anhydride, however, is the substance used to make heroin and the components used to make amphetamines.
The second case refers to the fake tetaloglobulin anti-tetanus vaccine, which was analyzed at the request of the MUP Belgrade, and in which there was no trace of proteins that should have been there. It was about the most common gentamicin, a broad-spectrum antibiotic, ten times cheaper than the anti-tetanus vaccine and completely ineffective against the bacteria that causes tetanus.
The fraud most similar to this one with Slime Line capsules was discovered when satibo capsules, again Chinese, and again allegedly a natural preparation for increasing potency, arrived at the Faculty of Chemistry from the Institute of Public Health in Belgrade for analysis. Instead of herbal ingredients, the capsules contained the synthetic drugs Viagra and Cialis, widely known pharmaceutical preparations for potency.
The USA and New Zealand are the only two countries in the Western world where pharmaceutical products are freely advertised. In 2015, the company Eli Lilly, which created Prozac, decided to use this drug for commercial purposes. Today, the American market is flooded with a preparation called "sarafem", which supposedly treats premenstrual syndrome and something called severe premenstrual disorder, although this diagnosis has not been registered in any disease registry in the world, nor has its existence been scientifically confirmed. The product is packaged in a beautifully designed pink box, to make it clear that it is intended for women. What Eli Lilly did not inform the public about is the composition of sarafem - it is pure prozac, but in a dose of only five milligrams. That it is a question of pure extraction of money from consumers is evidenced by the instructions for use, according to which this preparation should be taken only one week before the start of the cycle. Prozac and all other SSRI antidepressants can indeed have a beneficial effect on premenstrual symptoms, but the first effects do not appear until several weeks of continuous use of the full dose. A week of taking four times less than the usual dose cannot have any effect on the body, unless it is a placebo.
