FRIDAY, July 30 (HealthDay News) -- Contrave, an experimental
weight loss drug that combines an antidepressant with an
anti-addiction medication, appears to help users shed pounds when
taken along with a healthy diet and exercise, researchers
report.
People who took the drug for more than a year lost an average of
5 percent or more of body weight, depending on the dose used, the
team said.
However, the regimen did come with side effects, and about half
of study participants dropped out before completing a year of
treatment.
Contrave is combination of two well-known drugs, naltrexone
(Revia, used to fight addictions) and the antidepressant bupropion
(known by a number of names, including Wellbutrin). The drug, which
is up for U.S. Food and Drug Administration review this December,
appears to boost weight loss by changing the workings of the body's
central nervous system, the researchers report.
The researchers, who report their findings online July 29 in
The Lancet, enrolled men (15 percent) and women (85 percent) from around the country, ranging in age from 18 to 65. They were all either obese or overweight with high blood fat levels or high blood pressure.
The participants were told to eat less and exercise, and they
were randomly assigned to take a twice-daily placebo or a
combination of the two drugs with naltrexone at one of two
levels.
After 56 weeks, only about half (870) of the more than 1,700
participants initially enrolled remained in the study. Almost half
(48 percent) of those who took the highest dose of naltrexone lost
5 percent of their weight or more, while only 16 percent of those
who took placebos did.
However, about 30 percent of those taking Contrave experienced
nausea, the study authors say, and other side effects included
headache, constipation, dizziness, vomiting and dry mouth.
Still, Contrave may give people struggling to lose weight a new
option, the researchers contend. "Although lifestyle modification
is first-line therapy for obesity, adherence to this intervention
is poor," they write. "The combination of naltrexone plus bupropion
could be a useful addition to the current range of medications that
facilitate adherence to lifestyle modification and produce
clinically meaningful weight loss for treatment of obesity and
obesity-related disorders."
The findings reflect the results of studies into other drugs,
such as the diet drugs Meridia, Xenical and Alli, said Lona Sandon,
an assistant professor of clinical nutrition at the University of
Texas Southwestern Medical Center in Dallas and spokeswoman for the
American Dietetic Association.
"When these are combined with a modestly reduced calorie diet, modest amounts of weight loss are achieved," she said. "One striking thing to note is the study drop-out rate of 50 percent. This may have been due to side effects of medications, the fact that it is hard to stick to dietary changes for 56 weeks, or [the fact that] slow and only modest weight loss did not meet participant expectations."
Cynthia Sass, a New York City-based nutritionist and author,
added that drugs used to treat addiction also appear to help with
weight control, supporting "the notion that food can be addictive
for many people."
The authors noted that additional studies are needed before
putting this regimen into practice. One concern is that blood
pressure did not drop as much as expected in the higher weight-loss
group, an accompanying editorial notes. "More data are needed to
get a better overall assessment of cardiovascular risk of this
otherwise promising combination therapy for obesity," wrote
Professor Arne Astrup, a nutrition expert at the University of
Copenhagen, Denmark.
More information
For more about
weight loss, visit the U.S. National Library of Medicine.