Weight Loss Drugs (continued)
In the Pipeline
Contrave (bupropion SR/naltrexone SR) by Orexigen
This is a combination of a known antidepressant and smoking cessation medication (bupropion/Wellbutrin) and a drug that treats alcohol and opioid addiction (naltrexone). Bupropion is thought to increase dopamine activity in the brain, which helps reduce appetite and increase energy burned. Naltrexone works by blocking opioid receptors. In clinical trials, it has shown success in helping patients lose weight—and keep the weight off—for up to a year. Those who took the drug for six months and participated in a weight management program lost 25 lbs. on average, compared to those taking the placebo and partaking in weight management who lost 17 lbs. in the same time period. The drug shows some promise in helping control cholesterol and blood sugar. Side effects include nausea, constipation, headache, vomiting, and insomnia, among others. The FDA had asked the manufacturer to conduct a long-term study of the drug's safety and efficacy after some concerns regarding the long-term cardiovascular effects of contrave surfaced in 2011. These studies can take years to complete, so stay tuned for more information as it becomes available.
Pramlintide/metreleptin by Amylin Pharmaceuticals, Inc. and Takeda Pharmecuticals Company Limited
Due to reassessment of this combination therapy, the makers announced in 2011 that they were discontinuing the development of the drug, which combined pramlintide, an analog of the natural hormone amylin, and metreleptin, an analog of the natural hormone leptin. The partners reported looking into perhaps developing a similar therapy with less frequent dosing to supply new options for weight loss.
Off the Market
Meridia (sibutramide) by Abbott
Meridia was approved by the FDA in 1997. As an appetite suppressant, it causes decreased intake of food by signaling a sense of fullness in the brain. Sibutramide raises the risk of heart attack and stroke, however, and experience with the drug over the years showed that for most patients, weight loss was very modest. In 2010, the FDA made the controversial decision to ask Abbott to remove this drug from the market. It's no longer available.
Reviewed by Susan Weiner, RD, MS, CDE, CDN 02/13
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...