Contrave

Contrave

The U.S. Food and Drug Administration (FDA) approved a new weight loss drug on September 10. Aren’t you excited? Don’t get your hopes up, we’re going to tell you all the reasons you should not take this drug.

I just lost 10 pounds by eating meat and vegetables for a month. I temporarily gave up ice cream and cheese, also. Why do you care about my diet? Because with Contrave you only get the best results by combining the drug with a non-drug weight management program (that is, proper diet and exercise.) Test results show that Contrave drug users might lose an average of 8 pounds more over 6 months than those losing weight without the drug, with both groups also doing a non-drug weight management program. The experts say that if you just use the drug with no changes in diet or exercise, it is not going to be successful. So why not just save yourself $200 a month and go with the non-drug weight management program?

OK, so some of the test results show that on average people on the drug lost 4% more weight over a year than those on a placebo, while doing the same non-drug weight management things. So how is Contrave supposed to work?

Well, funny thing about that. No one has a real clue about how Contrave works or doesn’t work. The best they can say is that sometimes it lessens one’s appetite. There is no way to predict the results, it is strictly trial and error.

There are not that many weight loss drugs on the market, leading some doctors to joke about slim pickings for the treatment of obesity. There is also controversy about whether obesity is really a medical condition or a symptom of a medical condition. In any case, let’s not follow all these red herrings and just describe this particular drug in more depth.

The FDA rejected the first approval request in 2011 for Contrave, and has given approval this year only with two additional requirements — more safety studies are needed, and the drug must carry a boxed warning about the risk of suicide and other bad side effects.

Suicide risk? Really? For weight loss? What kind of a drug is this?

Guess what, Contrave is a psychiatric drug. Two psych drugs in combination, actually. Contrave is a combination of bupropion (Wellbutrin), and naltrexone. The recommended daily dose is a total of 32 mg naltrexone and 360 mg bupropion.

You may recall that Wellbutrin is an antidepressant; as a short-acting antidepressant and amphetamine-like drug similar to Ritalin and Dexedrine, it is also marketed in slow-release form as Zyban for people trying to quit smoking.

The FDA approved Wellbutrin as an antidepressant in 1985 but because of the significant incidence of seizures at the originally recommended dose (400-600 mg), the drug was withdrawn in 1986. It was reintroduced in 1989 with a maximum dose of 450 mg per day.

It can cause seizures and at rates of four times that of other antidepressants. Fatal heart attacks in those with a history of heart-rhythm disturbances have occurred. Other side effects include agitation, insomnia, increased restlessness, anxiety, delusions, hallucinations, psychotic episodes, confusion, weight loss and paranoia. Teens have abused the drug by crushing and snorting it, causing seizures. So, we can see that weight loss is one of the possible side effects of Wellbutrin; only in the context of an antidepressant or smoking cessation drug, weight loss is an unwanted side effect. So why not change the name and market it as a weight loss drug?

Naltrexone, on the other hand, is an anti-addiction drug, technically an opioid receptor antagonist. It is FDA approved to treat alcohol and opioid dependence, although it must not be used if the person is still taking alcohol or opioids, as it can induce severe withdrawal symptoms. It also has side effects of depression and suicidal thoughts or suicide. I can believe it might suppress one’s appetite, as well.

I think I’ll just go buy some ice cream and drown my visions of weight loss in a sugar coma.

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