Bupropion plus Naltrexone for Weight Loss?

The history of drug therapy for obesity is littered with compounds that were marginally effective for weight loss but had unacceptable side effects. Most recently, rimonabant was barred from the U.S. market because of serious neuropsychiatric side effects, and sibutramine also is in trouble (JW Gen Med Sep 2 2010). Now, the combination of bupropion and naltrexone is being studied for possible weight-loss effects through its synergistic action on appetite signaling and the mesolimbic reward system.

U.S. investigators randomized 1742 obese patients (85% female; mean body-mass index, 36 kg/m²) without diabetes or cardiovascular disease to fixed-dose combinations of bupropion (180 mg twice daily) and naltrexone (either 8 mg or 16 mg twice daily)…