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CNS Drugs
Published in: CNS Drugs 10/2004

01-08-2004 | Leading Article

Psychotropic Drugs in the Treatment of Obesity

What Promise?

Authors: Dr Jose C. Appolinario, João R. Bueno, Walmir Coutinho

Published in: CNS Drugs | Issue 10/2004

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Abstract

Obesity is a chronic and highly prevalent medical condition associated with increased risk for the development of numerous and sometimes fatal diseases. Despite its severity, there are few anti-obesity agents available on the market. Although psychotropic agents are not approved for the treatment of obesity, they have been used by clinicians as a therapeutic tool in daily clinical practice. The purpose of this article is to review the rationale, as well as the evidence, for the potential use of these agents in obesity treatment.
Evidence for the efficacy of psychotropic agents in obesity treatment comes from different sources. The first type of evidence is weight loss observed with treatment in clinical trials of patients with neuropsychiatric syndromes (e.g. mood disorders, epilepsy). A recent example of such findings is the weight reduction reported in clinical trials involving obese patients with binge eating disorder. While randomised, controlled trials specifically designed to investigate the weight loss properties of psychotropic agents in obese patients are the most appropriate source of evidence of anti-obesity action, such trials remain scarce.
The most studied psychotropic agents in obesity trials are drugs used in the treatment of mood disorders, i.e. mainly antidepressants and antiepileptics. SSRIs (e.g. fluoxetine, sertraline and fluvoxamine) were amongst the first psychotropic agents investigated in the treatment of obesity. Additional data have also been published for other antidepressants (e.g. venlafaxine, citalopram and bupropion) and antiepileptics (e.g. topiramate and zonisamide). Based on the available data for the efficacy of psychotropic agents in obesity and other related conditions, SSRIs may be considered for the management of certain subgroups of obese individuals with comorbid conditions such as depression, binge eating disorder and type 2 diabetes mellitus. In addition, some newer agents, such as bupropion, topiramate and zonisamide, appear to be promising candidates for selective use in the treatment of obesity. However, further studies are needed to define their possible role as new pharmacological options in the treatment of obesity.
Literature
1.
Bray GA. Use and abuse of appetite-suppressant drugs in the treatment of obesity. Ann Intern Med 1993; 119(7): 707–13PubMed
2.
Stahl SM. How to appease the appetite of psychotropic drugs. J Clin Psychiatry 1998; 59(10): 500–1PubMedCrossRef
3.
World Health Organization. Obesity: preventing and managing the global epidemic. Report of WHO Consultation. Geneva: WHO, 2000
4.
Rossner S. Obesity: the disease of the twenty-first century. Int J Obes Relat Metab Disord 2002; 26Suppl. 4: S2–4PubMedCrossRef
5.
Monteiro CA, Mondini L, de Souza AL, et al. The nutrition transition in Brazil. Eur J Clin Nutr 1995; 49: 105–13PubMed
6.
Bray GA. Contemporary diagnosis and management of obesity. Newtown: Handbooks in Health Care Co, 1998
7.
Woods SC, Seeley RJ. Understanding the physiology of obesity: review of recent developments in obesity research. Int J Obes Relat Metab Disord 2002; 26Suppl. 4: S8–S10PubMedCrossRef
8.
Keesey RE, Hirvonen MD. Body weight set-points: determination and adjustment. J Nutr 1997; 127: 1875S–83SPubMed
9.
10.
Hill JO, Peters JC. Environmental contributions to the obesityepidemic. Science 1998; 280: 1371–4PubMedCrossRef
11.
Friedman JM. Obesity in the new millennium. Nature 2000; 404(6): 632–4PubMed
12.
13.
Bray GA, Tartaglia LA. Medicinal strategies in the treatment of obesity. Nature 2000; 404(6): 672–7PubMed
14.
Bray GA, Ryan DH, Gordon D, et al. A double-blind randomized placebo-controlled trial of sibutramine. Obes Res 1996; 3: 263–70
15.
James WPT, Astrup A, Finer N, et al. Effects of sibutramine on weight maintenance after weight loss: a randomised trial. Lancet 2000; 356: 2119–25PubMedCrossRef
16.
Finer N, James WP, Kopelman PG, et al. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor. Int J Obes Relat Metab Disord 2000; 24(3): 306–13PubMedCrossRef
17.
Sjostrom L, Rissanen A, Andersen T, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 1998; 352(9123): 167–72PubMedCrossRef
18.
Blundell J. Pharmacological approaches to appetite suppression. Trends Pharmacol Sci 1991; 12: 147–57PubMedCrossRef
19.
Woods SC, Schwartz MW, Baskin DG, et al. Food intake and the regulation of body weight. Annu Rev Psychol 2000; 51: 255–77PubMedCrossRef
20.
21.
Halford JC, Cooper GD, Dovey TM, et al. The psychopharmacology of appetite: targets for potential anti-obesity agents. Curr Med Chem —CNS Agents 2003; 3(4): 283–310CrossRef
22.
23.
Schwartz MW, Woods SC, Porte Jr D, et al. Central nervous system control of food intake. Nature 2000; 404(6778): 661–71PubMed
24.
McMinn JE, Baskin DG, Schwartz MW. Neuroendocrine mechanisms regulating food intake and body weight. Obes Rev 2000; 1(1): 37–46PubMedCrossRef
25.
Astrup A, Lundsgaard C. What do pharmacological approaches to obesity management offer: linking pharmacological mechanisms of obesity management agents to clinical practice. Exp Clin Endocrinol Diabetes 1998; 106Suppl. 2: 29–34PubMedCrossRef
26.
Mertens IL, Van Gaal LF. Promising new approaches to the management of obesity. Drugs 2000; 60(1): 1–9PubMedCrossRef
27.
Blundell JE. Is there a role for serotonin (5-hydroxytryptamine) in feeding? Int J Obes 1977; 1(1): 15–42PubMed
28.
Meguid MM, Fetissov SO, Varma M, et al. Hypothalamic dopamine and serotonin in the regulation of food intake. Nutrition 2000; 16(10): 843–57PubMedCrossRef
29.
Leibowitz SF, Alexander JT. Hypothalamic serotonin in control of eating behavior, meal size, and body weight. Biol Psychiatry 1998; 44(9): 851–64PubMedCrossRef
30.
Walsh AE, Smith KA, Oldman AD, et al. m-Chlorophenylpiperazine decreases food intake in a test meal. Psychopharmacology 1994; 116(1): 120–2PubMedCrossRef
31.
Lee MD, Kennett GA, Dourish CT, et al. 5-HT1B receptors modulate components of satiety in the rat: behavioural and pharmacological analyses of the selective serotonin 1B agonist CP-94,253. Psychopharmacology (Berl) 2002; 164(1): 49–60CrossRef
32.
Calapai G, Corica F, Corsonello A, et al. Leptin increases serotonin turnover by inhibition of brain nitric oxide synthesis. J Clin Invest 1999; 104(7): 975–82PubMedCrossRef
33.
Simansky KJ. Serotonergic control of the organization of feeding and satiety. Behav Brain Res 1996; 73(1–2): 37–42PubMed
34.
Dryden S, Wang Q, Frankish HM, et al. Differential effects of the 5-HT 1B/2C receptor agonist mCPP and the 5-HT1A agonist flesinoxan on hypothalamic neuropeptide Y in the rat: evidence that NPY may mediate serotonin’s effects on food intake. Peptides 1996; 17(6): 943–9PubMedCrossRef
35.
Leibowitz SF. The role of serotonin in eating disorders. Drugs 1990; 39 Suppl. 3: 33–48CrossRef
36.
Blundell JE, Lawton CL, Halford JC. Serotonin, eating behavior, and fat intake. Obes Res 1995; 3Suppl. 4: 471S–6SPubMed
37.
38.
Commins SP, Marsh DJ, Thomas SA, et al. Norepinephrine is required for leptin effects on gene expression in brown and white adipose tissue. Endocrinology 1999; 140(10): 4772–8PubMedCrossRef
39.
Jequier E, Munger R, Felber JP. Thermogenic effects of various beta-adrenoceptor agonists in humans: their potential usefulness in the treatment of obesity. Am J Clin Nutr 1992; 55(1 Suppl.): 249S–51SPubMed
40.
Berridge KC. Food reward: brain substrates of wanting and liking. Neurosci Biobehav Rev 1996; 20(1): 1–25PubMedCrossRef
41.
Kalra SP, Dube MG, Pu S, et al. Interacting appetite-regulating pathways in the hypothalamic regulation of body weight. Endocr Rev 1999; 20(1): 68–100PubMedCrossRef
42.
Stanley BG, Willett III VL, Donias HW, et al. The lateral hypothalamus: a primary site mediating excitatory amino acidelicited eating. Brain Res 1993; 630(1–2): 41–9PubMedCrossRef
43.
Stanley BG, Ha LH, Spears LC, et al. Lateral hypothalamic njections of glutamate, kainic acid, D,L-alpha-amino-3-hydroxy-5-methyl-isoxazole propionic acid or N-methyl-D-aspartic acid rapidly elicit intense transient eating in rats. Brain Res 1993; 613(1): 88–95PubMedCrossRef
44.
Maldonado-Irizarry CS, Swanson CJ, Kelley AE. Glutamate receptors in the nucleus accumbens shell control feeding behavior via the lateral hypothalamus. J Neurosci 1995; 15(10): 6779–88PubMed
45.
Zheng H, Patterson C, Berthoud HR. Behavioral analysis of anorexia produced by hindbrain injections of AMPA receptor antagonist NBQX in rats. Am J Physiol Regul Integr Comp Physiol 2002; 282(1): R147–55PubMed
46.
Backberg M, Collin M, Ovesjo ML, et al. Chemical coding of GABA (B) receptor-immunoreactive neurones in hypothalamic regions regulating body weight. J Neuroendocrinol 2003; 15(1): 1–14PubMedCrossRef
47.
Jegou S, Blasquez C, Delbende C, et al. Regulation of alpha-melanocyte-stimulating hormone release from hypothalamic eurons. Ann N Y Acad Sci 1993; 680: 260–78PubMedCrossRef
48.
Pu S, Jain MR, Horvath TL, et al. Interactions between neuropeptide Y and gamma-aminobutyric acid in stimulation of feeding: a morphological and pharmacological analysis. Endocrinology 1999; 140(2): 933–40PubMedCrossRef
49.
McMurdo ME, Hutchison GL, Lindsay G. Taste disturbance with acetazolamide. Lancet 1990; 336: 1190–1PubMedCrossRef
50.
Lynch CJ, Brennan Jr WA, Vary TC, et al. Carbonic anhydrase III in obese Zucker rats. Am J Physiol 1993; 264: E621–30PubMed
51.
Smoller JW, Truett GE, Hirsch J, et al. The Zucker fatty (fa) gene is not a mutation of corticotropin-releasing factor. Am J Physiol 1993; 264: R12–5PubMed
52.
Wadden TA, Stunkard AJ. Psychopathology and obesity. Ann N Y Acad Sci 1988; 165: 55–66
53.
Malhotra S, McElroy SL. Medical management of obesity associated with mental disorders. J Clin Psychiatry 2000; 63 Suppl. 4: 24–32
54.
Friedman MA, Brownell KD. Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117(1): 3–20PubMedCrossRef
55.
Roberts RE, Kaplan GA, Shema SJ, et al. Are the obese at greater risk for depression? Am J Epidemiol 2000; 152: 163–70PubMedCrossRef
56.
57.
Jimerson DC, Lesem MD, Kaye WH, et al. Eating disorders and depression: is there a serotonin connection? Biol Psychiatry 1990; 28: 443–54PubMedCrossRef
58.
Brewerton TD. Toward a unified theory of serotonin dysregulation in eating and related disorders. Psychoneuroendocrinology 1995; 20(6): 561–90PubMedCrossRef
59.
Wurtman RJ, Wurtman JJ. Brain serotonin, carbohydrate-craving, besity and depression. Adv Exp Med Biol 1996; 398: 35–41PubMedCrossRef
60.
Black DA, Goldstein RB, Mason EE. Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients. Am J Psychiatry 1992; 149: 227–34PubMed
61.
Ahlberg AC, Ljung T, Rosmond R, et al. Depression and anxiety symptoms in relation to anthropometry and metabolism in men. Psychiatry Res 2002; 112(2): 101–10PubMedCrossRef
62.
Shen S, Battersby S, Weaver M, et al. Refined mapping of the human serotonin transporter (SLC6A4) gene within 17q11 adjacent to the CPD and NF1 genes. Eur J Hum Genet 2000; 8(1): 75–8PubMedCrossRef
63.
Rosmond R, Bouchard C, Bjorntorp P. Increased abdominal obesity in subjects with a mutation in the 5-HT (2A) receptor gene promoter. Ann N Y Acad Sci 2002; 967: 571–5PubMedCrossRef
64.
Dobrow IJ, Kamenetz C, Devlin MJ. Psychiatric aspects of obesity. Rev Bras Psiquiatr 2002; 24 Suppl. 3: 63–7
65.
Yanovski SZ, Nelson JE, Dubbert BK, et al. Association of binge eating disorder and psychiatric comorbidity in obese subjects. Am J Psychiatry 1993; 150: 1472–9PubMed
66.
67.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994
68.
de Zwaan M. Binge eating disorder and obesity. Int J Obes 2001; 25Suppl. 1: S51–5CrossRef
69.
Bulik CM, Sullivan PF, Kendler KS. Medical and psychiatric morbidity in obese women with and without binge eating. Int J Eat Disord 2002; 32(1): 72–8PubMedCrossRef
70.
Telch CF, Agras WS. Obesity, binge eating and psychopathology: are they related? Int J Eat Disord 1994; 15(1): 53–61PubMedCrossRef
71.
Fontenelle LF, Mendlowicz MV, de Menezes GB, et al. Psychiatric comorbidity in a Brazilian sample of patients with binge eating disorder. Psychiatry Res 2003; 119(12): 189–94PubMedCrossRef
72.
De Chouly De Lenclave MB, Florequin C, Bailly D. Obesity, alexithymia, psychopathology and binge eating: a comparative study of 40 obese patients and 32 controls [French]. Encephale 2001; 27(4): 343–50PubMed
73.
Steiger H, Lehoux PM, Gauvin L. Impulsivity, dietary control and urge to binge in bulimic syndromes. Int J Eat Disord 1999; 26: 261–74PubMedCrossRef
74.
Sansone RA, Wiederman MW, Monteith D. Obesity, borderline personality symptomatology, and body image among women in a psychiatric outpatient setting. Int J Eat Disord 2001; 29: 76–9PubMedCrossRef
75.
Sharpe JK, Hills AP. Anthropometry and adiposity in a group of people with chronic mental illness. Aust N Z J Psychiatry 1998; 32(1): 77–81PubMedCrossRef
76.
Devlin MJ, Yanovski SZ, Wilson GT. Obesity: what mental health professionals need to know. Am J Psychiatry 2000; 157(6): 854–66PubMedCrossRef
77.
Goudie AJ, Smith JA, Haiford JC. Characterization of olanzapine-induced weight gain in rats. J Psychopharmacol 2002; 16(4): 291–6PubMedCrossRef
78.
Kaur G, Kulkarni SK. Studies on modulation of feeding behavior by atypical antipsychotics in female mice. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26(2): 277–85PubMedCrossRef
79.
Weissenburger J, Rush AJ, Giles DE, et al. Weight change in depression. Psychiatry Res 1986; 17(4): 275–83PubMedCrossRef
80.
Stunkard AJ, Fernstrom MH, Price A, et al. Direction of weight change in recurrent depression. Arch Gen Psychiatry 1990; 47: 857–60PubMedCrossRef
81.
Davidson JR, Miller R, Turnbull CD, et al. Atypical depression. Arch Gen Psychiatry 1982; 39: 527–34PubMedCrossRef
82.
Fagiolini A, Frank E, Houck PR, et al. Prevalence of obesity and weight change during treatment in patients with bipolar I disorder. J Clin Psychiatry 2002; 63(6): 528–33PubMedCrossRef
83.
Elmslie JL, Silverstone JT, Mann JI, et al. Prevalence of overweight and obesity in bipolar patients. J Clin Psychiatry 2000; 61(3): 179–84PubMedCrossRef
84.
Elmslie JL, Mann JI, Silverstone JT, et al. Determinants of overweight and obesity in patients with bipolar disorder. J Clin Psychiatry 2001; 62(6): 486–91PubMedCrossRef
85.
Vanina Y, Podolskaya A, Sedky K, et al. Body weight changes associated with psychopharmacology. Psychiatr Serv 2002; 53(7): 842–7PubMedCrossRef
86.
87.
Raber J. Detrimental effects of chronic hypothalamic-pituitary-adrenal axis activation: from obesity to memory deficits. Mol Neurobiol 1998; 18(1): 1–22PubMedCrossRef
88.
Arnold LM, McElroy SL, Hudson JI, et al. A placebo-controlled, randomized trial of fluoxetine in the treatment of binge-eating disorder. J Clin Psychiatry 2002; 63(11): 1028–33PubMedCrossRef
89.
Feighner JP. Mechanism of action of antidepressant medications. J Clin Psychiatry 1999; 60 Suppl. 4: 4–11
90.
Yen TT, Fuller RW. Preclinical pharmacology of fluoxetine, a serotonergic drug for weight loss. Am J Clin Nutr 1992; 55(1 Suppl.): 177S–80SPubMed
91.
Simansky KJ, Vaidya AH. Behavioral mechanisms for the anorectic action of the serotonin (5-HT) uptake inhibitor sertraline in rats: comparison with directly acting 5-HT agonists. Brain Res Bull 1990; 25(6): 953–60PubMedCrossRef
92.
Curzon G, Gibson EL, Oluyomi AO. Appetite suppression by commonly used drugs depends on 5-HT receptors but not on 5-HT availability. Trends Pharmacol Sci 1997; 18(1): 21–5PubMedCrossRef
93.
Kennett GA, Lightowler S, de Biasi V, et al. Effect of chronic administration of selective 5-hydroxytryptamine and noradrenaline uptake inhibitors on a putative index of 5-HT2C/2B receptor function. Neuropharmacology 1994; 33(12): 1581–8PubMedCrossRef
94.
Gutierrez A, Saracibar G, Casis L, et al. Effects of fluoxetine administration on neuropeptide y and orexins in obese zucker rat hypothalamus. Obes Res 2002; 10(6): 532–40PubMedCrossRef
95.
Dryden S, Frankish HM, Wang Q, et al. The serotonergic agent fluoxetine reduces neuropeptide Y levels and neuropeptide Y secretion in the hypothalamus of lean and obese rats. Neuroscience 1996; 72(2): 557–66PubMedCrossRef
96.
Wieczorek I, Schulz C, Jarry H, et al. The effects of the selective serotonin reuptake-inhibitor fluvoxamine on body weight in Zucker rats are mediated by corticotropin-releasing hormone. Int J Obes Relat Metab Disord 2001; 25(10): 1566–9PubMedCrossRef
97.
Smith BK, York DA, Bray GA. Activation of hypothalamic serotonin receptors reduced intake of dietary fat and protein but not carbohydrate. Am J Physiol 1999; 277: R802–11PubMed
98.
Blundell JE, Hill AJ. Do serotoninergic drugs decrease energy intake by reducing fat or carbohydrate intake: effect of dfenfluramine with supplemented weight-increasing diets. Pharmacol Biochem Behav 1988; 31(4): 773–8PubMedCrossRef
99.
Glazer G. Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Intern Med 2001; 161(15): 1814–24PubMedCrossRef
100.
Lawton CL, Wales JK, Hill AJ, et al. Serotoninergic manipulation, meal-induced satiety and eating pattern: effect of fluoxetine in obese female subjects. Obes Res 1995; 3(4): 345–56PubMed
101.
Foltin RW, Haney M, Comer SD, et al. Effect of fluoxetine on food intake of humans living in a residential laboratory. Appetite 1996; 27(2): 165–81PubMedCrossRef
102.
Ferguson JM, Feighner JP. Fluoxetine-induced weight loss in verweight non-depressed humans. Int J Obes 1987; 11 Suppl. 3: 163–70
103.
Levine LR, Enas GG, Thompson WL, et al. Use of fluoxetine, a selective serotonin-uptake inhibitor, in the treatment of obesity: dose-response study (with a commentary by Michael Weintraub). Int J Obes 1989; 13(5): 635–45PubMed
104.
Gray DS, Fujioka K, Devine W, et al. Fluoxetine treatment of the obese diabetic. Int J Obes Relat Metab Disord 1992; 16(3): 193–8PubMed
105.
Visser M, Seidell JC, Koppeschaar HP, et al. The effect of fluoxetine on body weight, body composition and visceral fat accumulation. Int J Obes Relat Metab Disord 1993; 17(5): 247–53PubMed
106.
Fernandez-Soto ML, Gonzalez-Jimenez A, Barredo-Acedo F, et al. Comparison of fluoxetine and placebo in the treatment of besity. Ann Nutr Metab 1995; 39(3): 159–63PubMedCrossRef
107.
Connolly VM, Gallagher A, Kesson CM. A study of fluoxetine in obese elderly patients with type 2 diabetes. Diabet Med 1995; 12(5): 416–8PubMedCrossRef
108.
Daubresse JC, Kolanowski J, Krzentowski G, et al. Usefulness of fluoxetine in obese non-insulin-dependent diabetics: a multicenter study. Obes Res 1996; 4(4): 391–6PubMed
109.
Bondi M, Menozzi R, Bertolini M, et al. Metabolic effects of fluoxetine in obese menopausal women. J Endocrinol Invest 2000; 23(5): 280–6PubMed
110.
Marcus MD, Wing RR, Ewing L, et al. A double-blind, placebo-controlled trial of fluoxetine plus behavior modification in the treatment of obese binge-eaters and non-binge-eaters. Am J Psychiatry 1990; 147(7): 876–81PubMed
111.
Darga LL, Carroll-Michals L, Botsford SJ, et al. Fluoxetine’s effect on weight loss in obese subjects. Am J Clin Nutr 1991; 54(2): 321–5PubMed
112.
Goldstein DJ, Rampey Jr AH, Enas GG, et al. Fluoxetine: a randomized clinical trial in the treatment of obesity. Int J Obes Relat Metab Disord 1994; 18(3): 129–35PubMed
113.
O’Kane M, Wiles PG, Wales JK. Fluoxetine in the treatment of obese type 2 diabetic patients. Diabet Med 1994; 11(1): 105–10PubMedCrossRef
114.
Breum L, Bjerre U, Bak JF, et al. Long-term effects of fluoxetine on glycemic control in obese patients with non-insulin-dependent diabetes mellitus or glucose intolerance: influence on muscle glycogen synthase and insulin receptor kinase activity. Metabolism 1995; 44(12): 1570–6PubMedCrossRef
115.
Orzack MH, Friedman LM, Marby DW. Weight changes on fluoxetine as a function of baseline weight in depressed outpatients. Psychopharmacol Bull 1990; 26(3): 327–30PubMed
116.
Michelson D, Amsterdam JD, Quitkin FM, et al. Changes in weight during a 1-year trial of fluoxetine. Am J Psychiatry 1999; 156(8): 1170–6PubMed
117.
Bacaltchuk J, Hay P, Mari JJ. Antidepressants versus placebo for the treatment of bulimia nervosa: a systematic review. Aust N Z J Psychiatry 2000; 34(2): 310–7PubMedCrossRef
118.
Goldstein DJ, Wilson MG, Thompson VL, et al. Long-term fluoxetine treatment of bulimia nervosa. Fluoxetine Bulimia Nervosa Research Group. Br J Psychiatry 1995; 166(5): 660–6
119.
Wadden TA, Bartlett SJ, Foster GD, et al. Sertraline and relapse prevention training following treatment by very-low-calorie diet: a controlled clinical trial. Obes Res 1995; 3(6): 549–57PubMed
120.
McElroy SL, Casuto LS, Nelson EB, et al. Placebo-controlled trial of sertraline in the treatment of binge eating disorder. Am J Psychiatry 2000; 157: 1004–6PubMedCrossRef
121.
Abell CA, Farquhar DL, Galloway SM, et al. Placebo controlled double-blind trial of fluvoxamine maleate in the obese. J sychosom Res 1986; 30(2): 143–6CrossRef
122.
Hudson JI, McElroy SL, Raymond NC. Fluvoxamine in the reatment of binge eating disorder: a multicenter placebo-controlled double-blind trial. Am J Psychiatry 1998; 155: 1756–62PubMed
123.
Ljung T, Ahlberg AC, Holm G, et al. Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study. J Intern Med 2001; 250(3): 219–24PubMedCrossRef
124.
Szkudlarek J, Eisborg L. Treatment of severe obesity with a highly selective serotonin reuptake inhibitor as a supplement to a low calorie diet. Int J Obes Relat Metab Disord 1993; 17(12): 681–3PubMed
125.
McElroy SL, Hudson JI, Malhotra S, et al. Citalopram in the treatment of binge-eating disorder: a placebo-controlled trial. J Clin Psychiatry 2003; 64(7): 807–13PubMedCrossRef
126.
Rudolph RL, Fabre LF, Feighner JP, et al. A randomized, placebo-controlled, dose-response trial of venlafaxine hydrochloride in the treatment of major depression. J Clin Psychiatry 1998; 59(3): 116–22PubMedCrossRef
127.
Malhotra S, King KH, Welge JA, et al. Venlafaxine treatment of binge-eating disorder associated with obesity: a series of 35 patients. J Clin Psychiatry 2002; 63(9): 802–6PubMedCrossRef
128.
Schatzberg AF. New indications for antidepressants. J Clin Psychiatry 2000; 61 Suppl. 11: 9–17
129.
Gadde KM, Parker CB, Maner LG, et al. Bupropion for weight loss: an investigation of efficacy and tolerability in overweight and obese women. Obes Res 2001; 9(9): 544–51PubMedCrossRef
130.
Zarrindast MR, Hosseini-Nia T. Anorectic and behavioural effects of bupropion. Gen Pharmacol 1988; 19(2): 201–4PubMedCrossRef
131.
Reimherr FW, Cunningham LA, Batey SR, et al. A multicenter evaluation of the efficacy and safety of 150 and 300 mg/d sustained-release bupropion tablets versus placebo in depressed outpatients. Clin Ther 1998; 20(3): 505–16PubMedCrossRef
132.
Settle EC, Stahl SM, Batey SR, et al. Safety profile of sustained-release bupropion in depression: results of three clinical trials. Clin Ther 1999; 21(3): 454–63PubMedCrossRef
133.
Croft H, Houser TL, Jamerson BD, et al. Effect on body weight of bupropion sustained-release in patients with major depression treated for 52 weeks. Clin Ther 2002; 24(4): 662–72PubMedCrossRef
134.
Holm KJ, Spencer CM. Bupropion: a review of its use in the management of smoking cessation. Drugs 2000; 59(4): 1007–24PubMedCrossRef
135.
Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999; 340(9): 685–91PubMedCrossRef
136.
Jain AK, Kaplan RA, Gadde KM, et al. Bupropion SR vs placebo for weight loss in obese patients with depressive symptoms. Obes Res 2002; 10(10): 1049–56PubMedCrossRef
137.
Anderson JW, Greenway FL, Fujioka K, et al. Bupropion SR enhances weight loss: a 48-week double-blind, placebo-controlled trial. Obes Res 2002; 10(7): 633–41PubMedCrossRef
138.
Privitera MD. Topiramate: a new antiepileptic drug. Ann Pharmacother 1997; 31(10): 1164–73PubMed
139.
Richard D, Ferland J, Lalonde J, et al. Influence of topiramate in the regulation of energy balance. Nutrition 2000; 16(10): 961–6PubMedCrossRef
140.
Rosenfeldt WE, Shaefer PA, Pace K. Weight loss patterns with topiramate therapy [abstract]. Epilepsia 1997; 38 Suppl. 3: 58
141.
Norton J, Potter D, Edwards K. Sustained weight loss associated with topiramate [abstract]. Epilepsia 1997; 38 Suppl. 3: 60
142.
Roy Chengappa KN, Levine J, Rathore D, et al. Long-term effects of topiramate on bipolar mood instability, weight change and glycemic control: a case-series. Eur Psychiatry 2001; 16(3): 186–90PubMedCrossRef
143.
Richard D, Picard F, Lemieux C, et al. The effects of topiramate and sex hormones on energy balance of male and female rats. Int J Obes Relat Metab Disord 2002; 26(3): 344–53PubMedCrossRef
144.
Picard F, Deshaies Y, Lalonde J, et al. Topiramate reduces energy and fat gains in lean (Fa/?) and obese (fa/fa) Zucker rats. Obes Res 2000; 8(9): 656–63PubMedCrossRef
145.
Gordon A, Price LH. Mood stabilisation and weight loss with topiramate. Am J Psychiatry 1999; 156(6): 968–9PubMed
146.
Shapira NA, Goldsmith TD, McElroy SL. Treatment of binge-eating disorder with topiramate: a clinical case series. J Clin Psychiatry 2000; 61(5): 368–72PubMedCrossRef
147.
Appolinario JC, Coutinho W, Fontenelle L. Topiramate for inge-eating disorder. Am J Psychiatry 2001; 158(6): 967–8PubMedCrossRef
148.
Teter CJ, Early JJ, Gibbs CM. Treatment of affective disorder nd obesity with topiramate. Ann Pharmacother 2000; 34(11): 1262–5PubMedCrossRef
149.
Appolinario JC, Fontenelle LF, Papelbaum M, et al. Topiramate use in obese patients with binge eating disorder: an open study. Can J Psychiatry 2002; 47: 271–3PubMed
150.
Schmidt do Prado-Lima PA, Bacaltchuck J. Topiramate in treatment-resistant depression and binge-eating disorder. Bipolar Disord 2002; 4(4): 271–3PubMedCrossRef
151.
Anghelescu I, Klawe C, Szegedi A. Add-on combination and maintenance treatment: case series of five obese patients with different eating behavior. J Clin Psychopharmacol 2002; 22(5): 521–4PubMedCrossRef
152.
McElroy SL, Arnold LM, Shapira NA, et al. Topiramate in the reatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial. Am J Psychiatry 2003; 160(2): 255–61PubMedCrossRef
153.
Pavuluri MN, Janicak PG, Carbray J. Topiramate plus risperidone for controlling weight gain and symptoms in preschool mania. J Child Adolesc Psychopharmacol 2002; 12(3): 271–3PubMedCrossRef
154.
Levy E, Margolese HC, Chouinard G. Topiramate produced weight loss following olanzapine-induced weight gain in schizophrenia [letter]. J Clin Psychiatry 2002; 63(1): 1045PubMedCrossRef
155.
McElroy SL, Kotwal R, Hudson JI, et al. Zonisamide in the treatment of binge-eating disorder: an open-label, prospective trial. J Clin Psychiatry 2004; 65(1): 50–6PubMedCrossRef
156.
Bray GA, Hollander P, Klein S, et al. A 6-month randomized, placebo-controlled, dose-ranging trial of topiramate for weight loss in obesity. Obes Res 2003 Jun; 11(6): 722–33PubMedCrossRef
157.
Van Gaal L, Rissanen A, Wilding J, et al. Efficacy and safety of topiramate in obese subjects [abstract T4: 01–2]. Int J Obes 2003; 27Suppl. 1: S14
158.
Gadde KM, Franciscy DM, Wagner II HR, et al. Zonisamide for weight loss in obese adults. JAMA 2003; 289(14): 1820–5PubMedCrossRef
159.
Oommen KJ, Mathews S. Zonisamide: a new antiepileptic drug. Clin Neuropharmacol 1999; 22: 192–200PubMed
160.
Okada M, Hirano T, Kawata Y, et al. Biphasic effects of zonisamide on serotonergic system in rat hippocampus. Epilepsy Res 1999; 34(2-3): 187–97PubMedCrossRef
161.
Okada M, Kaneko S, Hirano T, et al. Effects of zonisamide on dopaminergic system. Epilepsy Res 1995; 22(3): 193–205PubMedCrossRef
162.
163.
Coutinho W. Consenso Latino Americano de Obesidade. Arq Bras Endocrinol Metabol 1999; 43(1): 21–67CrossRef
Metadata
Title
Psychotropic Drugs in the Treatment of Obesity
What Promise?
Authors
Dr Jose C. Appolinario
João R. Bueno
Walmir Coutinho
Publication date
01-08-2004
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 10/2004
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200418100-00002