Millions of American adults are impacted by depression in a given year and make attempts to manage symptoms with the help of prescription medications. An unrelated millions of American adults also smoke and seek prescription medication intervention. Bupropion, a U.S. Food and Drug Administration approved medication, is labeled for use in treating depressive disorders and/or smoking cessation. However, this medication also has a side effect of weight loss and is undergoing clinical research for use as an obesity intervention.
In 1984, the antidepressant bupropion was introduced to the American market but removed in 1986 because of a high incidence of seizures in patients taking the drug. The medication was reintroduced in 1989 with a maximum dosage limit to prevent seizure side effects. This drug is unique as an antidepressant because it acts on the dopamine and norepinephrine neurotransmitter system as opposed to the serotonin system, which is what many antidepressant medications target for symptom relief. This dopamine system also has a role in the mechanisms of smoking. In 1997, the FDA approved bupropion sustained release for the treatment of smoking cessation. Bupropion is not approved for any other label uses. However, off-label, it is prescribed as complementary treatment for bipolar, anxiety and attention deficit hyperactivity disorders.
Bupropion and Weight Loss
Use of bupropion may cause weight loss among other side effects like excitement, dry mouth or excessive sweating. In 2001, Dr. Kishore Gadde and colleagues from Duke University Medical Center investigated the efficacy of bupropion on weight loss in overweight or obese women without a history of depression or smoking. The study was conducted initially for eight weeks using a randomized, double-blind, placebo-controlled comparison of 50 female subjects. At eight weeks, the bupropion group effectively lost more weight than the placebo group and medication responders went on to successfully lose weight for up to two years after the initial eight week trial.
Bupropion Combination Medication for Weight Loss
The success of bupropion alone for inducing the side effect of weight loss has spawned additional research of this drug in combination with medications that also have a weight loss side effect. The hope from researchers is an effective drug combination approved as a potential solution for pharmaceutical-based obesity treatment. A 2007 study published in the "Journal of Clinical Psychiatry" investigated the combination of the drug zonisamide, approved only for seizure disorder treatment, and bupropion. The combination of these drugs effectively resulted in more weight loss than singular drug treatment alone. Similarly, the combination of naltrexone, an approved drug for opioid and alcohol addiction, and bupropion has also been proposed to the FDA for obesity treatment. As of 2011, the FDA has rejected applications for combination bupropion medications for use as obesity treatment.
Bupropion for the treatment of depression may increase suicidal thoughts in young adults taking the medication. Bupropion for the treatment of smoking may increase hostility, agitation, depressed mood or suicidal thoughts. Consult your physician regarding side effects before taking bupropion. Only take the prescribed dosage and report any unusual side effects like hallucinations, rash, swelling, chest pain or seizures to your physician immediately. In regards to bupropion for weight loss, no approved combination therapy exists. The manufacturers of the naltrexone and bupropion combination are undergoing appeals for the rejected application because the FDA requires additional clinical trials to determine cardiovascular safety for long-term use of these medications in treating obesity.
- "Obesity"; Bupropion for Weight Loss; An Investigation of Efficacy and Tolerability in Overweight and Obese Women; K. Gadde, et al.; 2001
- MedlinePlus: Bupropion
- "Journal of Clinical Psychiatry"; Combination Therapy of Zonisamide and Bupropion for Weight Reduction in Obese Women; A Preliminary, Randomized, Open-Label Study; K. Gadde, et al.; August 2007
- Orexigen.com: Clinical Trials: Contrave
- Drugs.com; FDA Issues Complete Response to New Drug Application for Contrave for the Management of Obesity; February 2011
- "Primary Care Companion to the Journal of Clinical Psychiatry"; The Many Uses of Bupropion and Bupropion Sustained Release in Adults; Timothy Berigan, M.D.; 2002