Efficacy and Safety of Long‐Term Fluoxetine Treatment of Obesity ‐ Maximizing Success

Abstract

Obesity is a major health care concern because of its associated medical complications and increased mortality. Despite a myriad of short‐term weight loss strategies and the motivation of improving health, patients have difficulty maintaining reduced weight. Pharmacologic agents, such as fluoxetine, a selective serotonin uptake inhibitor, have been investigated as adjunctive therapy to standard weight management programs. Extended therapy with fluoxetine has demonstrated clinically meaningful benefits on weight loss and obesity‐associated medical conditions in double‐blind placebo‐controlled studies. However, the magnitude of these benefits for individuals vary. Such findings are consistent with the belief that the obesity syndrome has differing etiologies. Accordingly not all patients are likely to benefit from a particular therapy. Studies should identify patient subgroups that are more likely to respond to a specific therapy. In this study of 719 fluoxetine‐treated and 722 placebo treated patients in four multicenter, randomized, double‐blind, long‐term clinical trials, we investigated possible predictors of a beneficial long‐term outcome from fluoxetine therapy. Patients' age, current smoking activity, and baseline uric acid concentration were predictors of a meaningful long‐term treatment effect. Further review of the weight loss patterns of patients achieving long‐term success provided the basis for a treatment monitor. Use of the predictors and the treatment monitor are strategies to maximize the benefits of therapy through improved patient selection and monitoring during a therapeutic program.

Mitochondrial uncoupling in skeletal muscle by UCP1 augments energy expenditure and glutathione content while mitigating ROS production

“…The most common treatments include a hypocaloric diet, increased physical activity, a very limited repertoire of medications, and bariatric surgery. The long-term success rate for current treatments is low, pointing to the need for the development of alternative treatment strategies (16,50). In recent years, brown adipose tissue (BAT) has emerged as a promising target for novel therapeutics.…”

Comparison of combinations of drugs for treatment of obesity: body weight and echocardiographic status

“…45,46 However, unlike other drugs approved for the treatment of obesity, weight losses did not persist, and after 1 year of treatment body weight was back to baseline. 45,46 Longer term studies suggest that fluoxetine, when used alone, may cause significant weight gain over time. 47 Data on phen-flu treatment are minimal.…”

Pharmacotherapy of Obesity: Past, Present and Future

“…Бупропион может также использоваться с целью сокращения или предотвращения увеличения массы тела у людей, пытающихся бросить курить [2,11]. будущее в развитии фармакотерапии ожи-рения к сожалению, достигнув больших успехов в понимании механизмов развития ожирения и кратковременного контроля за аппетитом, мы до сих пор не имеем принципиально новых эффективных препаратов.…”