The weight reducing effects of naltrexone-bupropion among obese psychiatric and non-psychiatric patients: a systematic review.

IF 3.3 3区医学 Q2 NEUROSCIENCES

Psychopharmacology Pub Date : 2025-08-25 DOI:10.1007/s00213-025-06873-0

Hafsah Alim Ur Rahman, Muhammad Ahmed Ali Fahim, Unaiza Naeem, Syed Hassan Ahmed, Muhammad Youshay Jawad, Hareem Arshad, Anil Kalyoncu, Mujeeb U Shad, Ahmad Hameed

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引用次数: 0

Abstract

Introduction: Obesity is a global concern leading to significant morbidity and mortality. Naltrexone-Bupropion (NB) is sought to be a favorable medication in obese patients with or without concurrent psychiatric illness. In this systematic review, we have compared NB's role as an obesity management strategy, against placebo and usual care, for overweight and obese psychiatric and non-psychiatric patients.

Methods: Cochrane Collaboration and PRISMA guidelines were followed for this study. We searched PubMed/Medline, Cochrane, and Clinicaltrials.gov from inception till June 1, 2024. The primary efficacy outcomes were changes in weight, BMI, and waist circumference.

Results: 12 RCTs with 5,367 patients were included in the final review. Eight studies used a combination of 32 mg naltrexone and 360 mg bupropion. Weight-related outcomes were reported in 10 studies. Among 5 studies including psychiatric patients, NB showed substantial weight loss. For non-psychiatric patients, NB resulted in significant weight loss and BMI reduction as well. Psychiatric outcomes assessed with BDI-II scores showed greater depression reduction in NB groups. Biomarker outcomes indicated a decrease in LDL and triglycerides, with an increase in HDL for NB groups.

Conclusion: Our review highlights NB as a potential option in the management of overweight and obese patients with or without psychiatric comorbidity.

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纳曲酮-安非他酮在肥胖精神病和非精神病患者中的减肥效果：一项系统综述。

简介：肥胖是一个全球性的问题，导致显著的发病率和死亡率。纳曲酮-安非他酮（NB）被认为是一种对伴有或不伴有精神疾病的肥胖患者有利的药物。在这篇系统综述中，我们比较了NB作为肥胖管理策略的作用，与安慰剂和常规护理相比，对于超重和肥胖的精神病和非精神病患者。方法：本研究遵循Cochrane Collaboration和PRISMA指南。我们检索了PubMed/Medline， Cochrane和Clinicaltrials.gov从成立到2024年6月1日。主要疗效指标是体重、BMI和腰围的变化。结果：12项rct共5367例患者纳入最终综述。8项研究使用了32毫克纳曲酮和360毫克安非他酮的组合。10项研究报告了体重相关的结果。在包括精神病患者在内的5项研究中，NB表现出明显的体重减轻。对于非精神病患者，NB也导致显著的体重减轻和BMI降低。用BDI-II评分评估的精神病学结果显示，NB组的抑郁程度有所降低。生物标志物结果显示，NB组LDL和甘油三酯降低，HDL升高。结论：我们的综述强调NB是治疗有或无精神合并症的超重和肥胖患者的潜在选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychopharmacology 医学-精神病学

CiteScore

7.10

自引率

5.90%

发文量

257

审稿时长

2-4 weeks

期刊介绍： Official Journal of the European Behavioural Pharmacology Society (EBPS) Psychopharmacology is an international journal that covers the broad topic of elucidating mechanisms by which drugs affect behavior. The scope of the journal encompasses the following fields: Human Psychopharmacology: Experimental This section includes manuscripts describing the effects of drugs on mood, behavior, cognition and physiology in humans. The journal encourages submissions that involve brain imaging, genetics, neuroendocrinology, and developmental topics. Usually manuscripts in this section describe studies conducted under controlled conditions, but occasionally descriptive or observational studies are also considered. Human Psychopharmacology: Clinical and Translational This section comprises studies addressing the broad intersection of drugs and psychiatric illness. This includes not only clinical trials and studies of drug usage and metabolism, drug surveillance, and pharmacoepidemiology, but also work utilizing the entire range of clinically relevant methodologies, including neuroimaging, pharmacogenetics, cognitive science, biomarkers, and others. Work directed toward the translation of preclinical to clinical knowledge is especially encouraged. The key feature of submissions to this section is that they involve a focus on clinical aspects. Preclinical psychopharmacology: Behavioral and Neural This section considers reports on the effects of compounds with defined chemical structures on any aspect of behavior, in particular when correlated with neurochemical effects, in species other than humans. Manuscripts containing neuroscientific techniques in combination with behavior are welcome. We encourage reports of studies that provide insight into the mechanisms of drug action, at the behavioral and molecular levels. Preclinical Psychopharmacology: Translational This section considers manuscripts that enhance the confidence in a central mechanism that could be of therapeutic value for psychiatric or neurological patients, using disease-relevant preclinical models and tests, or that report on preclinical manipulations and challenges that have the potential to be translated to the clinic. Studies aiming at the refinement of preclinical models based upon clinical findings (back-translation) will also be considered. The journal particularly encourages submissions that integrate measures of target tissue exposure, activity on the molecular target and/or modulation of the targeted biochemical pathways. Preclinical Psychopharmacology: Molecular, Genetic and Epigenetic This section focuses on the molecular and cellular actions of neuropharmacological agents / drugs, and the identification / validation of drug targets affecting the CNS in health and disease. We particularly encourage studies that provide insight into the mechanisms of drug action at the molecular level. Manuscripts containing evidence for genetic or epigenetic effects on neurochemistry or behavior are welcome.