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Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxiety

By nEone, Dec 4, 2007 | | |
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  1. nEone
    Time Magazine has an article about new diet pills that are hitting the market, and one of the pills caught my eye:

    ___________

    Approved by the European Drug Agency in June 2006 and sold under the name Acomplia, rimonabant takes a different weight-loss route than Meridia, which revs up metabolism and creates a feeling of fullness, and Alli, which reduces fat absorption from food. Rimonabant is the first of a new class of drugs designed to keep the user from getting the munchies. That's right: knowing that marijuana and other forms of cannabis stimulate the appetite, scientists wondered what might happen if they blocked the brain's cannabinoid receptors. Early studies suggested the anticannabinoid crew was on to something. Not only did the desire for food seem to diminish with rimonabant but other cravings, like nicotine, were easier to control.

    But it turns out there's a downside to blocking parts of the brain that are responsible for pleasure, relaxation and pain tolerance. A study published last month in the Lancet looked at more than 4,000 patients who had been given either 20 mg of rimonabant or a placebo (sugar pill) in double-blinded trials--meaning the participants didn't know which of the two pills they were getting and neither did their doctors. The results were downright depressing. Literally. Patients receiving rimonabant were 2.5 times as likely as placebo recipients to discontinue treatment because of depressive disorders. They were also three times as likely to stop taking the drug because of anxiety. The FDA panel nixed rimonabant's application for approval due to concerns that the drug increases the risk of suicidal thoughts.

    _________

    Link to full story: http://www.time.com/time/magazine/article/0,9171,1689206,00.html

Comments

  1. Alfa
    Re: Diet pill that blocks cannabinoids rejected by the FDA

    The Diet-Pill Dilemma

    As the obesity crisis worsens and more pharmaceutical companies are hoping to improve their bottom line by shrinking their customers' bottoms. After all, we are a short-cut society (who wouldn't rather pop a pill than engage in the hard work of exercise and calorie restriction?) with a short memory (remember the fen-phen diet-drug combo that led to a gazillion lawsuits?). The good news is that according to a recent report in the British Medical Journal, three relatively new antiobesity drugs helped patients lose a moderate amount of weight while doing such things as lowering cholesterol and reducing the incidence of diabetes. The bad news is that the list of possible side effects doesn't end there.

    The study found that both of the diet pills the U.S. Food and Drug Administration (FDA) has approved for long-term use may lead to a modest weight loss of about 5% to 10% of a person's total body mass within the course of a year. But sibutramine, which was approved as a prescription drug in 1997 and is sold under the trade name Meridia, has been associated with increased blood pressure, insomnia and constipation. Meanwhile, orlistat, which since February has been heavily marketed as the over-the-counter aid Alli, can cause oily bowel movements so frequently that the package insert suggests women wear a panty liner when starting the regimen.

    Such unappetizing details make one wonder what a diet drug has to do to get rejected by an FDA panel--Which is what happened this summer to the much hyped rimonabant. Approved by the European Drug Agency in June 2006 and sold under the name Acomplia, rimonabant takes a different weight-loss route than Meridia, which revs up metabolism and creates a feeling of fullness, and Alli, which reduces fat absorption from food. Rimonabant is the first of a new class of drugs designed to keep the user from getting the munchies. That's right: knowing that marijuana and other forms of cannabis stimulate the appetite, scientists wondered what might happen if they blocked the brain's cannabinoid receptors. Early studies suggested the anticannabinoid crew was on to something. Not only did the desire for food seem to diminish with rimonabant but other cravings, like nicotine, were easier to control.

    But it turns out there's a downside to blocking parts of the brain that are responsible for pleasure, relaxation and pain tolerance. A study published last month in the Lancet looked at more than 4,000 patients who had been given either 20 mg of rimonabant or a placebo (sugar pill) in double-blinded trials--meaning the participants didn't know which of the two pills they were getting and neither did their doctors. The results were downright depressing. Literally. Patients receiving rimonabant were 2.5 times as likely as placebo recipients to discontinue treatment because of depressive disorders. They were also three times as likely to stop taking the drug because of anxiety. The FDA panel nixed rimonabant's application for approval due to concerns that the drug increases the risk of suicidal thoughts.

    I know. This is probably the last thing you want to read this time of year amid all the marathon meals and the candy dishes on virtually every tabletop. But instead of searching for a magic weight-loss pill, you might heed a few simple tips to help get through the calorie-laden holidays. Try eating water-dense foods like salad and fruit at the beginning of a big meal. Push your plate away before you feel full; this will give your stomach time to send signals to your brain that you've had enough and really don't have room for seconds. And more important, don't be one of those people who plan to start a diet on Jan. 1. New Year's resolutions hardly ever work and mainly serve as an excuse to binge during the months beforehand. Sources: British Medical Journal and Mayo Clinic
  2. MrG
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    Actually the ultimate goal for big business is a diet drug that wouldn't affect your appetite but would still make you lose weight.

    Think about it, Big Pharma gets your dollars on a daily treatment so that you can keep spending big bucks on junk food. That would be their ideal diet pill.
  3. FuBai
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    It would also be the ideal diet pill for pretty much everyone. Eating is a pleasure, which is one of the main reasons people become fat. Being able to eat whatever the hell you want and never to gain weight would be awesome.
  4. MrG
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    I was thinking more along the lines of the massive strain on the body's internal filters in dealing with all that crap and trying to get a good balance of nutrients as well as the sociological effect in terms of the sheer amount of food that would need to be produced above what is being scarfed down now.

    We are already punching above our weight when it comes to the demand for low cost, high volume food. Any tree-hugger will tell you that we in the West are on the edge as far as our ability to meet current demands for food produce is concerned, never mind the emergence of rapidly developing nations like China and India who seem to already be catching the "fat" bug.
  5. bythetracks
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    I don't think drugs are the way to fight obesity. I never met anyone who overcame obesity long term through diet pills, but I know lots of people who did so through improved diet and daily excercise. If you could only make one change in your life to lose weight, daily exercise would be the most effective. Americans are loath to do that though. They would rather pop a pills or starve themselves than break a sweat.
  6. nEone
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    I read an interesting article once that put forward the hypothesis that the invention of "the pill" (Not a specific pill, just the method of delivery) was the most ground breaking invention of our time.

    The author argued that the simple and efficient method of delivery did more than make pharmacists' lives easier - it brought about a paradigm shift in the way we (Westerners) think about health-care. It became the defining way that we solve health problems. Pills like aspirin, birth control, and barbiturates all had distinct life-changing effects, and soon, the medicine itself wasn't as important as the concept of a Pill.

    Now, we hardly have any faith at all in any medicine that DOESN'T come in pill form.
  7. imyourlittlebare
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    that is so interesting. did the article say the brain area involved or mention the insular cortex?
  8. nEone
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    Not that I remember - it really mostly talked about it from a social perspective - about expectations and how the simple introduction of the concept of a pill-as-cure-all had changed the nature of our understanding of health, and of our own role in maintaining our health.
  9. enquirewithin
    Re: Rimonabant: Diet pill that blocks cannabinoids causes suicidal thoughts and anxie

    Obesity drug pulled over suicide risks

    By Jeremy Laurance, Health Editor

    Friday, 24 October 2008


    Doctors have been told to stop prescribing the anti-obesity drug rimonabant, whose brand name is Acomplia, because it poses a risk of psychiatric disorders and suicide.
    The European Medicines Evaluation Agency recommended suspension of the drug yesterday amid concerns that it may increase depression, sleep disorders, anxiety and aggression in some overweight or obese patients. As the patients at risk cannot be identified, marketing of the drug should be suspended, the EMEA said.

    The Medicines and Healthcare products Regulatory Agency (MHRA), which is responsible for drug safety in Britain, said doctors should not issue any new prescriptions for Acomplia.

    An estimated 97,000 patients in the UK have been prescribed Acomplia and 20,000 are currently taking it. The EMEA said patients should consult their GP but did not need to stop taking the drug immediately.
    Acomplia was approved for use on the NHS in June. However, concerns about the risks of depression and suicide among users have been expressed for some time. In July 2007, the EMEA warned it could be unsafe for patients taking anti-depressants. Data from recent studies and from the maker, sanofi-aventis, has revealed patients taking Acomplia have twice the risk of developing psychiatric disorders compared to those given a placebo. Five patients among 36,000 on a trial of the drug committed suicide between June and August, compared to one suicide among those taking the placebo. While the risks appeared higher than previously thought, the drug has proved less effective because patients only stay on it for a short time. The EMEA said its committee for medicinal products for human use "has concluded that the benefits of Acomplia no longer outweigh its risks".

    Acomplia has been authorised in the EU since June 2006 to be used alongside diet and exercise to treat obese or overweight patients. It has been "moderately effective", the EMEA said.

    Sanofi-aventis said it would "comply with the European authorities' request to temporarily suspend the marketing authorisation of Acomplia in obese and overweight patients". It said it would provide further evidence from clinical studies to aid the re-evaluation of Acomplia, adding that the drug provided "significant clinical benefits".

    97,000 patients

    Estimated number of people in the UK who are prescribed Acomplia.
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