In the equipment of drugs to obtain a weight loss, there are some products which really produce a weight loss but which are not used for this reason because of their heavy side effects, such as, for example, rimonabant (an antagonist of cannabinoid receptors, recently retired from the market) and, partly, sibutramine. At present, the association of bupropion and naltrexone is being studied, which synergically act on the sense of repletion and on mesolimbic system. 1742 obese people (85% women; average BMI 36 kg/ m2), not affected by either diabetes or cardiovascular diseases, have been randomized to receive a combination of bupropion (180 mg twice a day) and naltrexone (8-16 mg twice a day) or placebo. Sponsorship was given by the company producing the tablets with the two drugs already associated. The percentage of abandonment of the trial has been high: about half of the subjects in both groups have left experimentation during the first 16 weeks. With an intent-to-treat analysis, the average weight loss has been significantly higher in the group actively treated than in the placebo group (-6.1% and -5.0% with the two dosages of naltrexone; -1.3% with placebo). Side effects (nausea, vomiting, constipation, headache, dizziness, dry mouth) have been of mild-moderate intensity and temporary.
