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Expert Opin Pharmacother. 2011 Aug;12(11):1813-26. doi: 10.1517/14656566.2011.591382. Epub 2011 Jun 21.
Although pharmacological treatments for obesity represent only one option in managing obesity, they are a useful tool in an otherwise extremely limited armamentarium. Naltrexone/bupropion combination therapy was developed by using technological advances that have improved our understanding of how the brain regulates body weight.
This review covers the development of naltrexone/bupropion combination therapy for obesity, as well as the published clinical trials on the safety and efficacy of the combination in overweight and obese humans. The effect of naltrexone/bupropion on food craving seems to be unique, and the implications of this finding for weight loss are discussed.
Safety and tolerability issues seem to be manageable and consistent with the documented effects of each component. Appropriate patient management should address the mild sympathomimetic effect of bupropion, although the FDA has required that a cardiovascular outcomes study be conducted preapproval to determine the effects of long-term use of naltrexone/bupropion in an overweight/obese population. When used in conjunction with diet and exercise, the naltrexone/bupropion combination may be a useful treatment option for obesity, especially for overweight and obese adults who report difficulty controlling eating behavior and their response to food cravings.
尽管药物治疗肥胖症只是治疗肥胖症的一种选择，但对于本来就非常有限的治疗方法来说，它是一种有用的工具。纳曲酮/安非他酮联合疗法的开发利用了技术进步，这些进步提高了我们对大脑如何调节体重的理解。
本文综述了纳曲酮/安非他酮联合疗法治疗肥胖症的发展情况，以及已发表的关于该联合疗法在超重和肥胖人群中安全性和疗效的临床试验。纳曲酮/安非他酮对食物渴求的影响似乎是独特的，并且讨论了这一发现对减肥的影响。
安全性和耐受性问题似乎是可控的，并且与每个成分的记录效果一致。适当的患者管理应该解决安非他酮的轻微拟交感作用，尽管 FDA 已要求在批准前进行心血管结局研究，以确定长期使用纳曲酮/安非他酮在超重/肥胖人群中的影响。当与饮食和运动结合使用时，纳曲酮/安非他酮联合治疗可能是肥胖症的一种有用治疗选择，尤其是对于那些报告难以控制饮食行为和对食物渴望反应的超重和肥胖成年人。
