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

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.