title: Naltrexone/bupropion for obesity: an investigational combination pharmacotherapy for weight loss.
abstract: The mechanism of action of the combination therapy, naltrexone/bupropion (NB), for obesity has not been fully described to date. Weight loss attempts rarely result in long-term success. This is likely a result of complex interactions among multiple peripheral and CNS systems that defend against weight loss, and may explain the overwhelming lack of effective obesity treatments. NB is an investigational combination therapy for obesity that was developed based on evidence that obesity involves alterations in the hypothalamic melanocortin system as well as brain reward systems that influence food craving and mood. Naltrexone and bupropion both have actions in these brain regions that may cause them to influence food intake, food craving, and other aspects of eating behavior that affect body weight. We review the individual actions of naltrexone and bupropion in brain hypothalamic and reward systems, and describe the current in vitro, in vivo, and clinical evidence for how NB influences food intake and produces weight loss.
authors.affiliation: August Scientific, Encinitas, CA, USA. Electronic address: sonja@augustscientific.com.
authors.forename: Sonja K
authors.initials: SK
authors.lastname: Billes
authors.affiliation: College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.
authors.forename: Puspha
authors.initials: P
authors.lastname: Sinnayah
authors.affiliation: Department of Physiology, Monash University, Clayton, Victoria, Australia. Electronic address: michael.cowley@monash.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cowley
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology / Q000627:therapeutic use*; D016642:Bupropion / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004734:Energy Metabolism / Q000187:drug effects; D006801:Humans; D009271:Naltrexone / Q000494:pharmacology / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D009765:Obesity / Q000188:drug therapy*; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D009292:Narcotic Antagonists; D016642:Bupropion; D009271:Naltrexone
keywords: Bupropion; Drug interactions; Food craving; Food intake; Hypothalamus; Naltrexone; Obesity; Reward system; Weight loss