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Clinical Studies and Practice

A comparative study of five centrally acting drugs on the pharmacological treatment of obesity

International Journal of Obesity volume 38, pages 1097–1103 (2014)Cite this article

Subjects

Abstract

Context:

No long-term studies have compared centrally acting drugs for treating obesity.

Objective:

To compare the efficacy and safety of diethylpropion (DEP), fenproporex (FEN), mazindol (MZD), fluoxetine (FXT) and sibutramine (SIB) in promoting weight loss.

Design and Setting:

A prospective, randomized, placebo (PCB)-controlled study conducted at a single academic institution.

Patients:

A total of 174 obese premenopausal women.

Intervention:

Participants randomly received DEP 75 mg (n=28), FEN 25 mg (n=29), MZD 2 mg (n=29), SIB 15 mg (n=30), FXT 20 mg (n=29) or PCB (n=29) daily over 52 weeks. Diet and physical activity were encouraged.

Main Outcome Measures:

The primary endpoints were changes in body weight and the proportion of women who achieved at least 5% weight loss by week 52 in the intent-to-treat population. Other measurements included anthropometry, safety, metabolic and cardiovascular parameters.

Results:

Weight loss was greater than PCB (−3.1±4.3 kg) with DEP (−10.0±6.4 kg; P<0.001), SIB (−9.5±5.9 kg; P<0.001), FEN (−7.8±6.9 kg; P<0.01) and MZD (−7.4±4.9 kg; P<0.01) but not with FXT (−2.5±4.1 kg). Ten (33.3%) women lost⩾5% of their initial weight with PCB, compared with 20 (71.4%; P<0.001) with DEP, 20 (69%; P<0.02) with FEN, 21 (72.4%; P<0.01) with MZD, 22 (73.3%; P<0.001) with SIB and 10 (35.5%) with FXT. Each medically treated group experienced more adverse events compared with PCB (P<0.001). Compared with PCB, constipation was more prevalent with DEP, SIB and MZD (P<0.01); anxiety was more prevalent with DEP (P=0.01); and irritability occurred more frequently with DEP and FEN (P=0.02). Significant improvements in the depression and anxiety scores, binge-eating episodes and quality of life correlated with weight loss.

CONCLUSION:

The centrally acting drugs DEP, FEN, MZD and SIB were more effective than PCB in promoting weight loss in obese premenopausal women, with a satisfactory benefit–risk profile.

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Acknowledgements

SIB and FXT were generously provided by Medley Pharmaceuticals. FEN and DEP were generously provided by Aché Pharmaceuticals. MZD and PCB were prepared by Apparenza Drugstore, which was also responsible for packing all medications in identical bottles.

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Authors and Affiliations

  1. Endocrine Division (SEMPR), Department of Internal Medicine, Parana Federal University, Curitiba, Brazil

    H Suplicy, C L Boguszewski, C M C dos Santos, M do Desterro de Figueiredo, D R Cunha & R Radominski

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  1. H Suplicy
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Correspondence to H Suplicy.

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Suplicy, H., Boguszewski, C., dos Santos, C. et al. A comparative study of five centrally acting drugs on the pharmacological treatment of obesity. Int J Obes 38, 1097–1103 (2014). https://doi.org/10.1038/ijo.2013.225

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