Low-certainty evidence suggests that off-label fluoxetine may decrease weight compared with placebo .
However , low-certainty evidence suggests an increase in the risk for dizziness , drowsiness , fatigue , insomnia and nausea following fluoxetine treatment
BACKGROUND Fluoxetine is a serotonin reuptake inhibitor indicated for major depression .
It is also thought to affect weight control : this seems to happen through appetite changes result ing in decreased food intake and normalisation of unusual eating behaviours .
However , the benefit-risk ratio of this off-label medication is unclear .
OBJECTIVES To assess the effects of fluoxetine for overweight or obese adults .
A comparative study of five centrally acting drugs on the pharmacological treatment of obesity
Context : No long-term studies have compared central ly 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 prospect i ve , r and omized , placebo (PCB)-controlled study conducted at a single academic institution . Patients : A total of 174 obese premenopausal women . Intervention : Participants r and omly 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 central ly 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
Low-certainty evidence suggests that off-label fluoxetine may decrease weight compared with placebo .
However , low-certainty evidence suggests an increase in the risk for dizziness , drowsiness , fatigue , insomnia and nausea following fluoxetine treatment
BACKGROUND Fluoxetine is a serotonin reuptake inhibitor indicated for major depression .
It is also thought to affect weight control : this seems to happen through appetite changes result ing in decreased food intake and normalisation of unusual eating behaviours .
However , the benefit-risk ratio of this off-label medication is unclear .
OBJECTIVES To assess the effects of fluoxetine for overweight or obese adults .