The People's Perspective on Medicine

Will Contrave Help You Lose Weight Safely?

Contrave is a combination drug for obesity. Is it a good way to lose weight safely?
Feet on scale. Weight loss and diet concept. Woman weighing herself. Fitness lady dieting. Weightloss and dietetics. Dark late night mood.

Americans have been getting heavier for the past few decades. Most of us find weight control to be a struggle, so it’s little wonder we might be tempted to try a drug that promises to make it easier. Is this a good way to lose weight safely? One reader who tried it doesn’t think so.

Trying Contrave to Lose Weight Safely:

Q. I started taking Contrave two weeks ago. I was so desperate to lose weight that I spent a lot for it instead of forking that much out for a month of Nutrisystem.

That was a huge mistake. I have had nausea, vomiting, migraine headaches, constipation, horrible heartburn, blurry vision and hot flashes (especially at night). I have lost sleep because I am constantly pulling my covers off, then back on, then off again. In addition, I find myself eating more than usual because I am constantly trying to fight off the nausea by keeping something in my stomach. Another side effect is that I have no energy to exercise.

I have always encouraged my friends and family to try out their new prescriptions for a full month before giving up because of side effects. It takes a while for most people’s bodies to get used to a new med. Although I consider myself pretty tough, I am going to actually throw in the towel and stop instead of increasing the dose tomorrow as prescribed. It’s time for me to listen to my body.

What Is Contrave?

A. Contrave contains two different medications: the antidepressant bupropion and the opioid blocker naltrexone. Bupropion (Zyban) has FDA approval to help people quit smoking. Naltrexone (Revia) is approved for alcohol dependence. The combination has the FDA’s blessing for weight loss.

How good is Contrave for weight loss? In one clinical trial, subjects on the drug shed about eight pounds more than people taking placebos. That was after six months. In most of the clinical trials pre-approval, people taking Contrave lost about 5 percent of their initial body weight (P & T, March 2016). For comparison, those on placebo lost approximately 1.5 percent over the course of the same year. People who combined Contrave with behavioral modification got the best results, losing around 8 percent of their body weight in a year.

Side Effects of Contrave:

Side effects can include digestive distress, headache, dizziness, insomnia, sweating, dry mouth, anxiety, hot flushes, tremor and confusion. Blood pressure and heart rate may rise, although in the clinical studies people did not have important cardiac changes.

The FDA requires a boxed warning regarding its potential to trigger suicidal thoughts or actions in the prescribing information. That is because it contains bupropion. In addition,  Contrave might cause other alarming reactions, including hallucinations, delusions, paranoia, aggression and hostility. Moreover, this drug could also lead to seizures.

Some individuals on Contrave have had elevated liver enzymes or even liver injury. Others have had their previously quiescent mania re-activated.

Interactions with Contrave:

Due to interactions with the naltrexone component, people on opioid medications for pain relief should avoid taking Contrave. It could trigger an opioid withdrawal syndrome.

The Bottom Line on Contrave to Lose Weight Safely:

Since Contrave is still a relatively new treatment option, patients and physicians should discuss its pros and cons thoroughly before beginning a prescription. That way, people can consider whether it is the best way for them to lose weight safely.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Sherman MM et al, "Naltrexone/bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obese adults." P & T, March 2016.
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Thanks for information. I once took Contrave and lost weight like crazy. After 6 months and a loss of about 60 pounds, I decided to go it alone. That did not work, and when I wanted to start up again it was too costly for my budget. (I had been on a study program at a reduced cost). Anyway, I had NO side effects other than reduced appetite, and fast weight loss, and slight constipation, which was easily controlled. I am now taking the 2 drugs separately and doing just great again. As my primary will tell you, I do not like pharma drugs when something natural will work. But the Contrave worked for me. Others can make their own decisions.

Have you done a show about KETO? Getting off sugar and starch is how to lose fat.

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