Contrave

Potential Health Benefits of Contrave

• Promotes weight loss [2-22]
• Wards off depression [23-36]
• Reduces blood sugar levels [2, 37-38]
• Improves sexual function [39-47]
• Improves cholesterol levels [48-50]
• Treats cigarette addiction [51-55]

What is Contrave?

Contrave is an FDA-approved drug for adults with a body mass index (BMI) of 30 or higher who wants to lose weight. In some cases, doctors recommend this drug for patients with a BMI of 27 or higher who have one or more weight-related conditions or illnesses, such as hypertension, high cholesterol, or type 2 diabetes. [1] The active ingredients in contrave are bupropion, an antidepressant, and naltrexone, a drug used to combat opioid addiction.

How Contrave Works

The exact neurochemical mechanism by which contrave exerts its weight loss effects is by affecting the function of the hypothalamus, the hunger center of the brain. This in turn promotes satiety, reduces food intake, and boosts energy expenditure. The combination of bupropion and naltrexone also works on the mesolimbic pathway, the brain network that provides rewarding feelings. By regulating this pathway, food-seeking behaviors will be significantly reduced.

Chemical Structure of Contrave

Research on Contrave

Promotes Weight Loss

The main benefit of this FDA-approved drug is to help overweight and obese people achieve a healthier weight and lower their risk for weight-related medical conditions. An overwhelming body of clinical evidence supports this:

1. In overweight/obese individuals with type 2 diabetes, administration of 32 mg naltrexone sustained-release (SR)/360 mg bupropion SR (NB) resulted in significantly greater weight reduction. [2]
2. In non-diabetic patients, three phase 3 trials of naltrexone SR plus bupropion SR (NB) demonstrated significant weight loss without any adverse side effects. [3-5]
3. When combined with lifestyle intervention and modest calorie reduction, the naltrexone–bupropion combination appears to achieve clinically significant weight loss (over 5% of total body weight)after 6 months to 1 year of treatment. [6]
4. A study found that contrave treatment was associated with 3 to 7% weight loss and improvements in obesity-related comorbidities and cardiovascular risk factors. [7]
5. Patients who received 1 year of naltrexone ER/bupropion ER combination therapy with greater than 5% weight lost were likely to maintain clinically significant results. [8]
6. In overweight and obese patients, naltrexone/bupropion (NB) combination therapy was associated with significantly greater weight loss. [9]
7. In patients with uncomplicated obesity, combined bupropion and naltrexone therapy caused gradual sustained weight loss over 48 weeks. [10]
8. In middle-aged white females, contrave treatment significantly reduced weight. [11-13]
9. In obese mice, contrave significantly reduced weight by increasing the activity of POMC cells, which are peptides that play an integral role in weight regulation. [14]
10. Direct injection of bupropion and naltrexone in mice produced a greater reduction in food intake. [15-16]
11. In obese patients, contrave treatment reduced body fat and visceral adipose tissue. [17]
12. A study found that contrave has a greater weight loss efficacy than other FDA-approved drugs for obesity, such as orlistat and lorcaserin. [18]
13. Studies also found that contrave has favorable effects on obesity, medication-related weight gain, and binge eating behaviors. [19-22]

Wards Off Depression

There’s also a good deal of evidence supporting the mood-boosting properties of this FDA-approved weight loss drug:

1. An analysis of several studies found that there is a strong correlation between obesity and depression, suggesting that weight loss treatment with contrave can have positive effects on mood. [23-31]
2. In overweight/obese women with major depressive disorder, contrave therapy for 24 weeks was associated with improvement in depressive symptoms. [32]
3. A large pooled analysis of 5 clinical trials found that contrave was associated with lesser depressive symptoms and psychiatric adverse events compared to placebo. [33-34]
4. In patients with major depression, treatment with contrave reduced binge eating, a common symptom of depression. [35]
5. Administration of low-dose naltrexone in combination with bupropion in patients with major depressive disorder significantly reduced the incidence of relapse and recurrence. [36]

Reduces Blood Sugar Levels

Not only does contrave improves body composition but it can also help bring down high levels of blood sugar. Evidence suggests that it can be beneficial for diabetic patients as well as those with chronic elevations in blood sugar levels:

1. In overweight and obese patients with type 2 diabetes, treatment with 32 mg naltrexone sustained-release (SR)/360 mg bupropion SR (NB) was associated with improvement in blood sugar control as evidenced by a greater reduction in hemoglobin A1c (HbA1c). [2]
2. In diabetic patients, naltrexone/bupropion therapy decreased HbA1c approximately 0.5% more than placebo. [37]
3. In overweight and obese patients, contrave also decreased major cardiovascular risk factors such as high blood sugar. [38]

Improves Sexual Function

Evidence suggests that contrave has beneficial effects on the sexual health of both men and women:

1. Studies suggest that obesity is linked with greater impairment in sexual function, suggesting that losing weight through contrave supplementation can have a positive impact on sexual health. [39-42]
2. Bupropion, the component of contrave, has been reported to have pro‐sexual effects. [43-46]
3. In obese patients, administration of contrave significantly improved sexual function as well as the quality of life. [47]

Improves Cholesterol Levels

Contrave-induced weight loss is known to play a role in reducing high cholesterol levels. Studies found that patients taking this drug had better lipid profiles:

1. In obese patients, naltrexone/bupropion combination significantly reduced the levels of low-density lipoprotein (bad cholesterol) and increased the levels of high-density lipoprotein (good cholesterol). [48]
2. In overweight and obese patients, daily treatment with contrave increased high-density lipoprotein cholesterol and decreased triglycerides. [49]
3. In obese adults undergoing weight management, contrave administration also increased high-density lipoprotein cholesterol. [50]

Treats Cigarette Addiction

High-quality clinical trials show that contrave treatment can be considered a safe and effective smoking cessation strategy:

1. A preliminary investigation of the combination of naltrexone and bupropion as a treatment for cigarette addiction showed increased smoking cessation rates. [51]
2. Smokers who received contrave treatment for 7 weeks reported reduced nicotine withdrawal. [52]
3. A study found that both naltrexone and bupropion can help improve adherence to smoking cessation interventions. [53]
4. One clinical trial found that subjects treated with low-dose naltrexone combined with bupropion stopped cigarette smoking with lesser weight gain. [54]
5. In overweight or obese smokers, combination therapy of naltrexone and bupropion was associated with decreased nicotine use, limited nicotine withdrawal symptoms, and no significant weight gain. [55]

Associated Side Effects of Contrave

Contrave side effects are very uncommon. There have been some side effects associated with the use of this drug wherein the patient had one of the issues listed below at some point while being on contrave. However, these side effects weren’t confirmed to be associated with the treatment and could have been a coincidence and not related to the use of contrave. Despite this, it was listed as a side effect associated with contrave even though these associated side effects are very uncommon.

Side effects associated with contrave may include the following:

• Constipation
• Diarrhea
• Dizziness
• Dry mouth
• Headache
• Insomnia
• Nausea
• Vomiting

References

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