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The World in Medicine
December 19, 2007

Rimonabant Caution

JAMA. 2007;298(23):2733. doi:10.1001/jama.298.23.2733-c

The antiobesity drug rimonabant increases the risk of severe depression and anxiety, according to a meta-analysis by Danish researchers (Christensen R et al. Lancet. 2007;370[9600]:1707-1713).

Rimonabant targets the endocannabinoid system, which is involved in regulation of food intake and in the central nervous system's reward system. The drug was approved by European authorities in June 2006.

The researchers analyzed data from 4 double-blind, randomized controlled trials, involving more than 4100 participants, that compared 20 mg/d of rimonabant with placebo. Compared with those taking placebo, those who received the drug lost 4.7 kg more weight but experienced significantly more adverse effects and 1.4 times more serious adverse effects. Despite depressed mood being an exclusion criterion in the trials, participants in the rimonabant group were 2.5 times more likely to stop treatment because of depression and 3 times more likely to discontinue treatment because of anxiety.

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