Two Drugs for Treating Addiction Help with Obesity
Naltrexone and Buproprion may have applications in treating obesity as well
Interview with Dr. Gene-Jack Wang, Senior Clinician and Clinical Director, Laboratory of Neuroimaging, National Institute of Alcohol Abuse and Alcoholism.
In this post, Dr. Wang, former chairman of the Brookhaven National Laboratory Medical Department, comments on an article he co-authored in the International Journal of Obesity that holds out hope for patients suffering from obesity.
Q. Dr. Wang, the journal article, “Effect of combined naltrexone and bupropion therapy on the brain’s reactivity to food cues,” is difficult for lay people to decipher, especially because of technical medical references like “insular and subcortical brain regions,” to give one example. Is the following interpretation correct?
Naltrexone (generic names are Revia and Depade) reduces the craving for alcohol and opioids for people in recovery, and Bupropion (also called Wellbutrin) reduces the high a person taking meth experiences, as well as the cravings that visual cues prompt. Researchers have found that the two drugs taken together also help people suffering from obesity by working in a similar way: they reduce the craving for food and dull the visual cues associated with food.
A. Since we assessed global changes during the food cues, our results suggested the combination of two medications have greater synergic effects which were more than the effects reported by other investigators. We found greater activation in brain regions involving self-control, internal awareness and memory (i.e., prefrontal, insular, hippocampal regions) and decreased activation in the hypothalamus, which integrates hunger and satiety signals. These changes might underlie therapeutic benefits of the combined medications.
Q. Are the study results important because experts have already seen success with these drugs in those suffering from addiction? Why is that important? And is this study also important because while all medications have side effects, these drugs don’t affect the heart in the same way that obesity drugs do?
A. Each medication has its mechanism for addiction treatment. The importance of the medications is the combination of treating opiate and dopamine systems. These two systems contribute greatly to eating behaviors. Neither one of the medications has side effects on heart. The combination of medication can also decrease the dose of each one when you give it alone.
Q. Is the study also important because it means that we can use an existing drug now, while waiting for more treatments?
A. The neurobiological mechanism of obesity is very complex. It would be very difficult to find one medication that can treat all patients for obesity. The combination of medications can have a synergic effect and decrease side effects of individual medication if there are any. Even we find a better solution or medication in the future, we still can combine it with other existing medications to treat those patients in need.