Controversial Weight Loss Drug Available For NHS Use

Despite fears of an increased risk of depression and possible suicide as a 'side-effect', a controversial anti-obesity drug has been made available for NHS use.

Although not licensed in the US - or in Scotland - Rimonabant, sold as Acomplia, is already in wide use in other parts of the UK and it is claimed that coupled with exercise, it could help patients lose up to 10% of their body weight.

The National Institute for Health and Clinical Excellence (NICE) has published final guidance on the use of rimonabant for the treatment of the overweight and obese patients.

Among the guidance recommended is that rimonabant treatment should be continued beyond six months only if the individual has lost at least 5% of their initial body weight since starting the treatment.

Also, it is recommended that rimonabant treatment should not be continued for longer than two years without a formal clinical assessment and discussion of the individual risks and benefits with the person receiving treatment.

Andrew Dillon, NICE Chief Executive said: "The independent advisory committee recommended rimonabant, along with diet and exercise, as a treatment option for adults who are obese or overweight. This good news for patients from whom orlistat and sibutramine are not effective.

"Being overweight or obese can lead to a range of serious health problems, including heart disease, type 2 diabetes, osteoarthritis and some cancers. These recommendations should be used in conjunction with the NICE guideline 'Obesity: the prevention, identification, assessment, and management of overweight and obesity in adults and children' published in December 2006."

Last year, the European Medicines Agency warned that rimonabant "may be unsafe" for patients also taking anti-depressants.

Doctors have been told not to give it to patients with a history of severe depression and to be alert to new symptoms of depression in patients taking the drug.

Evidence suggests that one in 10 might develop mental side-effects including low mood and depression as well as anxiety and sleep disorders.

However, it can also lead to weight loss and improve general health.

Dr David Haslam, the Clinical Director of the National Obesity Forum says that he "welcomes" its approval for NHS use.

Dr Haslam said it "is a very good drug" and there are "very many people" who might benefit from it.

However, Professor Alan Maryon-Davis, President of the UK Faculty for Public Health said that "whilst these drugs may be right for some patients", they are "not the long-term solution" and "may have potentially serious side-effects".

Rimonabant was first made available in the UK in 2006. The Medicines and Healthcare Products Regulatory Agency has received 720 reports of adverse drug reactions covering 2,123 individual reactions.

Scotland and the US have yet to approve the drug.

It is reported that rimonabant is the first selective CB1 receptor blocker to be approved for use anywhere in the world. AS of 2008, the drug is available in 56 countries.

People in the UK, Germany and France are the highest users of the drug worldwide.

(DS)