Recently, the media has been all aflutter (here, here, and in many other places) about Contrave, the next great hope in weight loss drugs. Currently in FDA testing, Contrave is not a new drug at all, rather it is the combination of two drugs (Welbutrin and Naltrexone) which have been on the market for years. According to Orexigen Therapeutics Inc (the producer of Contrave) Contrave takes the metabolism boosting power of Welbutrin and combines it with the craving killing power of Naltrexone to help you lose weight.
Welbutrin has been used for years as an anti-depressant and Naltrexone is used to treat various addictions. With an almost combined 20 years of every day use by patients, I began to wonder if Contrave was anything to get excited about, at all. It occurred to me that if someone was so inclined that they could go to their doctor and get a prescription for both Welbutrin and Naltrexone bypassing that whole messy FDA phase three study thing we’ve all been hearing about.
So then why bother re-branding two drugs that have been available for a combined two decades? First, the FDA approves drugs for a specific purpose, and anything else is considered off label. Even if Topamax does help a lot of people lose weight, it is still a migraine/anti-seizure medication according to the FDA. If doctors prescribe you a drug for an off-label use, and it kills you your doctor could be in serious trouble. Second, a new weight-loss drug (especially one that won’t make your heart beat so fast that it kills you, or cause ‘leakage’) is sure to be a “blockbuster drug” just like Viagra or Cialis is which means an incredible amount of money for the Orexigen (and their investors).
It seems odd to me that research money was spent trying different combinations of drugs rather than trying to come up with a new and more effective way to treat obesity. Weight loss is a potential side effect of many drugs, but there are very few drugs (according to the FDA) which actually help people lose weight, and keep it off. If Contrave is approved for the treatment of obesity, then shouldn’t the treatment of obesity then be applied as label usages of both Welbutrin and Naltrexone? Make no doubt about it, Orexigen will be going to great lengths to make sure this doesn’t happen, and that is the problem with this entire situation.
I am all for anything that will make people lead healthier lives, at the same time Contrave seems like taking half of a Ford Mustang, and Half of a Dodge Challenger, combining them and calling it a Chalstang. You’re still taking two things that have exited for a really long time and blending them together. Could Contrave help a great number of people, lose weight? YES! Will it do a better job than just taking the sum of its parts (and at much much cheaper prices)?
I don’t see how it could.
Andrew