Medical and Dental Defence Union of Scotland - Protecting you since 1902
25 June 2008
The drug rimonabant has been approved for use in England and Wales for the treatment of obesity with a proviso on risks for patients with pre-existing depression.
New NICE guidance recommends the use of rimonabant as a possible treatment for adults who are obese (BMI of 30 or more) or who are overweight (BMI of 27 or more) and have risk factors, such as type 2 diabetes or high levels of cholesterol. The drug should be used in addition to diet and exercise for adults who have had an inadequate response to, are intolerant of or are contraindicated to the weight-loss medicines orlistat and sibutramine.
NICE further recommends that treatment with rimonabant should continue for longer than 6 months only if the person has lost at least 5% of their body weight since starting treatment. Treatment should be stopped if the person returns to their original body weight, and should only be continued beyond 2 years after a medical assessment and discussion of the risks and benefits.
The committee also recommended that clinicians consult NICE guidelines on the management of anxiety and depression when considering the presence of current or previous depressive disorders/mood alterations and during regular monitoring for the emergence of such symptoms.
Rimonabant is contraindicated in people with major depressive illness or those receiving concomitant treatment with antidepressants, people with uncontrolled psychiatric illness and people with severe renal impairment. The summary of product characteristics (SPC) states that if depression or psychiatric illness is diagnosed during rimonabant therapy, treatment must be stopped.
Link to the full guidance: Obesity - rimonabant
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