Diet Drugs

Contrave contains a combination of bupropion and naltrexone. Bupropion is an antidepressant medicine that can also decrease appetite. Naltrexone is usually given to block the effects of opioids or alcohol in people with addiction problems. Naltrexone may also curb hunger and food cravings.

Warnings

• You should not use Contrave if you have uncontrolled high blood pressure, seizures, an eating disorder, opioid addiction, if you take opioid medicine or other forms of bupropion, have bulimia or anorexia nervosa, are taking a MAOI, or if you have suddenly stopped using alcohol, seizure medication, or a sedative.

Do not use Contrave if you are pregnant.

• Some young people have thoughts about suicide when first taking bupropion. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
• Do not take Contrave if you also take narcotic medicine or other forms of bupropion (such as Wellbutrin or Zyban), or if you are going through withdrawal from alcohol or drug addiction.

What to avoid
Drinking alcohol with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can also cause seizures in a regular drinker who suddenly stops drinking.
Follow your doctor's instructions about any restrictions on food, beverages, or activity. Do not take other weight-loss products or diet pills unless your doctor has told you to.
Do not use opioid medication, methadone, heroin, or other street drugs while you are taking Contrave. Doing so could result in dangerous effects, including coma and death.

Contrave side effects
Get emergency medical help if you have signs of an allergic reaction to Contrave: fever, swollen glands, mouth sores, muscle or joint pain; hives, rash or itching; chest pain, difficult breathing; swelling of your face, lips, tongue, or throat.
A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, severe drowsiness, or if you are hard to wake up.

GLP-1s reduce body weight by 5–18 % in trials, with modestly lower effects in real-world analyses, with multiple demonstrated clinical benefits.
Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness.
Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread.
Priorities to address this include:
(a) patient-centered initiation of GLP-1s, including goals for weight reduction and health;
(b) baseline screening, including usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions;
(c) comprehensive exam including muscle strength, function, and body composition assessment;
(d) social determinants of health screening;
(e) and lifestyle assessment including aerobic activity, strength training, sleep, mental stress, substance use, and social connections.