Use of a serotonin re-uptake inhibitor, fluoxetine, in the treatment of obesity. Use of fluoxetine, a selective serotonin-uptake inhibitor, in the treatment of obesity: a dose-response study (with a commentary by Michael Weintraub). Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. Use of nutritional supplements to increase the efficacy of fluoxetine in the treatment of anorexia nervosa. Changes in weight during a 1-year trial of fluoxetine. Fluoxetine: a randomized clinical trial in the treatment of obesity. Effect of serotonin re-uptake inhibition by fluoxetine on body weight and spontaneous food choice in obesity. Double-blind placebo-controlled administration of fluoxetine in restricting- and restricting-purging-type anorexia nervosa The addition of dexfenfluramine to fluoxetine in the treatment of obesity: a randomized clinical trial. Fluoxetine, a Selective Serotonin Uptake Inhibitor, for the Treatment of Outpatients with Major Depression An open trial of fluoxetine in patients with anorexia nervosa. Serotoninergic manipulation, meal-induced satiety and eating pattern: effect of fluoxetine in obese female subjects. A randomized, double-blind trial comparing sertraline and fluoxetine 6-month treatment in obese patients with Binge Eating Disorder Efficacy and safety of long-term fluoxetine treatment of obesity--maximizing success. Fluoxetine versus sertraline and paroxetine in major depressive disorder: changes in weight with long-term treatment. The selective serotonin reuptake inhibitor fluoxetine does not change rectal sensitivity and symptoms in patients with irritable bowel syndrome: a double blind, randomized, placebo-controlled study. Fluoxetine in medically stable, depressed geriatric patients: effects on weight.
Health risks associated with obesity are well known and compliance with st and ard regimens for weight reduction is frequently unsatisfactory . Fluoxetine is a specific inhibitor of serotonin re-uptake with very minimal affinity for serotonergic or other receptors . It causes a decrement in food intake in animals . Placebo or fluoxetine was given for up to 8 weeks to non-depressed , otherwise healthy , obese patients given minimal dietary advice . Patients given fluoxetine  lost 4.5 + /- 4.0 kg , significantly more than those receiving placebo , 1.4 + /- 0.1 kg . The weight loss was correlated with the degree of obesity in the  fluoxetine-treated patients .  Asthenia was the only event reported significantly more frequently by fluoxetine-treated patients ( 23 percent ) than by those treated with placebo ( 3 percent ) ( P less than 0.01 ) . Fluoxetine appears to be safe and effective in inducing weight loss over periods of up to 8 weeks Pharmacologic measures which increase serotonergic activity in the brain decrease food consumption and lead to decreased weight in animals .  Fluoxetine , an inhibitor of serotonin reuptake , decreases food intake in animals and is associated with weight loss in depressed and otherwise healthy obese patients . To determine the most effective daily fixed dose which causes weight loss in nondepressed obese patients , fluoxetine ( 10 , 20 , 40 or 60 mg ) or placebo was administered once daily for 8 weeks to 655 patients consisting primarily of women ( mean age 40 years , mean weight 95 kg ) .  Diet and activity were not controlled . The placebo-treated patients lost 0.6 + /- 2.3 kg . With the 60-mg fluoxetine dose , patients lost an average of 4.0 + /- 3.9 kg ( P less than 0.001 ) , with intermediate responses at the lower doses . Weight loss was proportional to the initial body mass index ( weight/height squared ) . There were no statistically significant differences between any fluoxetine treatment group and placebo for discontinuations from the study . There were statistically significant dose-dependent increases in reports of asthenia , somnolence and sweating . Thus , fluoxetine 60 mg daily appears to be potentially effective for use in weight reduction BACKGROUND The effect of extended anti-depressant treatment on weight has been poorly investigated . Also unknown is whether different compounds have differential effects . The aim of the present study was to assess changes in weight in obsessive-compulsive disorder ( OCD ) patients treated for 2.5 years with  clomipramine or selective serotonin reuptake inhibitors . METHOD 138 DSM-IV OCD patients who responded to 6-month acute treatment at the Mood and Anxiety Disorders Unit , Department of Neuroscience , University of Turin , Italy , were followed-up for 2 years while receiving open-label clomipramine , citalopram , fluoxetine , fluvoxamine , paroxetine , or sertraline .  Patients were consecutively recruited and followed from May 1998 to March 2003 . The mean percentage change in weight was compared for each group , as was the proportion of patients who had a > or = 7 % weight increase from baseline . RESULTS At the end of the 2.5-year study period , patients had gained a mean of 2.5 % of their body weight with respect to baseline ( 1.58 kg ) ; 14.5 % of the total sample experienced a significant ( > or = 7 % ) weight increase . Within each but the fluoxetine treatment group , paired t tests showed a significant increase in weight from baseline to final visit . Analysis of variance showed a significant difference between treatment groups ( p = .009 ) , with clomipramine being associated with the highest weight increase and fluoxetine and sertraline with the lowest . A higher proportion of clomipramine-treated patients ( 34.8 % ) gained > or = 7 % in weight as compared with sertraline and fluoxetine , which accounted for the lowest percentage of patients with a significant weight gain ( 4.5 % and 8.7 % , respectively ) , although this difference was not statistically significant . CONCLUSION Risk of weight gain during extended serotonin reuptake inhibitor treatment for OCD differs depending on which compound is used . The differences among antiobsessive drugs may affect compliance with medication and health risks OBJECTIVE Selective serotonin reuptake inhibitor ( SSRI ) medication does not appear to be effective in ill , malnourished anorexia nervosa ( AN ) patients . However , it may be effective in preventing relapse after weight restoration . The purpose of this study was to determine whether nutritional supplements could potentiate the effects of fluoxetine in underweight AN subjects . METHOD Twenty-six subjects with AN participated in a trial of fluoxetine . In a double-blind , placebo-controlled manner , subjects received either nutritional supplements or a nutritional placebo . The nutritional supplement included tryptophan ( the precursor of serotonin ) , vitamins , minerals , and essential fatty acids believed to influence serotonin pathway function . RESULTS There was no significant difference in weight gain between subjects treated with fluoxetine plus nutritional supplements versus fluoxetine plus a nutritional placebo . Moreover , there were no significant differences between groups on mean changes in anxiety or obsessive and compulsive symptoms . DISCUSSION The results of this study suggest that supplement strategies are not a substitute for adequate nutrition and are ineffective in increasing the efficacy of fluoxetine in underweight AN subjects OBJECTIVE Fluoxetine has been associated with weight loss during acute treatment , but no controlled studies of weight change during long-term treatment with fluoxetine or other selective serotonin reuptake inhibitors have been reported . Weights were assessed for patients whose depressive symptoms had disappeared with acute fluoxetine treatment . Patients were then r and omly assigned to continuation treatment with fluoxetine or placebo . METHOD Patients whose illness had remitted after 12 weeks of treatment with fluoxetine , 20 mg/day , were r and omly assigned to receive up to 38 weeks of treatment with fluoxetine or placebo .  Weight was assessed at each visit . Change in weight was analyzed during the initial 12 weeks of acute treatment and after 14 , 26 , and 38 weeks . Relationships between weight change and body mass index and between weight change and appetite change were assessed . RESULTS During the initial 4 weeks of therapy , a mean absolute weight decrease of 0.4 kg was observed for all patients . Among patients who completed 50 weeks of therapy , the mean absolute weight increase during continuation treatment was similar for both the placebo- and fluoxetine-treated groups . Weight increase was not related to initial body mass index but was related to both poor appetite at study entry and to improvement in appetite after recovery . No patients discontinued therapy because of weight gain . CONCLUSIONS Acute therapy with fluoxetine is associated with modest weight loss . After remission of depressive symptoms , weight gain for patients taking fluoxetine for longer periods is not different from that for patients taking placebo and is most likely related to recovery from depression Fluoxetine hydrochloride ( Lovan , Eli Lilly and Company , Indianapolis , Indiana , USA ) , a specific serotonin uptake inhibitor , was compared with placebo in 458 obese out patients in a 52-week double-blind r and omized ten-site trial to study its effect on weight reduction .  Patients in the fluoxetine and placebo groups were predominantly Caucasian ( 81 % and 85 % , respectively ) and female ( 81 % and 79 % , respectively ) , with a mean body mass index ( BMI ) of 36.2 and 35.8 kg/m2 , respectively , and a mean age of 43 years ( both groups ) .  Fluoxetine therapy ( 60 mg/day ) result ed in statistically significantly ( P < or = 0.05 ) greater mean weight loss than placebo to week 28 . Although some patients continued to lose weight throughout the 52-week therapy period , maximum mean weight loss occurred at week 20 . There was no treatment difference at 52 weeks . The change in visit frequency ( biweekly to week 8 , monthly to week 20 , then bimonthly to week 52 ) may have affected results . Patients with higher baseline BMI s ( > 40 kg/m2 ) attained and maintained a greater weight loss than patients with lower baseline BMI s ( < 40 kg/m2 ) . Two sites demonstrated greater efficacy than the study as a whole . The use of nutrition counselling at one site and behaviour modification at the other , or other site-to-site differences , may account for the improved efficacy . Fluoxetine was well tolerated and appeared to be safe therapy for the treatment of obesity with efficacy demonstrated for 28 weeks The effect of fluoxetine on body weight and spontaneous food choice was studied in twenty-three healthy , non-depressed , obese females on an outpatient basis . After a one week placebo run-in period , subjects were r and omized to receive either fluoxetine ( FXT ) 60 mg daily ( n = 11 ) or placebo ( P ) ( n = 12 ) for 6 weeks in a double blind study design .  BMI ( 35.2 + /- 0.8 vs 36.4 + /- 1.3 kg/m2 , mean + /- s.e.m . ) and age ( 38.1 + /- 239 vs 37.3 + /- 2.7 years ) were not different in either group . No specific diet was prescribed . On four separate days per 14 days food records were collected . Data were analysed with the use of food composition tables . Statistical analysis was performed using Student 's t test for independent sample s for data on body weight and calorie intake . Macro-nutrient composition of the diet was analysed using multivariate analysis of variance and post hoc Student 's t test for independent sample s. All subjects lost weight during fluoxetine treatment . Mean ( + /- s.e.m . ) weight loss in the fluoxetine treated group was 3.6 + /- 0.5 kg , compared to a mean weight gain of 0.3 + /- 0.5 kg in the placebo treated group ( P less than 0.001 ) . In all patients food intake was reduced during fluoxetine treatment and this reduction could fully account for the observed weight loss . The mean total caloric intake per day was significantly lower during fluoxetine treatment compared with placebo ( FXT 1123 + /- 118 kcal vs P 1845 + /- 87 kcal , P less than 0.001 ) . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND Anorexia nervosa is an often chronic disorder with high morbidity and mortality . Many people relapse after weight restoration . This study was design ed to determine whether a selective serotonin reuptake inhibitor would improve outcome and reduce relapse after weight restoration by contributing to maintenance of a healthy normal weight and a reduction of symptoms . METHODS We administered a double-blind placebo-controlled trial of fluoxetine to 35 patients with restricting-type anorexia nervosa . Anorexics were r and omly assigned to fluoxetine ( n = 16 ) or a placebo ( n = 19 ) after inpatient weight gain and then were observed as out patients for 1 year . RESULTS Ten of 16 ( 63 % ) subjects remained on fluoxetine for a year , whereas only three of 19 ( 16 % ) remained on the placebo for a year ( p = .006 ) . Those subjects remaining on fluoxetine for a year had reduced relapse as determined by a significant increase in weight and reduction in symptoms . CONCLUSIONS This study offers preliminary evidence that fluoxetine may be useful in improving outcome and preventing relapse of patients with anorexia nervosa after weight restoration Current evidence demonstrates that pharmacologic agents , alone or in combination produce short-term weight-loss and may remain effective for extended periods of time in obese patients . We have evaluated the weight loss of a selective inhibitor of serotonin uptake , fluoxetine , alone as compared with combined therapeutic trial with another serotoninergic drug , dexfenfluramine .  Thirty-three patients were r and omly assigned in a double-blind r and omized clinical trial divided to two groups : Group I [ Fluoxetine 40 mg and placebo ( n = 13 ) ] and Group II [ Fluoxetine 40 mg plus dexfenfluramine 15 mg at night ( n = 20 ) ] . Both groups had a significant weight loss at the end of 8 months ( Group I , mean + /- SEM 6.2 + /- 2.8 kg and Group II 13.4 + /- 6.3 kg , p < 0.05 ) . Group II patients had a significantly greater weight loss as compared with Group I both in terms of mean weight loss in kg and BMI in kg/m2 . However significance between Group I and II related to BMI mean values and weight mean values were only achieved after , respectively , 4 and 6 months of treatment . At laboratory level there was an elevation of HDL-cholesterol and lowering of serum lipids values ( cholesterol and triglycerides ) in both groups . Side effects were relatively minor and no altered clinical vital signs or abnormal laboratory values were observed . We concluded that the combination of fluoxetine ( daytime ) and dexfenfluramine ( at night ) may be more effective than fluoxetine alone in weight reduction although the small size of this study does not permit broad generalization In a double-blind , placebo-controlled study the authors found that fluoxetine , a potent and selective inhibitor of serotonin reuptake , was an effective antidepressant in moderately depressed , ambulatory out patients . Typical adverse effects reported by patients treated with fluoxetine  included agitation , nausea , fatigue , and insomnia . Compared to imipramine , fluoxetine was associated with fewer complaints of dry mouth , constipation , and dizziness BACKGROUND Anorexia nervosa is a disorder of unknown etiology with a high rate of relapse and no known treatment . Because anorexia nervosa shares some similarities with obsessive compulsive disorder , we hypothesized that a serotonin-specific medication might be useful in the treatment of this illness . METHOD We administered an open trial of fluoxetine to 31 patients with DSM-III-R anorexia nervosa . Most anorexics were started on fluoxetine treatment after inpatient weight restoration and then discharged from the hospital and followed up as out patients . RESULTS At the time of follow-up ( 11 + /- 6 months on fluoxetine ) , 29 of the 31 patients had maintained their weight at or above 85 % average body weight ( 97 % + /- 13 % average body weight for the group ) . We judged response as good in 10 , partial in 17 , and poor in 4 anorexics as measured by improvements in eating behavior , mood , and obsessional symptoms . Restrictor anorexics responded significantly better than bulimic and /or purging-type anorexics . CONCLUSION This open trial suggests that fluoxetine may help patients with anorexia nervosa maintain a healthy body weight as out patients . The reasons for the positive effects of fluoxetine are uncertain , but the agent may help by improving eating behavior and /or reducing obsessionality , depression , and anxiety . It is important to emphasize that this was not a double-blind , placebo-controlled study . Thus we can not be certain of the efficacy of fluoxetine and caution that fluoxetine should not be used as the sole treatment of anorexia nervosa at this time Twelve nondepressed healthy female obese subjects ( BMI > 30 kg/m2 ) took part in a study which conformed to a double-blind r and omized crossover design . Each subject acted as her own control across 2 weeks of treatment with either 60 mg of the 5-HT reuptake inhibitor fluoxetine or matching placebo . On days 7 and 14 of both treatment phases subjects were provided with fixed energy lunch meals high in either CHO or fat . The effect of these meals on satiety during the fluoxetine and placebo phases was assessed by a battery of procedures . Subjects felt less hungry after consuming the high CHO meal than after consuming the high-fat meal . They also felt less hungry when taking fluoxetine than when taking the placebo . Analysis of energy intake from the test meal revealed a main effect of prior lunch meal type ( high CHO or high fat ) and a main effect of drug treatment . Subjects consumed an average of 574 kcal following the high CHO meal compared to 689 kcal following the high-fat meal . Subjects also consumed an average of 532 kcal when taking fluoxetine compared to 730 kcal when taking the placebo . Fluoxetine did not exert any significant effects on macronutrient selection . Mean daily energy intake , calculated from food diary records , was 1881 kcal when subjects were taking the placebo compared to 1460 kcal when taking fluoxetine ( a reduction of 22.4 % ) . Fluoxetine treatment produced a significant weight loss of 1.97 kg over the two weeks of treatment compared to a weight loss of only 0.04 kg on placebo Previous studies support the use of selective serotonin reuptake inhibitors ( SSRIs ) , in overweight patients with Binge Eating Disorder ( BED ) , but results are far from conclusive . Sertraline has been studied less extensively , and there have been a few studies concerning SSRIs that report follow-up data at more than 12 weeks of follow-up . The present study assesses the effectiveness of sertraline and fluoxetine over a period of 24 weeks in obese patients with BED ( DSM-IV-TR ) . Forty-two obese out patients were r and omized and assigned to one of two different drug treatments : 22 were treated with sertraline ( dose range : 100 - 200 mg/day ) and 20 with fluoxetine ( dose range : 40 - 80 mg/day ) . Subjects were assessed at baseline and at 8 , 12 , and 24 weeks of treatment for binge frequency , weight loss , and severity of psychopathology . No significant differences were found between the two treatments . After 8 weeks of treatment a significant improvement in the Binge Eating Scale score and a significant weight loss emerged . These results were maintained by responders ( weigh loss of at least 5 % of baseline weight ) over 24 weeks . The results suggest that a 6-month treatment with SSRI may be an effective option to treat patients with BED Obesity is a major health care concern because of its associated medical complications and increased mortality . Despite a myriad of short-term weight loss strategies and the motivation of improving health , patients have difficulty maintaining reduced weight . Pharmacologic agents , such as fluoxetine , a selective serotonin uptake inhibitor , have been investigated as adjunctive therapy to st and ard weight management programs . Extended therapy with fluoxetine has demonstrated clinical ly meaningful benefits on weight loss and obesity-associated medical conditions in double-blind placebo-controlled studies . However , the magnitude of these benefits for individuals vary . Such findings are consistent with the belief that the obesity syndrome has differing etiologies . Accordingly not all patients are likely to benefit from a particular therapy . Studies should identify patient subgroups that are more likely to respond to a specific therapy . In this study of 719 fluoxetine-treated and 722 placebo treated patients in four multicenter , r and omized , double-blind , long-term clinical trials , we investigated possible predictors of a beneficial long-term outcome from fluoxetine therapy . Patients ' age , current smoking activity , and baseline uric acid concentration were predictors of a meaningful long-term treatment effect . Further review of the weight loss patterns of patients achieving long-term success provided the basis for a treatment monitor . Use of the predictors and the treatment monitor are strategies to maximize the benefits of therapy through improved patient selection and monitoring during a therapeutic program BACKGROUND The effects of extended selective serotonin reuptake inhibitor ( SSRI ) treatment on weight are not well characterized . Also unknown is whether different agents have differential effects . To examine these questions , we assessed weight changes in patients r and omly assigned to long-term treatment with  fluoxetine , sertraline , or paroxetine . METHOD Patients ( N = 284 ) with major depressive disorder ( DSM-IV ) were r and omly assigned to double-blind treatment with fluoxetine ( N = 92 ) , sertraline , ( N = 96 ) , or paroxetine ( N = 96 ) for a total of 26 to 32 weeks . The mean percent change in weight was compared for each group , as was the number of patients who had > or = 7 % weight increase from baseline . RESULTS Patients ( fluoxetine , N = 44 ; sertraline , N = 48 ; paroxetine , N = 47 ) who completed the trial were included in these analyses . Paroxetine-treated patients experienced a significant weight increase , fluoxetine-treated patients had a modest but nonsignificant weight decrease , and patients treated with sertraline had a modest but nonsignificant weight increase . The number of patients whose weight increased > 7 % from baseline was significantly greater for paroxetine-treated compared with either fluoxetine-treated or sertraline-treated patients . CONCLUSION Risk of weight gain during extended SSRI treatment differs depending on which SSRI is used BACKGROUND & AIMS Although widely prescribed , the evidence for the use of antidepressants for the treatment of irritable bowel syndrome ( IBS ) is limited . In this study , we hypothesized that fluoxetine ( Prozac ) , a selective serotonin reuptake inhibitor , has visceral analgesic properties , leading to increased sensory thresholds during rectal distention and improvement of symptoms , in particular in IBS patients with visceral hypersensitivity . METHODS Forty non-depressed IBS patients underwent a rectal barostat study  to assess the sensitivity to rectal distention before and after 6 weeks of treatment with fluoxetine 20 mg or placebo .  Abdominal pain scores , individual gastrointestinal symptoms , global symptom relief , and psychologic symptoms were assessed before and after the intervention . RESULTS At baseline , 21 of 40 patients showed hypersensitivity to rectal distention . Fluoxetine did not significantly alter the threshold for discomfort/pain relative to placebo , either in hypersensitive ( 19 + /- 3 vs. 22 + /- 2 mm Hg above MDP ) or in normosensitive ( 34 + /- 2 vs. 39 + /- 4 mm Hg above MDP ) IBS patients . Overall , 53 % of fluoxetine-treated patients and 76 % of placebo-treated patients reported significant abdominal pain scores after 6 weeks ( not significant ) . In contrast , in hypersensitive patients only , fluoxetine significantly reduced the number of patients reporting significant abdominal pain . Gastrointestinal symptoms , global symptom relief , and psychologic symptoms were not altered . CONCLUSIONS Fluoxetine does not change rectal sensitivity in IBS patients . Possible beneficial effects on pain perception need to be confirmed in larger trials This study assessed the effect of fluoxetine 20 mg/day on weight loss in older patients treated for major depression in a multicenter , double-blind placebo-controlled , 6-week clinical trial . Thirty U.S. outpatient clinics affiliated with psychiatric programs participated in the study that involved 671 medically stable out patients at least 60 years old who had normal cognition and met DSM-III-R criteria for major depression .  Weight was recorded at weekly visits . As a measure of adiposity , patients were categorized into two groups , high and low/normal body mass index ( BMI ) groups . Analyses were done for each group . The high BMI group , but not the low/normal BMI group , had a statistically greater proportion of fluoxetine-treated patients who lost at least 5 % of their baseline weight . Overall mean weight change for the fluoxetine-treated patients was about 1 % compared with essentially no change for placebo-treated patients . Only one patients , who was treated with fluoxetine and in the low/normal BMI group , discontinued from the study because of weight loss . Although 5 % weight loss occurred in more fluoxetine-treated than placebo-treated patients , most of the patients who lost weight had higher adiposity at baseline . There was not a statistically significant difference in the proportion of fluoxetine-treated and placebo-treated patients in the low/normal group who had at least 5 % weight loss . Medically relevant weight loss in older patients treated with fluoxetine was uncommon
Low-certainty evidence suggests that off-label fluoxetine may decrease weight compared with placebo .
However , low-certainty evidence suggests an increase in the risk for dizziness , drowsiness , fatigue , insomnia and nausea following fluoxetine treatment
BACKGROUND Fluoxetine is a serotonin reuptake inhibitor indicated for major depression .
It is also thought to affect weight control : this seems to happen through appetite changes result ing in decreased food intake and normalisation of unusual eating behaviours .
However , the benefit-risk ratio of this off-label medication is unclear .
OBJECTIVES To assess the effects of fluoxetine for overweight or obese adults .