비만 환자에서 12주 Fluoxetine 치료의 용량별 체중 감량 및 식욕 감소 효과 = Dose-response Study of 12-weeks Fluoxetine Therapy on Weight Reduction and Appetite Loss in Obese Patients

다국어 초록 (Multilingual Abstract)

Background: The drug theraphy for obesity could be considered in patients who are BMI$gt;30 kg/㎡ or BMI $gt;25 kg/㎡ with substantial co-morbidity in spite of nonpharmacologic treatment. SSRI (selective serotonin reuptake inhibitors) has been shown to reduce appetite, and decrease body weight in obese patients, and its recommended dose for obesity is 60 mg. The purposes of this study are to investigate the efficacy of low dose fluoxetine (20 mg or 40 mg) in obesity treatment, and the dase-response relationship on weight reduction and appetite loss in obese patients.
Methods: Eighty eight subjects (7 men and 81 women) followed-up after 12 weeks treatment of fluoxetine 20 mg (45) or 40 mg (43) were selected among two hundreds and seventy one patients (34 men and 237 women) who visited into 'Clinic for Obesity' in AMC and were treated for weight control by behavior, diet, exercise, and drug therapy. We monitored and compared anthropometries, dietary intakes, appetite, and adverse events before and after fluoxetine therapy.
Results:
1) The age, anthropometries, and dietary intakes were not different between two groups. 2) The fluoxetine-treated patients lost 6.81 kg with 40 mg compared 4.26 kg with 20 mg. The decrese of BMI were 2.57 kg/㎡ with 40 mg compared 1.64 kg/㎡ with 20 mg. 3) The appetite loss in 40mg fluoxetine-treated group was more prominent than 20 mg fluoxetine-treated group. 4) The dietary intakes in 40 mg fluoxetine-treated group much more decreased than 20 mg fluoxetine-treated group. 5) The adverse events were not significantly different between two groups except nausea.
Conclusion: Fluoxetine therapy combined with behavior, diet, and exercise showed 5.3% weight reduction with 20 mg, and 7.9% with 40 mg in obese patients. There were significant dose-response relationships on weight reduction, appetite loss, and food consumption. Fluoxetine is a comparatively safe and effective adjunctive therapy for obesity treatment. We need long-term clinical trials in drug therapy for obesity treatment.