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Short-term effect of sibutramine versus placebo on mood in depressed and non-depressed obese patients

Kristina Elfhag and Stephan Rossner

Background: Sibutramine is an anti-obesity satiety-enhancing drug which elicits its effect by inhibiting the reuptake of serotonin and noradrenalin. Objective: The aim of this study was to test the short-term effect on mood with sibutramine versus placebo in obese patients with and without depressive features. Materials & methods: The participants consisted of 36 obese patients with a mean body mass index of 39 kg/m2. Depressive features were measured with the Comprehensive Psychopathological Rating Scale (CPRS). Sibutramine (15 mg) and placebo were administered daily in a cross-over design over 14-day periods. At baseline, 19 (53%) patients demonstrated depressive features. Results: A significant short-term difference, implying lower mood with sibutramine versus placebo, was observed for depressed patients, in particular, in the CPRS subscale for anxiety. This result persisted as statistically significant also when removing an item on increased sleeping difficulties in the CPRS anxiety scale. Sleeping difficulties, which are common side effects of anti-obesity drugs, were also greater with sibutramine in depressed patients. No differences were found in the nondepressed population. Conclusion: Patients with depressive features can be more susceptible to experiencing a relatively higher initial discomfort with sibutramine compared with placebo at onset of treatment.