Mood Emot 2024 Mar; 22(1): 19-26   https://doi.org/10.35986/me.2024.22.1.19
Efficacy of Naltrexone-Bupropion and Phentermine-Topiramate in Psychiatric Patients: A Retrospective Study at a University Outpatient Clinic
Min-Kyu Song, MD1 , Won-Seok Choi, MD, PhD2 , Young Sup Woo, MD, PhD2 , Won-Myong Bahk, MD, PhD2
1St. Mary’s Gong-Gam Mental Health Clinic, Siheung, 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Won-Myong Bahk, MD, PhD
Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea
TEL +82-2-3779-1051 FAX +82-2-761-8497 E-mail wmbahk@catholic.ac.kr ORCID https://orcid.org/0000-0002-0156-2510
Young Sup Woo, MD, PhD
Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea
TEL +82-2-3779-1139 FAX +82-2-780-6577 E-mail youngwoo@catholic.ac.kr ORCID https://orcid.org/0000-0002-0961-838X
Received: December 22, 2023; Accepted: January 27, 2024; Published online: March 31, 2024.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders.
Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred.
Results: A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs. 40.0%, p=0.022)
Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.
Keywords: Obesity; Psychiatric patients; Anti-obesity drug; Safety; Efficacy

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