Naltrexone is a prescription medication primarily used to treat opioid and alcohol addiction. While its primary function is to manage substance use disorders, research indicates it may also influence weight. This article explores the connection between naltrexone and weight loss, including its mechanisms, potential benefits and risks, and optimal timing for usage.
What is Naltrexone?
Naltrexone, sold under brand names like Revia and Vivitrol, is approved by the Food and Drug Administration (FDA) for treating opioid and alcohol addiction. Revia and generic naltrexone, available in pill form, are typically prescribed for alcohol use disorder, while Vivitrol, an extended-release intramuscular formulation, is approved for opioid and alcohol addiction. Naltrexone functions as an opioid receptor antagonist, binding to opioid receptors in the brain and blocking the euphoric effects of opioids and alcohol, thereby reducing cravings.
The Connection Between Naltrexone and Weight Loss
The observation that some individuals taking naltrexone for addiction management experienced unintentional weight loss led to investigations into its potential role in weight management. Naltrexone's impact on appetite is linked to its ability to block opioid receptors, which affects various bodily functions.
How Naltrexone Affects Appetite
Naltrexone's blockade of opioid receptors can reduce the reward feedback system associated with food consumption. Overeating, particularly of sugary and fatty foods, typically triggers a rush of satisfaction. Naltrexone diminishes this effect, reducing the incentive to overeat. A 2011 study indicated that individuals taking naltrexone were three times more likely to lose 15% of their body weight.
Naltrexone and Bupropion Combination
Many studies focus on combining naltrexone with bupropion, an antidepressant that also reduces tobacco cravings. The combination of naltrexone and bupropion can enhance weight loss effects. Naltrexone helps prevent overeating, while bupropion boosts energy and stabilizes mood. This combination is available as a single medication called Contrave.
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Advantages of Using Naltrexone for Weight Loss
Naltrexone offers several potential advantages for weight management:
- Lowered Appetite: Naltrexone can reduce the frequency and intensity of food cravings.
- Reduced Incentive to Overeat: By diminishing the satisfaction derived from overeating, naltrexone can help reduce binge eating.
- Improved Mood: Especially when combined with bupropion, naltrexone can stabilize mood and reduce stress.
- Stabilized Blood Sugar: Naltrexone improves insulin sensitivity, reducing drastic blood sugar swings.
- Increased Growth Hormones: Naltrexone can increase the growth hormone response.
Potential Side Effects and Concerns of Using Naltrexone for Weight Loss
Despite its benefits, naltrexone is not a foolproof weight loss solution and has potential side effects. In a 2017 study, 22% of participants withdrew due to side effects, the most common being gastrointestinal upset and nausea. Other potential side effects include:
- Nausea and vomiting
- Dizziness
- Sleepiness
- Sleep disturbances
- Muscle cramps and joint pain
- Headache and toothache
- Flu-like symptoms
- Anxiety and irritability
- Constipation or diarrhea
- Depression
- Hallucinations
- Pneumonia
- Confusion
- Blurred vision
- Dangerous allergic reaction
- Hepatitis or liver damage
- Injection site reactions
Severe adverse effects of taking Revia may include: Depression, Hallucinations, Pneumonia, Confusion, Blurred vision, Dangerous allergic reaction, including swelling of mouth or tongue, chest pain, trouble breathing, and rash, Hepatitis or liver damage, including dark-colored urine and jaundice, Injection site reactions, including severe pain, tissue death, blisters, lumps, or open wounds.
High doses of naltrexone may cause liver damage. These side effects are often strongest at the beginning of treatment and diminish over time. However, it is important to note that naltrexone is generally considered safe, with research suggesting that patients taking naltrexone may report fewer serious health problems compared to those taking a placebo.
Risks Associated with Misuse
Using naltrexone for weight loss can negatively affect physical and psychological health, particularly for those with a history of dieting, increasing the risk of disordered eating and eating disorders. Research indicates that about one-quarter of individuals who engage in severe dieting develop an eating disorder. Other symptoms of eating disorders include: Severe caloric restriction, Skipping meals, A preoccupation with food, weight, and thinness, A pathological drive for thinness, Distorted body image, Low self-esteem, Purging behaviors like laxative use, excessive exercise, and self-induced vomiting, Binge eating episodes, Feeling profound shame and guilt related to disordered eating behaviors, Eating alone or avoiding situations in which food will be present.
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Who Can Benefit From Losing Weight With Naltrexone?
Naltrexone is typically prescribed for individuals with severe weight issues, rather than those seeking to lose a few pounds. Doctors generally reserve it for patients who have not found success with traditional weight loss methods due to the potential side effects.
Contraindications
Naltrexone is not safe for pregnant or nursing women or individuals with acute liver failure. It is also not prescribed for patients who continue to use opioids, alcohol, or other substances that slow breathing, as it can increase the risk of overdose by lowering tolerance and blocking the effects of these substances.
Naltrexone Dosage and Timing
The dosage of naltrexone for weight loss varies depending on the individual, their BMI, medical history, and treatment goals. The specific dosage is determined and prescribed by a healthcare provider.
Optimal Timing for Naltrexone Intake
The drug manufacturer does not specify the best time to take naltrexone, but many individuals take it in the morning, often after breakfast, for ease of remembering. However, some people experience drowsiness after taking naltrexone and may prefer to take it at night.
Duration of Treatment
The duration of naltrexone treatment depends on individual weight loss goals and progress, monitored by a medical professional.
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Maximizing the Benefits of Naltrexone for Weight Loss
To maximize the benefits of naltrexone for weight loss, it is essential to combine it with healthy lifestyle changes and consistent habits.
Lifestyle Changes
- Healthy Diet: Eating a reduced-calorie diet rich in fruits, vegetables, lean protein, and whole grains can promote weight loss and overall health.
- Regular Exercise: Regular physical activity helps burn calories and reduce stress.
Consistent Habits
- Tracking Progress: Monitoring weight, waist circumference, and BMI can help track progress over time.
- Support Groups: Joining a support group can provide motivation, encouragement, and advice.
- Professional Guidance: Working with a healthcare professional is crucial for managing a chronic weight management plan and tailoring treatment to individual needs.
Naltrexone vs. Traditional Weight Loss Methods
Naltrexone is one of many tools available for weight loss, with traditional methods like counting calories and regular exercise also proving effective. Combining naltrexone with professional nutritional guidance to relearn healthy eating habits can yield the best results.
Important Considerations and Precautions
It is very important that a doctor checks progress at regular visits to make sure the medicine is working properly and to check for unwanted effects.
- Using this medicine while pregnant can harm an unborn baby. Effective birth control should be used to prevent pregnancy during therapy.
- Naltrexone and bupropion combination should not be taken with a monoamine oxidase (MAO) inhibitor (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]).
- Naltrexone and bupropion combination should not be started during the 2 weeks after stopping a MAO inhibitor, and one should wait 2 weeks after stopping naltrexone and bupropion combination before starting a MAO inhibitor.
- This medicine should not be used if Zyban® is being used to quit smoking or Aplenzin® or Wellbutrin® for depression, because they also contain bupropion.
- This medicine should not be taken if narcotic drugs (e.g., buprenorphine, methadone, or other habit-forming painkillers) have been used within the past 7 to 10 days.
- This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors, and it may also cause some people to have suicidal thoughts and tendencies or to become more depressed.
- Individuals have a higher risk of accidental overdose, serious injury, or death if they use heroin or any other narcotic medicine while being treated with naltrexone and bupropion combination.
- Naltrexone prevents individuals from feeling the effects of heroin if they use it.
- Individuals should not stop taking this medicine without checking with their doctor.
- Blood pressure might get too high while using this medicine, which may cause headaches, dizziness, or blurred vision.
- This medicine may cause a serious allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention.
- Serious skin reactions (e.g., Stevens-Johnson syndrome) can occur with this medicine.
- Individuals should check with their doctor right away if they have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
- Individuals should check with their doctor right away if blurred vision, eye pain, or any other change in vision occurs during or after treatment.
- This medicine may increase the risk of hypoglycemia (low blood sugar) in patients with diabetes.
- Drinking alcoholic beverages should be limited or avoided, if possible, with this medicine.
- Before any medical tests, the medical doctor in charge should be told that the individual is taking this medicine, as the results of some tests may be affected by this medicine.
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