Weight loss drugs in highlights

A controversial weight-loss drug has been approved for use on the NHS. Rimonabant will be made available to overweight or obese patients who cannot take, or who have had no success with, two other drugs, orlistat and sibutramine. It comes after concerns about rimonabant's side-effects, including suicidal thoughts and depression.

The news comes after the medicines watchdog said last month that it had received 720 reports of adverse drug reactions (totalling 2,123 individual reactions) in the UK since the drug launched in 2006.

Five resulted in death (one suicide, one from infection, one sudden death from an unknown cause and two heart attacks), the data, from the Medicines and Healthcare products Regulatory Agency (MHRA), showed. Of the total number of reactions, 974 involved psychiatric disorders, of which 48 reports involved suicidal thoughts. A total of 93 involved depression, 32 involved panic attacks while others related to, among other things, inability to sleep, mood swings and tearfulness.

The drug went on sale in the UK in June 2006 but approval from the National Institute for Health and Clinical Excellence (Nice) for use on the NHS has only just been issued.

People in the UK, Germany, and France are the highest users of rimonabant worldwide. It has not yet been authorised in the US due to safety fears. In December, research published in The Lancet medical journal warned of the the mental health hazards from rimonabant. A review of trial evidence involving more than 4,000 patients found they were three times more likely to stop treatment because of anxiety than patients given a dummy drug, and 2.5 times more likely to stop because of depression.

The Nice guidance recommends rimonabant "as an addition to diet and exercise for adults who are obese or overweight and who have had an inadequate response to, are intolerant of or are contraindicated to orlistat and sibutramine".