Diet Drug Rimonabant Tied to Depression, Anxiety

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Mitchell noted that depression is common in overweight and obese people, and is something that doctors need to take into account when prescribing weight-loss drugs.

"This increased risk of depression and anxiety is a major safety issue in the treatment of obesity, as obese patients already have an increased risk of depression even prior to treatment," Mitchell said.

As far as rimonabant is concerned, Mitchell believes doctors should consider alternate weight-loss drugs for people who are depressed. "If one is using rimonabant, patients should be monitored carefully for the emergence of depressive symptoms and/or suicidal thoughts," he added.

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In June, rimonabant's maker, French pharmaceutical giant Sanofi-Aventis, said in a statement that despite the FDA's decision, the company "is confident in the positive benefit-risk ratio of rimonabant 20 milligrams when used in the appropriate population."

Another expert said more data on the safety of rimonabant is needed.

"Rimonabant is potentially beneficial in some patients, but we really need long-term data demonstrating reductions in major obesity-related comorbidities such as heart attack, stroke and sleep apnea and/or mortality, to be completely certain," said Dr. Raj Padwal, an assistant professor of general internal medicine at the University of Alberta in Edmonton, Canada.

The drug needs to be avoided in anyone who has a mood disorder, Padwal added. "Since many patients with weight issues have depression, this means that the drug cannot be used in a large number of people. In the remaining individuals in whom the drug is used, the patient and physician must be cognizant of the risk of a mood disorder and monitor accordingly," he said.

In a related study in the Nov. 16 issue of the British Medical Journal, Padwal's team found that long-term users of weight-loss drugs such as orlistat (Xenical), sibutramine (Meridia) and rimonabant experienced only modest weight loss -- less than 11 pounds, which was less than 5 percent of their total body weight.

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