Slimming Drug Takes Weight and Memory

By ROSS TARA

NEW ZEALAND research into the weight-loss pill Reductil raises new questions over the drug’s safety.

More than 17,400 Kiwis have been prescribed the drug since it was introduced here in 2001.

A study by medicines watchdog the Intensive Medicines Monitoring Programme (IMMP), based in Dunedin, reveals some have suffered side effects, including amnesia.

The IMMP has been analysing the drug’s use after overseas reports of cardiovascular complications.

Director Mira Harrison-Woolrych said the study, which will be presented at the Otago Obesity Research Conference this week, is the first to link amnesia with Reductil. It found a 39-year-old woman, whose case has since been recorded in the British Medical Journal, developed memory problems after a month.

“Her memory loss was so great she couldn’t remember how to work her kitchen appliances,” Harrison-Woolrych said. “When the medication stopped, her memory came back, which is quite suggestive of a causal link with the medication.”

Researchers uncovered an Australian case of a 50-year-old woman who experienced amnesia a day after starting Reductil and a further 33 accounts of Reductil-associated amnesia on the World Health Organisation’s international database.

New Zealand Heart Foundation medical director Norman Sharpe said the findings sounded a note of caution for dishing out the drug.

It was useful for some seriously obese people but only as long as the benefits outweighed its many risks.

“This is no silver bullet,” he warned.

Yet others say the drug is becoming a lifestyle choice for people who are not obese but are overweight.

Christchurch School of Medicine general practice professor Les Toop said its heavy promotion fuelled an inappropriate demand for the drug.

“One GP was asked to prescribe it for a woman who wanted to reduce her dress size two sizes in three weeks for a wedding.”

But Reductil was expensive, had modest benefit – one 12-month study showed the average weight loss in obese people, beyond the weight loss of those taking a placebo, was less than 5kg – and had significant side- effects, Toop said.

“The last time I counted there were 18 contraindications to taking it. Well, they don’t appear in the ads do they?”

Reductil, which is available only on prescription, at a cost of $160 to $190 a month, alters the level of brain chemicals to curb appetite.

It carries warnings of side effects as minor as insomnia and constipation and as serious as increased blood pressure and heart rate.

Reductil, also known by the generic name sibutramine, was withdrawn from sale in Italy in 2002 after the deaths of two women, but was later reinstated.

A spokesman for drug company Abbott Laboratories said the company stood behind Reductil. Patient safety was a priority for the company and it knew of reviews showing memory impairment and bruising but not of heart-related problems.

The Dunedin researchers believe they have identified a link between Reductil and a heartbeat irregularity that might explain some of the overseas cardiac deaths.

Their finding, based on a New Zealand woman’s heart attack, will be reported in the British Journal of Pharmacology at the end of the year.

“It’s a new signal, as is amnesia, that’s never been reported,” Harrison-Woolrych said.

Medsafe senior medical adviser Stewart Jessamine saw no need for any further warnings or changes to the drug’s safety information.