What are the available doses of fluoxetine

Cochrane

Question
What effects does fluoxetine treatment have on people who are overweight or obese?

background
Fluoxetine is a drug that is actually used to treat depression. However, one side effect of this antidepressant is decreased appetite. It is therefore believed that fluoxetine can also be used to treat people who are overweight and obese. For this group of people, the administration of fluoxetine means off-label use, i. that is, the drug is not approved for the treatment of obesity.

Study characteristics
We found 19 randomized controlled trials (clinical trials where people were randomly assigned to one of two or more treatment groups) that looked primarily at women who received different doses of fluoxetine. A total of 1,280 overweight or obese participants received fluoxetine and 936 participants received primarily placebo or another obesity drug. The observation period in the included studies varied between three weeks and one year.

Main results
In the main comparison - fluoxetine versus placebo - and combined for all fluoxetine doses, there was a weight loss of 2.7 kg in favor of fluoxetine. However, it is not clear whether another study would show a benefit from fluoxetine again. A total of 399 of 627 participants (63.6%) with fluoxetine experienced side effects compared to 352 of 626 participants (56.2%) with placebo. Dizziness, tiredness, fatigue, insomnia and nausea were about twice as likely in the fluoxetine group compared to the placebo group. A total of 15 of 197 participants (7.6%) with fluoxetine experienced depression compared to 12 of 196 participants (6.1%) with placebo. The studies did not report on all-cause mortality, health-related quality of life and socio-economic impact.

This evidence is current as of December 2018.

Trustworthiness of the evidence
In general, the trustworthiness of the evidence was low or very low. This was mainly due to the small number of studies per endpoint measurement and the small number of participants.