It follows the findings of a meta-analysis of four trials carried out by Danish researchers that showed patients given rimonabant were 2.5 times more likely to stop treatment because of depression than those on placebo.

Patients were also three times more likely to quit treatment because of anxiety.

The four trials included a total of 4,105 patients who were randomly assigned 20mg rimonabant daily or placebo. Any patients suffering from depressed mood at baseline were excluded from the trial.

Patients given the drug had 4.7kg greater weight loss after the first year than those on placebo.

However, the rate of serious adverse events was 40 per cent higher in the treatment group.

In July this year, the EMEA said rimonabant should be contraindicated in those with major depression or those on antidepressants.

Dr David Haslam, clinical director of the National Obesity Forum, said GPs need to consider these contraindications before prescribing rimonabant.

A spokeswoman for manufacturer Sanofi-Aventis said it ‘has actively sought to ensure that treatment is prescribed to the right patient’.

rachel.liddle@haymarket.com

www.thelancet.com

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