EFFICACIES OF DEXFENFLURAMINE AND FLUOXETINE IN PREVENTING WEIGHT-GAIN AFTER SMOKING CESSATION

We tested whether 14 wk of dexfenfluramine (30 mg) ol fluoxetine (40 m g) treatment would prevent weight gain after subjects quit smoking. No rmal-weight women (n = 144) were randomly assigned to drug or placebo on a double-blind basis for 2 wk before quitting smoking and 12 wk the reafter. The fluoxetine group had more dropouts (28/49, 57.1%) than th e dexfenfluramine group (17/47, 36.2%), with an intermediate number of dropouts from the placebo group (21/48, 43.8%). All groups gained wei ght during treatment, but their amount and pattern of weight gain diff ered. In the first month after quitting smoking, the placebo group gai ned more weight than either the dexfenfluramine or fluoxetine group (P < 0.05). By 2 mo postcessation, dexfenfluramine still suppressed weig ht gain in comparison with placebo (P < 0.05); weight gain with fluoxe tine was not differentiable from either dexfenfluramine or placebo. By 3 mo postcessation, the dexfenfluramine group had gained 1.0 +/- 0.7 kg, significantly less than either the placebo (3.5 +/- 0.7 kg) or flu oxetine (2.7 +/- 0.5 kg) groups. Three months after drug discontinuati on, formerly medicated, but not placebo patients, showed additional we ight gain, eliminating differences between groups. Results indicate th at weight gain, an adverse accompaniment of smoking cessation, can be minimized to some degree by serotoninergic drugs, although only for th e duration of drug treatment.