Table 1.

Drugs that are approved or have been trialed for the treatment of obesity and their psychotropic effects.

Mechanism	Drug	Approved for obesity, either alone, or in combination	Favourable psychotropic effects	Unfavourable psychotropic effects	Euphoria or addiction
1. PREVENTING NUTRIENT ABSORPTION
Lipase inhibitor	Orlistat	Yes	No	No
2. HOMEOSTASIS: ENERGY AND CARBOHYDRATE BALANCE
Glucagon-like peptide-1 analog	Liraglutide	Yes	No	No
3. CENTRAL EFFECTS
Potentiating catecholamines (blocking reuptake, enhancing release)	Stimulants: Phentermine Dexamphetamine	Yes No	Improvements in executive functioning, mood elevation, increased vigor/activity	Anger/hostility, depression, paranoia, hyperlocomotion, psychosis	Yes
	Bupropion	Yes	Improvements in executive functioning	Hyperlocomotion psychosis	Yes
	Tesofensine	No	Mood elevation, increased vigor/activity	Anger/hostility
Selective serotonin 2C receptor agonist	Lorcaserin	Yes	Reduces impulsive behavior	Fatigue, depression, cognitive impairment
Cannibinoid type 1 receptor blocker	Rimonabant Taranabant	No No	Increased vigor/activity	Anger/hostility, anxiety, depression, suicide risk
Mu-opioid receptor antagonist	Naltrexone	Yes	Reduces craving
Anticonvulsant: mechanism of action in obesity unclear	Topiramate	Yes	Mood improvement	Sedation, cognitive impairment, depression, aggression, psychosis

The psychotropic effects may be managed by appropriate dosage adjustments.