Developing a cost-effective treatment program for obesity using dexamphetamine
Obesity is a major problem for our local population in Penrith. Access to treatment is limited due to lack of resources within the public sector. We are working on developing a 6 month treatment programme for establishing lifestyle changes promoting weight control for adults with obesity, based on combining behavioural intervention with dexamphetamine, starting off with a randomised controlled trial. We are utilizing dexamphetamine principally because of its psychotropic effect of enhancing motivation. We view the anorexigenic effect as an added advantage for promoting weight loss.
1. To compare dexamphetamine with placebo for establishing the lifestyle changes for long term weight control
2. To investigate objective means for monitoring the clinical effects during dose titration, such as the Stop Signal Task.
3. To analyse the baseline predictors of weight loss sustained after 2 years (eg ADHD status, dopamine receptor single nucleotide polymorphism).
Double blind RCT: 200 participants aged 18-65 with BMI >30 and no medical contraindications randomised to dexamphetamine or placebo. After baseline screening (questionnaires, examination, blood tests and cardiac investigations) they will receive either dexamphetamine or placebo, titrating the dose while monitoring for adverse effects. All will receive advice on diet and exercise and half in each group will also receive behavioural intervention. The Stop Signal Task will be administered at baseline and after every dose increase. Weight loss will be analysed by treatment allocation. Baseline characteristics will be correlated with outcome.
The overall research program for developing the principles of using dexamphetamine safely and effectively in the treatment of obesity encompasses the following research topics:• RCT comparing dexamphetamine with placebo
- Developing a behavioural programme for use with dexamphetamine to increase response rate
- Baseline predictors of treatment success in terms of long-term weight control, including previous history of attempts to lose weight, behavioural characteristics, features of ADHD, genetic predictors
- Establishing objective indicators that can be used to guide dose titration for an appropriate therapeutic dose
- Monitoring for medical/health benefits to treatment and treatment side effects during and after the treatment phase
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The opportunity ID for this research opportunity is: 62
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