21 June 2007

I took my first dose of Rimonabant this morning.  At least, I am pretty sure that I did.  Is a sealed box containing blister-packed tablets, with a hologram affixed, and purchased in Tijuana for slightly more than the going price, the real thing?

I thought I might have detected a little nausea about half an hour after I took the pill.  It might be related: some stop taking the drug because of nausea.  I may also have noted a little blurring of vision, though that is gone. After two hours, no sign of depression, nor ideation of suicide.  Of course, it takes about nine days for the full circulating blood levels level off.  By all accounts, it should be easy to spot depression in me, should it happen.

Depression?  Tijuana? Fake drugs?   Why would I do this?

Because rimonabant is the first in a new class of weight-control drugs.  I have metabolic syndrome, an easy guess, judging by my age and shape.  And I need help. When I diet, I gain weight.  I worked out, and exchanged some fat for muscle.  Then I didn't fit in commuter jets or my suits.  I tried <a href="../cheap/hoodia.html">hoodia</a>, and it reduced my body weight by about 1%.

The CB1 receptor was discovered about 20 years ago. It is one of a number of receptors and feedback loops that have been under intense study for possible anti-obesity treatments. The biology is complex, but the potential financial and health effects of successful treatment are vast. 

My doctors are very interested in my experiment.  I actually have a prescription for a 90-day supply.  They encouraged me to start the drug after my current travels are over. In general, you should start a new medicine on home turf.

But I have gotten impatient.  And I am spending a lot of time sitting quietly in dark rooms listening to talks.  This conference seems like a pretty good test environment. I've given my keynote, so I am off the hook if this stuff disables me.

Side Effects

Side effects are likely to be the opposite of any effect cannabis has.  Countering the munchies is the point of the drug.  But cannabis is used to counter nausea in cancer patients.  Nausea is a side effect that discourages the majority of rimonabant users from continuing.  Pot's euphoria translates to depression in some rimonabant users, and is the reason the FDA has been reluctant to approve the drug.

The CB1 receptor is found in a number of places throughout the body.  Besides the "munchies receptor" in the brain, there are receptors in fat cells.  Rimonabant appears to increase the secretion of adiponectin by fat cells, which may be an anti-obesity signal of its own.

There are CB1 receptors in the retina[Porcella et al, 2000] ,  which may explain marajuana's effects on glaucoma. That would suggest that rimonabant may contribute to increased intraocular pressure, which could certainly be a problem for glaucoma patients.

Acute marijuana use can disrupt working memory and episodic memory functions [Ilan et al, 2004]. Does rimonabant improve memory?  I've never seen any reports on this.

Of course, this drug has passed a number of phase 3 clinical trials, and has been approved for use in Europe since summer 2006.


  • [Porcella et al, 2000] Anna Porcella, Chiara Maxia, Gian Luigi Gessa, Luca Pani (2000), The human eye expresses high levels of CB1 cannabinoid receptor mRNA and protein. European Journal of Neuroscience 12 (3), 1123–1127. 
  • [Ilan et al, 2004] Aaron B. Ilan, Michael E. Smith, and Alan Gevins, Effects of marijuana on neurophysiological signals of working and episodic memory. Psychopharmacology (Berl). 2004 November; 176(2): 214–222.