Contrave
Bupropion + Naltrexone Extended-Release
Unlike stimulant appetite suppressants, Contrave works on the brain's reward system and craving circuitry — making it especially effective for people who struggle with emotional eating, food obsession, or reward-driven overeating.
What Is Contrave?
Contrave is a fixed-dose combination of two well-known medications — bupropion (an antidepressant and smoking cessation aid) and naltrexone (an opioid receptor blocker used for addiction treatment). Together, they work on two distinct areas of the brain simultaneously.
Bupropion activates neurons in the hypothalamus (appetite regulation center) to reduce hunger and improve energy. Naltrexone blocks the opioid receptors in the brain's reward pathway, reducing the pleasure derived from eating — and breaking the "reward loop" that drives overeating, cravings, and binge behavior.
The combination is FDA-approved specifically for chronic weight management and is one of the few weight loss medications that directly addresses the psychological component of overeating.
Quick Facts
- Form Oral extended-release tablet, taken twice daily
- Schedule Not a controlled substance
- Use duration Long-term (chronic weight management)
- Average loss 5–9% of body weight over 1 year
- Best for Emotional eating, food cravings, binge patterns
Who benefits most?
Patients who eat not because they're hungry, but because of stress, boredom, habit, or emotional states often see the greatest benefit from Contrave's reward-pathway mechanism.
Key Benefits
Targets the brain's reward and craving circuits — not just appetite
Particularly effective for emotional eating and food addiction patterns
Non-stimulant — no jitteriness, no cardiovascular stimulant effects
Not a controlled substance — no DEA scheduling
Improves mood and energy in many patients (bupropion effect)
Reduces binge eating behaviors and food obsession
Gradual dose escalation minimizes side effects
FDA-approved specifically for chronic weight management
What to Expect: Dosing Titration
Single morning dose to establish tolerance
Adding evening dose to reach therapeutic range
Increasing morning dose
Full maintenance dose — 360mg bupropion / 32mg naltrexone daily
The gradual 4-week titration minimizes nausea and side effects. If Contrave hasn't produced measurable weight loss after 12 weeks at full dose, we'll reassess your treatment plan together.
Who Is It For?
Contrave may be a good fit if you:
- Have a BMI ≥ 30, or ≥ 27 with a weight-related condition
- Struggle with emotional, stress-related, or reward eating
- Experience food cravings or obsessive food thoughts
- Want a non-stimulant, non-controlled substance option
- Are looking for long-term (not just short-term) management
Contraindications
Contrave is not appropriate if you have:
- Uncontrolled hypertension
- Seizure disorder or history of seizures
- Current use of opioid medications (naltrexone will block them)
- Eating disorder (anorexia or bulimia)
- Current use of MAO inhibitors
- Are pregnant or planning pregnancy
- Bupropion allergy or serious reactions to bupropion-containing products
Ready to Break the Cycle?
If cravings, emotional eating, or food obsession have been standing in your way, Contrave may be the missing piece. Book a consultation to find out.