Contrave Review: Can The Obesity Drug Cause Suicidal Thoughts?

Contrave Review: Can The Obesity Drug Cause Suicidal Thoughts?

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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Contrave is a prescription weight loss pill that's approved for use in the U.S. by the Food and Drug Administration (FDA) for overweight and obese adults above a Body Mass Index (BMI) level of 27.

The generic name for the drug is naltrexone HCL/bupropion HCL and we'll use these terms interchangeably throughout this article as they refer to the same active drug ingredient(s).

In this article we’ll review medical studies on Contrave to determine if the drug is effective for weight loss. We'll also highlight side effects of the drug, and share before-and-after images from a real user.

Does Contrave Work for Weight Loss?

Contrave has been studied in several clinical trials, four of which were summarized in this meta-review published in the Pharmacy & Therapeutics journal. Researchers found that in all four trials, Contrave caused weight loss on average.

36% of patients lost greater than 5% of their body weight in 56 weeks in the worst-performing trial, while 57% of patients lost greater than 5% of their body weight in 56 weeks in the best-performing trial.

A more recent medical review examined whether Contrave was effective for weight loss in a patient population with type-2 diabetes. Data from over 4,500 patients was analyzed, and the researchers found that Contrave was effective for this patient population, resulting in average weight loss of 11-22 pounds (lbs) over the course of the 56 week studies. 

Based on the available medical research, we will conclude that Contrave is effective for weight loss.

Contrave Side Effects

Contrave does cause side effects in some patients, and the side effects may be more severe than other weight loss drugs such as Plenity because Contrave works neurochemically while Plenity simply takes up space in the stomach. 

A medical review published in the Hormones journal detailed the most common side effects of Contrave: nausea (experienced by 29-42% of patients), constipation (16-24%) and headache (14-24%). These are relatively minor side effects.

The more concerning side effects, which are significantly more rare, involve suicidality. 

Contrave's FDA label contains a "black box" warning, which is the most severe type of warning required by the FDA. It indicates a side effect which may be life-threatening. The label states that Contrave may increase risk of suicidal thinking and actions in children, adolescents and young adults.

The risk of suicidal thoughts or actions likely affects a very small percentage of Contrave users, but this side effect suggests that patients with a personal or family history of suicide may benefit from speaking with their doctor about alternative weight loss medications that don't carry this risk.

Contrave Before-and-After Images

Patients are often curious about before-and-after images of weight loss drug patients, given that the manufacturers rarely share such images of real patients on their websites.

A popular YouTube video published by a channel called "B Runewicz" shares before-and-after images of their weight loss while using Contrave:

Questionable Inactive Ingredients

Contrave ingredients

Contrave contains two active ingredients as we referenced in the intro to this article.

Like many prescription medications, Contrave also contains several inactive ingredients we consider questionable from a health perspective, like Opadry II Blue and FD&C Blue #2 aluminum lake. These are artificial dyes.

A medical review on the toxicology of artificial food dyes found all of them to be potentially harmful, and the study authors suggested that all be removed and replaced with safer alternatives.

We generally recommend avoiding artificial dyes wherever possible, and we hope that Contrave's manufacturer phases out their use. There are no medical or nutritive benefits to artificial dye consumption, and it seems questionable to add these ingredients for branding purposes to products that are prescribed to people in an already-compromised health state.

Our Clean Weight Loss Picks

There are food-based nutrients which have been shown in medical studies to be effective for weight loss.

Dietary fiber was shown in a medical review published in The Journal of Nutrition to cause 16 pounds of weight loss in 6 months when combined with moderate caloric restriction (750 calories per day below baseline).

Supergut Fiber Mix is our top fiber supplement, because it contains three different types of fiber powder, and retails for only $1.75 per serving at a subscription rate.

MCT oil was shown in a meta-study to cause more than one pound of weight loss over 10 weeks. This equates to potential annualized weight loss of 6 pounds per year with less than one tablespoon's worth of MCT oil per day.

Bulletproof MCT Oil is our top MCT oil product, because the only ingredient is MCT oil derived from coconuts. and it currently costs only $15.50 for over a month's worth of product.

Ginger intake "significantly decreased body weight" according to a 2019 meta-study on ginger and weight loss that analyzed data from 14 clinical trials.

Pique La Ginger is our top ginger product, because it's an organic tea in convenient crystallized form, and all that's needed is to pour the powder into a glass and add hot water.

All three of the products mentioned in this section are entirely free of additive ingredients that we consider to be unhealthy or unsafe.

We're not suggesting any of these supplements should be used to treat any medical condition, or that they're as effective as any FDA-approved medication; rather, we're just sharing information that individuals averse to prescription medication can speak with their doctor about.

Contrave User Reviews

Contrave has been reviewed over 1,000 times on for treating obesity. Its average rating is 6.9/10. allows prescription medication users to publish reviews of their personal experience using a drug.

We cannot verify the accuracy or authenticity of any reviews on this site, but we find it to be a more objective resource for user drug reviews than a manufacturer's website.

The top positive review for Contrave is written by a user named "Court98" who claims the drug caused a significant amount of weight loss:

"When I started I was 275lb and was just not happy with where I was with my body and health...As of now (3 months in) I am 45 pounds down weighing in at 230. It is such a simple medication and works so quickly when paired with a good diet."

The top negative review comes from a user named "Dee Dee" who claims that Contrave is less cost-effective than taking the generic versions of the drug separately:

"Contrave is costly. To avoid paying unnecessary money, just have your MD prescribe the two medical ingredients separately ie bupropion as one med and the naltrexone as the other. I only pay $20/month. By having them prescribed separately, my insurance covers almost ALL the cost."

Contrave Dosage

According to the research review published in the Pharmacy & Therapeutics journal linked above, Contrave is typically dosed at one capsule for the first week, which contains 8 milligrams (mg) of naltrexone HCL and 90 mg of bupropion HCL. Another tablet is added to the daily regimen on week two, and by week four the maximally-effective dose of four daily tablets should be achieved.

This final dose contains 32 mg of naltrexone and 360 mg of bupropion.

Doctors will typically prescribe patients a dose at the lower end of the therapeutic range to assess efficacy. If the patient experiences beneficial results at that low dose, their doctor may keep them at this dose because it will minimize the risk of side effects.

Stay up-to-date on our research reviews


Contrave is effective for treating obesity in both healthy and type-2 diabetic patient populations. Over the course of a year, the drug causes weight loss of greater than 5% of body weight in nearly 50% of patients, based on medical research.

However, Contrave does carry the risk of side effects, such as nausea, constipation and headache. The drug may also increase the risk of suicidal thoughts and actions in a small subset of the population.

We find two of the additive ingredients in Contrave to be questionable from a health perspective, and we hope that the manufacturer phases out use of artificial dye in their manufacturing process.

Supplemental dietary fiber and MCT oil are two research-backed OTC weight loss options that patients may wish to speak with their doctor about because of their considerable research backing and favorable side effect profile.

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