Amitriptyline cause weight gain: Amitriptyline and weight gain: a biochemical and endocrinological study
Weight gain. A side-effect of tricyclic antidepressants
. 1984 Oct;7(2):133-8.
G H Berken, D O Weinstein, W C Stern
G H Berken et al.
J Affect Disord.
. 1984 Oct;7(2):133-8.
G H Berken, D O Weinstein, W C Stern
Body weight and appetite were evaluated in 40 depressed outpatients from a private psychiatric practice who were receiving low-modest doses of tricyclic antidepressants. Amitriptyline (maximum of 150 mg/day), nortriptyline (maximum of 50 mg/day), and imipramine (maximum of 80 mg/day) were given for an average of 6 months of treatment. There was a mean weight increase of 1.3-2.9 lbs/month, which led to an average total weight gain of 3-16 lbs, depending on drug, dose and duration. These weight increases were linear over time and were accompanied by marked increases in the preference for sweets. Ultimately, excessive weight gain was the most common cause of discontinuation of treatment, occurring in one-half of the patients. Significant weight loss occurred upon discontinuation of drug. These findings show that chronic administration of low-modest doses of tricyclic antidepressants frequently cause considerable weight gain and can significantly interfere with the ability to provide long-term maintenance therapy.
Dosing of antidepressants–the unknown art.
J Clin Psychopharmacol. 1995 Dec;15(6):435-9. doi: 10.1097/00004714-199512000-00008.
J Clin Psychopharmacol. 1995.
Tricyclic antidepressant concentrations in plasma: an estimate of their sensitivity and specificity as a predictor of response.
Perry PJ, Zeilmann C, Arndt S.
Perry PJ, et al.
J Clin Psychopharmacol. 1994 Aug;14(4):230-40.
J Clin Psychopharmacol. 1994.
[Tricyclic antidepressants dosage and depressed elderly inpatients: a retrospective pharmaco-epidemiologic study].
Ballon N, Siobud-Dorocant E, Even C, Slama F, Dardennes R.
Ballon N, et al.
Encephale. 2001 Jul-Aug;27(4):373-6.
Tricyclic antidepressant plasma levels after fluoxetine addition.
Vandel S, Bertschy G, Bonin B, Nezelof S, François TH, Vandel B, Sechter D, Bizouard P.
Vandel S, et al.
Neuropsychobiology. 1992;25(4):202-7. doi: 10.1159/000118838.
Implications of dosing tricyclic antidepressants and benzodiazepines in geriatrics.
Cutler NR, Narang PK.
Cutler NR, et al.
Psychiatr Clin North Am. 1984 Dec;7(4):845-61.
Psychiatr Clin North Am. 1984.
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Does Amitriptyline Cause Weight Gain?
If you have depression, an anxiety disorder or a form of chronic pain, your healthcare provider may prescribe an antidepressant called amitriptyline.
It’s normal to have concerns about side effects when you start using a new medication. In fact, even a quick online search for antidepressant treatment options can turn up a lot of conflicting information about what to expect in terms of potential adverse effects.
One common side effect that many people wonder about with amitriptyline and other treatment options for depression is weight gain.
Although early studies of amitriptyline and similar antidepressants did find a link between their use and changes in weight, most modern research suggests that medications like amitriptyline aren’t linked to any significant amount of weight gain.
Below, we’ve gone into more detail about what amitriptyline is, as well as how it works to treat depression.
We’ve also dug into the research on amitriptyline and weight gain to explain how you can keep your weight and body composition consistent while using medication for depression.
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What is Amitriptyline?
Amitriptyline, which is sold as a generic medication and under the brand name Elavil®, is a type of medication that’s used to treat depression.
More specifically, amitriptyline belongs to a class of drugs referred to as tricyclic antidepressants (TCAs). This class of antidepressants works by increasing levels of certain neurotransmitters in your brain and body, such as serotonin and norepinephrine.
This medication is taken orally, and generally patients start with taking 25mg at bedtime. If this dosage doesn’t improve your depressive symptoms, your healthcare provider may increase it to help you gain better relief from depression.
Amitriptyline is approved by the FDA as a medication for major depressive disorder (MDD). It’s also used off-label to treat a variety of conditions, including:
Post-traumatic stress disorder (PTSD)
Sleep disorders, such as insomnia
Chronic and/or severe migraines
Irritable bowel syndrome (IBS)
Sialorrhea (excessive salivation)
Interstitial cystitis (bladder pain syndrome)
Shingles complications, such as postherpetic neuralgia
Diabetic neuropathy, fibromyalgia and other chronic pain conditions
As a tricyclic antidepressant, amitriptyline generally isn’t used as a first-line treatment (meaning the first type of medication that’s prescribed for a certain condition) for major depression.
Instead, depression is generally treated with newer antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which offer similar results to amitriptyline and other antidepressants with a lower risk of side effects.
However, your healthcare provider may prescribe amitriptyline if SSRIs or other medications are ineffective for you, or if you have a condition that’s best treated with amitriptyline specifically.
For example, although amitriptyline is slightly more likely to cause side effects than newer drugs for depression, research suggests that it’s more effective at treating clinical depression for some people.
Side Effects of Amitriptyline
So, what are the potential side effects of amitriptyline, and is an increase in body weight one of them?
Like other antidepressants, amitriptyline can cause a range of side effects. Most of these issues are mild and transient, meaning they gradually improve. However, certain unwanted side effects of amitriptyline may be more severe and/or persistent.
Common amitriptyline side effects include:
Amitriptyline can also cause sexual side effects, such as changes in your level of interest in sex or sexual functioning.
Although uncommon, amitriptyline may also cause more serious side effects, such as orthostatic hypotension (low blood pressure while standing), heart rate variation, acute angle glaucoma and a reduced seizure threshold.
As with other antidepressants, amitriptyline comes with a “black box” warning from the FDA that notifies users of an increased risk of suicidal ideation and behavior in children, adolescents and adults aged 24 years or less.
If you notice any side effects while using amitriptyline — particularly if they’re bothersome and/or severe — it’s important to talk to your healthcare provider as soon as you can.
Does Amitriptyline Cause Weight Gain?
You may have noticed that one of the potential side effects of amitriptyline above is “changes in weight.” Over the years, several studies have looked into the weight-related side effects of TCA medications like amitriptyline, with some research suggesting that it causes weight gain.
For example, one study published in the Journal of Affective Disorders in 1984 found that users of tricyclic antidepressants such as amitriptyline experienced an average weight increase of 1. 3 to 2.9lbs per month, resulting in a total weight gain of three to 16lbs over six months.
This study also found that the participants showed significant weight loss after ending treatment with tricyclic antidepressants.
As a result of study findings such as this, medications like amitriptyline are often perceived to be highly likely to cause excessive weight gain, especially when they’re used over the long term.
However, the reality is more complicated. This study, while helpful, isn’t perfect. For example, its sample size consists of only 40 people, who used three different antidepressants — amitriptyline, imipramine and nortriptyline.
Furthermore, the study — which was published in the mid-1980s — only featured people treated with antidepressants, without a control group. This makes it difficult to know if any weight gain that occurred during the study was caused by the medications or by other, unrelated factors.
More recent, higher quality research generally suggests that the link between amitriptyline and weight gain isn’t quite as strong as originally thought.
For example, one systematic review published in 2015 in the Journal of Clinical Endocrinology and Metabolism looked at a range of randomized trials that compared popular antidepressants to placebo treatments and assessed their effects on body weight.
The authors of the review found that amitriptyline was associated with average weight gain of just 1.8kg (approximately four pounds), which was slightly higher than the average amount of weight gained from newer antidepressants, such as fluoxetine (Prozac®).
Another larger and more recent study, which was published in the journal JAMA Psychiatry in 2014, found that amitriptyline produced less weight gain than citalopram (Celexa®), an SSRI that’s commonly used as a first-line treatment for depression.
Overall, although amitriptyline is linked to some degree of weight gain, the average amount of weight that’s gained during treatment is only a few pounds.
If you’re prescribed amitriptyline or another antidepressant medication and notice that you’re starting to gain weight, there could be a reason other than your medication.
For many people, depression can result in a loss of appetite that can affect your eating habits and cause you to lose weight.
If amitriptyline or a similar antidepressant drug improves your mood, you may go back to your previous eating habits, causing you to gain back any weight that you may have lost while you were eating less.
You may also go through changes in your activity level while dealing with and recovering from depression that affect your average daily energy expenditure and weight regulation.
What to Do if You’re Experiencing Weight Gain From an Antidepressant
Dealing with weight gain can be a frustrating experience, especially when you’re trying to focus on recovering from depression. Thankfully, there are several things to do if you notice that your weight is starting to increase while using amitriptyline or a similar antidepressant:
Try not to worry about small weight fluctuations. It’s normal for your weight to go up and down over the course of the week. If you only notice a gain or loss of a few pounds from your baseline weight, it’s generally best not to worry about it.
Take note of your eating habits and food intake. There’s no evidence that drugs like amitriptyline affect your metabolism, meaning any weight gain is generally the result of a change in your intake of food and beverages.
If you’re becoming concerned about weight gain, try to take note of your eating habits to see if you’re consuming more calories than normal.
Focus on a healthy diet. Regardless of what medications you may be on, your meals should contain protein (like lean meats and fish), a healthy carbohydrate (such as fruit, veggies or whole grains) and healthy fats.
Try to eat a balanced, healthy diet with appropriate portion sizes. Sticking to a balanced diet can help you to manage your weight and avoid unwanted weight gain.
Try increasing your physical activity level. Not only can regular exercise help you to maintain a healthy weight — it also offers benefits for the treatment of depression thanks to its effects on endorphins and neurotrophic factors.
Try to keep yourself physically active. If you’ve noticed your weight creeping up, adding a daily walk, jog, bike ride or other form of physical exercise to your schedule may help you to lose weight while improving your mental wellbeing.
Keep yourself well hydrated. Staying hydrated can help to keep you full. Try to stick to low or zero-calorie drinks such as water, and drink on a regular basis to avoid becoming dehydrated during the daytime.
Talk to your healthcare provider. If you’re uncomfortable with changes in your weight that occur while using amitriptyline, let your healthcare provider know. They may switch you to a different antidepressant or suggest changes to make to your routine.
Alternatives to Amitriptyline
Amitriptyline is one of many medications used in antidepressant therapy. These days, it’s largely been phased out as a first-line treatment for depression in favor of newer antidepressants with a lower risk of side effects.
If you’re prescribed amitriptyline and have concerns about weight gain or other side effects, you may want to consider talking to your healthcare provider about using a different medication.
We offer several modern antidepressants via our online mental health platform, including SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs).
We also offer bupropion (Wellbutrin®), an atypical antidepressant medication that has a reduced risk of causing weight gain when compared to other medications for depression.
You can find out more about your options for treating depression and anxiety by taking part in a provider evaluation now using our online psychiatry service.
If appropriate, you may receive a prescription for medication and ongoing follow-ups to check in on your results and progress.
Amitriptyline and Weight Gain: The Bottom Line
Antidepressant medications like amitriptyline can be valuable tools for treating depression. Used in combination with options such as psychotherapy and changes to your lifestyle, they can make your symptoms less severe and help you to make real progress towards recovering.
Although amitriptyline does appear to cause a small degree of weight gain on average, it isn’t a significant amount. Most research only shows minor weight changes that are either comparable to or lower than those from similar antidepressants.
If you’ve noticed your weight going up after recently starting treatment with amitriptyline, do not stop taking your medication abruptly.
Doing this may cause your depression symptoms to return and increase your risk of developing antidepressant withdrawal symptoms.
Instead, try talking to your mental health provider or connecting with a psychiatry provider using our online psychiatry platform. They’ll be able to assess what’s going on and give you actionable advice to keep yourself both mentally and physically healthy.
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.
- Amitriptyline. (2017, July 15). Retrieved from https://medlineplus.gov/druginfo/meds/a682388.html
- Thour, A. & Marwaha, R. (2022, May 15). Amitriptyline. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537225/
- Moraczewski, J. & Aedma, K.K. (2022, May 2). Tricyclic Antidepressants. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557791/
- Chu, A. & Wadhwa, R. (2022, May 8). Selective Serotonin Reuptake Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/
- Barbui, C. & Hotopf, M. (2018). Amitriptyline v. the rest: still the leading antidepressant after 40 years of randomised controlled trials. The British Journal of Psychiatry. 178 (2), 129-144. Retrieved from https://www. cambridge.org/core/journals/the-british-journal-of-psychiatry/article/amitriptyline-v-the-rest-still-the-leading-antidepressant-after-40-years-of-randomised-controlled-trials/149B8AB17D99C548445A9E40986FADF3
- Berken, G.H., Weinstein, D.O. & Stern, W.C. (1984, October). Weight gain. A side-effect of tricyclic antidepressants. Journal of Affective Disorders. 7 (2), 133-138. Retrieved from https://pubmed.ncbi.nlm.nih.gov/6238068/
- Domecq, J.P., et al. (2015, February). Drugs Commonly Associated With Weight Change: A Systematic Review and Meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 100 (2), 363-370. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393509/
- Blumenthal, S.R., et al. (2014, August). An Electronic Health Records Study of Long-Term Weight Gain Following Antidepressant Use. JAMA Psychiatry. 71 (8), 889-896. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1878922
- Medication Frequently Asked Questions. (n.d.). Retrieved from https://www.nami.org/FAQ/Mental-Health-Medication-FAQ/My-doctor-recently-started-me-on-an-antidepressant
- Moon, J., Gwanpyo, K., (2020). Clinical Evidence and Mechanisms of High-Protein Diet-Induced Weight Loss. Journal of Obesity and Metabolic Syndrome. 29 (3), 166-173 Retrieved from https://www.jomes.org/journal/view.html?doi=10.7570/jomes20028
- Exercise is an all-natural treatment to fight depression. (2021, February 2). Retrieved from https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
Is it true that antidepressants make you fat?
Author: Aleksandra Kurchatova
views not all. In addition, each person reacts differently to antidepressants: some people gain weight, while others do not.
Why people get fat because of antidepressants is still not clear. Some drugs are known to be more likely to cause weight gain than others. These include the following:
- Most commonly prescribed selective serotonin reuptake inhibitors (SSRIs). They have few side effects, but some drugs, such as paroxetine, can cause weight gain.
- Tricyclic and tetracyclic antidepressants such as amitriptyline, imipramine and doxepin. They are used less often than SSRIs because they have more side effects. Among them are constipation, drowsiness, weight gain.
- Monoamine oxidase inhibitors such as phenelzine (Nardil). They have many side effects, including weight gain. Those who take them have to avoid certain drugs and foods, such as cheeses, sausages, soy, and other foods high in tyramine and tyrosine.
- Atypical antidepressants are drugs that are not classified in other groups. One of them, mirtazapine (Remeron), increases appetite and promotes weight gain.
Not all drugs in the categories listed cause weight gain. For example, bupropion, an atypical antidepressant, does not have this side effect.
Weight is affected not only by antidepressants, but also by a person’s condition.
Symptoms of depression vary from person to person. For example, someone overeats, so they gain weight. Someone, on the contrary, does not want to eat – and he loses weight. And then he starts taking antidepressants, because of this, his mood improves, appetite appears, which leads to natural weight gain.
Sometimes weight gain has nothing to do with depression or medication. Adults tend to get better with age.
People with depression often change their lifestyle. I lose strength for sports, walks, it’s hard to even get myself out of bed. If there are fewer activities and more food, then the weight may increase. Because a person consumes more calories than they burn during the day.
It is perfectly normal to be nervous before taking a new drug, especially if it is an antidepressant that affects the biochemical processes of the brain. Discuss your experiences with the therapist or psychiatrist from whom you received the prescription. Perhaps together you will select a drug that does not have such a side effect.
But be prepared that this is not always possible. The benefits of taking the right antidepressant, that is, the cure for depression, are more important than temporary weight gain. If you have the strength, weight can be controlled by a balanced diet and increased physical activity. Even the simplest types of exercise will do: walking, running, cycling.
First, don’t blame yourself.
Second, if you’ve gained weight since you started taking antidepressants, don’t stop treatment. Watch your body for a couple of weeks: the body needs to get used to the drug, and then the side effects will pass. If you are concerned about changes in the body, the side effects should be discussed with a therapist or psychiatrist. He can change the dosage or choose another drug. Physical activity and a balanced diet will also help here.
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Taking antidepressants can cause weight gain!
Taking antidepressants can cause weight gain
You’re more likely to put on weight if you take antidepressants, according to a new British study.
The discovery surprised mental health experts.
“Psychiatrists have been aware of this for a decade, writing articles about it, and hearing about it from their patients all the time,” says Dr. Brian Keefe, psychiatrist and chief medical officer at Zucker Hills Hospital in Glen Oaks, New York, who was not involved in the study.
During the experiment, according to scientists, it turned out that the risk of gaining 2-3 extra pounds in patients who took at least one antidepressant is 21 percent higher than in other subjects.
According to the lead author of the study, it was not possible to prove the existence of a direct causal relationship between the use of antidepressants and weight gain – all that can be said is that there is some connection, and studying it can help explain the accumulation of fat in the human body.
“It is important to emphasize the following: no patient should stop taking medication because of this. If a person experiences any side effects from taking the drug, they should talk to their doctor or pharmacist about it,” says Dr. Rafael Ghafoor, a psychiatrist at King’s College London, who led the study.
According to him, the peak of the probability of gaining weight falls on the interval from 2-3 to 6 years of continuous use of antidepressants. Gafur says that while scientists do not know why the weight begins to grow precisely from the 2nd year of taking the remedy, and not earlier.
However, during this period of time, many people manage to gain excess weight or even become obese – when taking antidepressants, the risk of such an outcome increases by 29%.
Researchers say that in people who were already overweight before starting antidepressants, these drugs also increase the risk of obesity by 29%.
According to one of the American doctors, treatment with antidepressants always affects the form of his patients in different ways.
“I’ve seen some people not gain weight, some people gain a lot of extra pounds, and some even lose weight after taking antidepressants,” says Dr. Jamie Kane, director of Northwell Health Hospital’s Weight Management Center at Syosset, New York.
In his opinion, those patients who, while taking antidepressants, notice that their weight begins to increase, should try to adjust their diet and start exercising more often.
In addition, antidepressants, according to Kane, have alternatives – psychotherapy and increased physical activity.
Gafur and his team recruited approximately 300,000 men and women between 2004 and 2014 to conduct the study, 20% of whom were taking antidepressants.
For investigators, a weight gain of at least 5% of previous body weight was significant in any of the study participants.
Research has shown that 11 out of every 100 people who take antidepressants gain weight in a year. Among those who do not take medication, about 8 out of 100 people gain weight.
Those who took antidepressants at 2-3 years of medication had an approximately 46% higher risk of gaining more than 5% of their body weight than those who did not take such drugs.