Amitriptyline cause weight gain. Amitriptyline and Weight Gain: A Comprehensive Analysis of Biochemical and Endocrinological Factors

15.06.202121.07.2023 by alexxlab

How does amitriptyline affect body weight. What are the mechanisms behind tricyclic antidepressant-induced weight gain. Can low doses of amitriptyline cause significant weight changes. How long does it take for weight gain to occur on amitriptyline. Are there ways to mitigate weight gain while taking tricyclic antidepressants.

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The Link Between Amitriptyline and Weight Gain

Amitriptyline, a commonly prescribed tricyclic antidepressant, has been associated with weight gain in many patients. A study published in the Journal of Affective Disorders in 1984 examined this phenomenon in detail, providing valuable insights into the relationship between amitriptyline and changes in body weight.

The research, conducted by Berken, Weinstein, and Stern, focused on 40 depressed outpatients from a private psychiatric practice who were prescribed low to moderate doses of tricyclic antidepressants, including amitriptyline. The study aimed to evaluate body weight and appetite changes in these patients over an average treatment period of 6 months.

Key Findings of the Study

Patients experienced a mean weight increase of 1.3-2.9 pounds per month
The average total weight gain ranged from 3 to 16 pounds, depending on factors such as drug type, dosage, and duration of treatment
Weight gain was linear over time
Patients reported a marked increase in preference for sweet foods
Excessive weight gain was the most common reason for discontinuing treatment, affecting half of the patients
Significant weight loss occurred upon discontinuation of the medication

Mechanisms Behind Amitriptyline-Induced Weight Gain

The exact mechanisms by which amitriptyline and other tricyclic antidepressants cause weight gain are not fully understood. However, several theories have been proposed based on the drug’s effects on various biochemical and endocrinological processes in the body.

Increased Appetite and Carbohydrate Cravings

One of the most notable findings of the study was the increased preference for sweet foods among patients taking amitriptyline. This suggests that the drug may alter appetite regulation and food preferences, particularly for carbohydrates.

How does amitriptyline increase appetite? The drug affects neurotransmitter systems in the brain, particularly serotonin and norepinephrine. These neurotransmitters play crucial roles in regulating mood, appetite, and metabolism. By altering their levels and activity, amitriptyline may stimulate hunger and increase cravings for high-calorie foods.

Metabolic Changes

Tricyclic antidepressants like amitriptyline may also influence metabolic processes in the body. Some research suggests that these medications can affect glucose metabolism and insulin sensitivity, potentially leading to weight gain.

Do tricyclic antidepressants slow down metabolism? While more research is needed to fully understand the metabolic effects of these drugs, some studies have shown that they may reduce basal metabolic rate, making it easier for patients to gain weight even without significant changes in caloric intake.

Dosage and Duration: Key Factors in Amitriptyline-Induced Weight Gain

The study by Berken et al. focused on patients receiving low to moderate doses of tricyclic antidepressants, including amitriptyline at a maximum dose of 150 mg/day. This is particularly noteworthy, as it demonstrates that even relatively low doses of the medication can lead to significant weight changes.

Impact of Dosage on Weight Gain

Can low doses of amitriptyline cause weight gain? The study’s findings suggest that even modest doses of amitriptyline can lead to considerable weight gain over time. This is important for both patients and healthcare providers to consider when evaluating the risks and benefits of treatment.

The researchers observed that the extent of weight gain varied depending on the specific drug, dosage, and duration of treatment. This suggests that there may be a dose-dependent relationship between amitriptyline and weight gain, with higher doses potentially leading to more significant weight changes.

Time Course of Weight Gain

How long does it take to gain weight on amitriptyline? The study found that weight gain was linear over time, with patients experiencing an average increase of 1.3-2.9 pounds per month. This steady progression of weight gain highlights the importance of regular monitoring during treatment.

The cumulative effect of this gradual weight gain can be substantial, with patients in the study gaining an average of 3-16 pounds over the 6-month treatment period. This range likely reflects individual variations in factors such as metabolism, diet, and physical activity level.

Clinical Implications of Amitriptyline-Induced Weight Gain

The findings of this study have significant implications for the clinical use of amitriptyline and other tricyclic antidepressants. Weight gain can be a distressing side effect for many patients, potentially impacting their overall health, self-esteem, and adherence to treatment.

Treatment Discontinuation Due to Weight Gain

One of the most striking findings of the study was that excessive weight gain was the most common reason for discontinuing treatment, affecting half of the patients. This highlights the importance of addressing weight-related concerns in patients taking amitriptyline.

Is weight gain on amitriptyline reversible? The study found that significant weight loss occurred upon discontinuation of the drug, suggesting that the weight gain is indeed reversible. However, it’s important to note that abruptly stopping antidepressant medication can have serious consequences and should only be done under medical supervision.

Challenges in Long-Term Maintenance Therapy

The researchers concluded that chronic administration of even low to moderate doses of tricyclic antidepressants can significantly interfere with the ability to provide long-term maintenance therapy. This poses a challenge for healthcare providers in managing depression over extended periods.

How can healthcare providers balance the need for effective depression treatment with the risk of weight gain? This may involve strategies such as:

Regular monitoring of weight and metabolic parameters
Providing dietary and lifestyle counseling to patients
Considering alternative antidepressant medications with lower risk of weight gain
Adjusting dosages or incorporating weight management strategies into the treatment plan

Strategies to Mitigate Weight Gain on Amitriptyline

While weight gain is a common side effect of amitriptyline, there are several strategies that patients and healthcare providers can employ to help mitigate this issue.

Dietary Modifications

Given the increased preference for sweet foods observed in the study, dietary interventions may be particularly important for patients taking amitriptyline.

What dietary changes can help prevent weight gain on amitriptyline? Some potentially helpful strategies include:

Limiting intake of high-sugar and high-carbohydrate foods
Increasing consumption of lean proteins, fruits, vegetables, and whole grains
Practicing portion control and mindful eating
Keeping a food diary to track intake and identify problematic eating patterns

Regular Physical Activity

Exercise can play a crucial role in managing weight and may help offset some of the metabolic changes associated with amitriptyline use.

How much exercise is needed to counteract amitriptyline-induced weight gain? While individual needs may vary, general recommendations include:

Aiming for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week
Incorporating strength training exercises at least twice a week
Finding enjoyable forms of physical activity to increase adherence

Alternative Antidepressant Options

For patients who are particularly concerned about weight gain or who have experienced significant weight changes on amitriptyline, alternative antidepressant medications may be worth considering.

Newer Antidepressants with Lower Weight Gain Risk

Are there antidepressants less likely to cause weight gain? Some newer antidepressants have been associated with a lower risk of weight gain compared to tricyclic antidepressants like amitriptyline. These include:

Selective Serotonin Reuptake Inhibitors (SSRIs) such as fluoxetine or sertraline
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like venlafaxine or duloxetine
Bupropion, which has been associated with weight loss in some patients

It’s important to note that the effectiveness and side effect profile of antidepressants can vary greatly between individuals. Any changes in medication should be made under the guidance of a healthcare provider.

Future Research Directions

While the study by Berken et al. provides valuable insights into the relationship between amitriptyline and weight gain, there are still many unanswered questions in this area.

Genetic Factors in Antidepressant-Induced Weight Gain

One promising area of research is the role of genetic factors in determining an individual’s susceptibility to weight gain on antidepressants.

Can genetic testing predict who will gain weight on amitriptyline? While current genetic tests are not yet able to reliably predict antidepressant-induced weight gain, ongoing research in pharmacogenomics may eventually lead to more personalized approaches to antidepressant selection and dosing.

Long-Term Metabolic Effects

Further research is needed to fully understand the long-term metabolic effects of amitriptyline and other tricyclic antidepressants. This includes investigating potential impacts on glucose metabolism, lipid profiles, and cardiovascular risk factors.

Do the metabolic effects of amitriptyline persist after discontinuation? While the study found that weight loss occurred upon stopping the medication, more research is needed to determine whether other metabolic changes fully reverse after treatment cessation.

In conclusion, the relationship between amitriptyline and weight gain is complex and multifaceted. While this side effect can pose challenges for long-term treatment, understanding the underlying mechanisms and implementing appropriate management strategies can help patients and healthcare providers navigate this issue more effectively. As research in this area continues to evolve, it is hoped that more targeted and personalized approaches to antidepressant therapy will emerge, optimizing treatment outcomes while minimizing unwanted side effects like weight gain.

Weight gain. A side-effect of tricyclic antidepressants

. 1984 Oct;7(2):133-8.

doi: 10.1016/0165-0327(84)90031-4.

G H Berken, D O Weinstein, W C Stern

PMID:
6238068
DOI:
10.1016/0165-0327(84)90031-4

G H Berken et al.

J Affect Disord.

1984 Oct.

. 1984 Oct;7(2):133-8.

doi: 10.1016/0165-0327(84)90031-4.

Authors

G H Berken, D O Weinstein, W C Stern

PMID:
6238068
DOI:
10. 1016/0165-0327(84)90031-4

Abstract

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.

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Medically reviewed by Alan Carter, Pharm. D. — By Jacquelyn Cafasso — Updated on April 18, 2019

Overview

Weight gain is a possible side effect of many antidepressant drugs. While each person responds to antidepressant treatment differently, the following antidepressants may be more likely to cause weight gain during your treatment.

Tricyclic antidepressants, also known as cyclic antidepressants or TCAs, may cause weight gain. These drugs include:

amitriptyline (Elavil)
amoxapine
desipramine (Norpramin)
doxepin (Adapin)
imipramine (Tofranil-PM)
nortriptyline (Pamelor)
protriptyline (Vivactil)
trimipramine (Surmontil)

TCAs were some of the first drugs approved to treat depression. They aren’t prescribed as often anymore because newer treatments cause fewer side effects.

Weight gain was a common reason people stopped treatment with these types of antidepressants, according to a 1984 study.

Still, TCAs can be effective in people who don’t respond to other types of antidepressant drugs, despite the unwanted side effects.

Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressants to be developed. MAOIs that cause weight gain include:

phenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)

Doctors prescribe MAOIs most often when other antidepressants don’t work due to certain side effects and safety concerns. Of the three MAOIs listed above, phenelzine is the most likely to result in weight gain, according to a 1988 review.

However, a newer formulation of an MAOI known as selegiline (Emsam) has been shown to result in weight loss during treatment. Emsam is a transdermal medication that’s applied to the skin with a patch.

SSRIs are the most commonly prescribed class of depression drugs. Long-term use of the following SSRIs may cause weight gain:

paroxetine (Paxil, Pexeva, Brisdelle)
sertraline (Zoloft)
fluoxetine (Prozac)
citalopram (Celexa)

Although some SSRIs are associated with weight loss at first, long-term use of SSRIs is mostly linked to weight gain. Long-term use is considered treatment that lasts longer than six months.

Of the SSRIs listed above, paroxetine is most commonly associated with weight gain with both long-term and short-term use.

Mirtazapine (Remeron) is a noradrenergic antagonist, which is a type of atypical antidepressant. The drug has been shown repeatedly to be more likely to cause weight gain and to increase appetite than other drugs.

Mirtazapine is less likely to make people gain weight compared with TCAs.

It also doesn’t result in as many other side effects as other antidepressants. However, it can cause:

nausea
vomiting
sexual dysfunction

Other antidepressants have been associated with less weight gain as a side effect. These antidepressants include:

escitalopram (Lexapro, Cipralex), an SSRI
duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor (SNRI), may cause modest weight gain with long-term use
bupropion (Wellbutrin, Forfivo, and Aplenzin), an atypical antidepressant
nefazodone (Serzone), a serotonin antagonist and reuptake inhibitor
venlafaxine (Effexor) and venlafaxine ER (Effexor XR), which are both SNRIs
desvenlafaxine (Pristiq), an SNRI
levomilnacipran (Fetzima), an SNRI
vilazodone (Viibryd), a serotonergic antidepressant
vortioxetine (Trintellix), an atypical antidepressant
selegiline (Emsam), a newer MAOI that you apply to your skin, which may lead to fewer side effects than MAOIs taken by mouth

Weight gain is also less likely to occur with the following SSRIs when they’re used for less than six months:

sertraline (Zoloft)
fluoxetine (Prozac)
citalopram (Celexa)

Not everyone taking an antidepressant will gain weight. Some people will actually lose weight.

Experts emphasize that worries about gaining weight shouldn’t influence the choice of antidepressant for most people. There are other side effects and factors to consider when choosing an antidepressant.

If you do gain some weight while taking an antidepressant, the drug may not actually be the direct cause of the weight gain. An improved mood while taking an antidepressant, for example, may increase your appetite, leading to weight gain.

Don’t stop taking your drug right away even if you do gain a little bit of weight. You’ll need to work with your doctor to find an antidepressant that helps with your depression symptoms and doesn’t result in unwanted side effects. This may take a little bit of patience.

Your doctor can also give you some tips for preventing weight gain while on antidepressant therapy.

Last medically reviewed on April 18, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Medically reviewed by Alan Carter, Pharm.D. — By Jacquelyn Cafasso — Updated on April 18, 2019

Is it true that antidepressants make you fat?

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07/15/2021

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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Study: taking antidepressants leads to weight gain

May 25, 2018, 2:58 pm

Widespread use of antidepressants may contribute to rising rates of obesity in developed countries. The risk of becoming overweight in those who take drugs to combat depression for a long time is 21% higher. This conclusion was reached by doctors at King’s College London. The work was published in the medical journal The BMJ. This is reported by The Independent.

“The widespread use of antidepressants may be one of the reasons for the long-term increase in the weight of the world’s population,” said one of the co-authors of the work, Martin Gulliford.

The study showed that the risk of weight gain increased after 2-3 years of taking antidepressants. The risk of developing obesity and the appearance of extra pounds in such patients was 29% higher.

As noted by the authors, the findings suggest that antidepressants should be used less often in the treatment of mild forms of depression. In such cases, cognitive behavioral therapy and exercise should be a priority.

The study was based on data from 300,000 British patients between 2004 and 2014. Information included data on patients taking antidepressants and their body mass indexes (BMI). The researchers adjusted for other factors that could influence weight, such as age, chronic illness, smoking, and other medications.

Weight gain of 5% of body weight or more within a year was 8.1% among patients not taking antidepressants. Among those who took medication to combat depression, the figure was 11.2%. After 3 years of taking antidepressants, the risk of gaining 5% of body weight per year increased to 46%. The study showed that the risk of becoming overweight is highest in the second and third years of taking antidepressants. In the next 6 years, the risk also remains elevated.

Researchers analyzed the effects of 12 common types of antidepressants on body weight. Thus, the drug mirtazapine (another name is remeron) in half of the cases led to an increase in the weight of patients by at least 5% of the body weight before taking the drugs. The drug citalopram increased the risk of weight gain by 26%.

According to the Organization for Economic Co-operation and Development (OECD), the majority of antidepressant users are in Iceland.

Amitriptyline cause weight gain. Amitriptyline and Weight Gain: A Comprehensive Analysis of Biochemical and Endocrinological Factors

The Link Between Amitriptyline and Weight Gain

Key Findings of the Study

Mechanisms Behind Amitriptyline-Induced Weight Gain

Increased Appetite and Carbohydrate Cravings

Metabolic Changes

Dosage and Duration: Key Factors in Amitriptyline-Induced Weight Gain

Impact of Dosage on Weight Gain

Time Course of Weight Gain

Clinical Implications of Amitriptyline-Induced Weight Gain

Treatment Discontinuation Due to Weight Gain

Challenges in Long-Term Maintenance Therapy

Strategies to Mitigate Weight Gain on Amitriptyline

Dietary Modifications

Regular Physical Activity

Alternative Antidepressant Options

Newer Antidepressants with Lower Weight Gain Risk

Future Research Directions

Genetic Factors in Antidepressant-Induced Weight Gain

Long-Term Metabolic Effects

Weight gain. A side-effect of tricyclic antidepressants

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Abstract

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16 Antidepressants That Cause Weight Gain

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Is it true that antidepressants make you fat?

Study: taking antidepressants leads to weight gain

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