Amitriptyline, Weight Gain and Carbohydrate Craving: A Side Effect
E. S. PAYKEL M.D., M.R.C.P., M.R.C.P.(Ed)., M.R.C.Psych.1,
P. S. MUELLER M.D.2, and
P. M. DE LA VERGNE 3
1 Consultant Psychiatrist, St. George's Hospital, London, S.W.17
2 Associate Professor of Psychiatry, Rutgers University, New Jersey, U.S.A.
3 Research Associate in Psychiatry, Yale University, New Haven, Connecticut, U.S.A.
This paper reports excessive weight gain associated with craving for carbohydrates, occurring as a side effect of treatment with amitriptyline. Subjects were 51 depressed women who had responded to initial treatment with amitriptyline and remained well. Nineteen were maintained on amitriptyline for nine months; 32 had the medication withdrawn after three months. Both groups gained weight during recovery. Subsequently the amitriptyline group continued to gain weight excessively, while the drug withdrawal group did not. This difference was not due to persisting depression. Withdrawal of active drug after nine months treatment was followed by weight loss. Amitriptyline patients also reported a striking and dose-related craving for carbohydrates, developing within one or two months of starting the drug. Fasting insulin and glucose, and intravenous insulin tolerance were not affected, and the mechanism of the side effect is not clear. However, in confirmation of previous work, insulin resistance was found in subjects with minor residual depression.
Submitted on October 24, 1972
