Weight Gain Associated with Amitriptyline

Introduction to Weight Gain Risk

Among tricyclic antidepressants, amitriptyline has the highest risk of weight gain, according to the American Gastroenterological Association 1, 2
The American Gastroenterological Association recommends considering the risk of weight gain when selecting an antidepressant, as it can impact treatment adherence and exacerbate obesity-related comorbidities 2

Antihistamine H1 receptor antagonists in the hypothalamus play a significant role in weight gain induced by certain psychotropic medications, as reported by the British Journal of Pharmacology 3

The American Gastroenterological Association suggests that bupropion is the only antidepressant consistently associated with weight loss 2, 4
Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline are associated with short-term weight loss and long-term weight neutrality, according to the American Gastroenterological Association 2
Protriptyline, another tricyclic antidepressant, is less likely to cause weight gain, as noted by the British Journal of Pharmacology 3

The American Medical Association recommends that patients with pre-existing overweight or obesity are at higher risk of significant weight gain and should be monitored closely 5
Regular weight monitoring is advised, particularly during the initial months of treatment, with a weight gain of more than 2 kg in one month or ≥7% of initial body weight prompting clinical attention, according to the American Medical Association 5, 6

The American Medical Association suggests that lifestyle modifications, such as a balanced diet and physical activity, can help limit weight gain 5
In some cases, adding metformin (1000 mg/day) or topiramate (100 mg/day) may be considered to counter weight gain effects, as recommended by the American Medical Association 5