Amitriptyline is a tricyclic antidepressant that can be prescribed to treat depression. Amitriptyline treatment can result in weight gain, although this likelihood can vary from person to person. People who experience weight gain on amitriptyline can seek advice from their doctor, who may change their medication or advise on weight management strategies.
- Amitriptyline is a tricyclic antidepressant, which can be used to treat mental health conditions and various physical health conditions causing chronic pain.
- Amitriptyline is one of the antidepressants most likely to cause weight gain, although this can depend on the individual.
- It is possible to manage weight gain during treatment by implementing a healthy diet and exercise, or by requesting medication adjustments with the prescribing physician.
Does amitriptyline cause weight gain?
Amitriptyline is likely to contribute to weight gain.
Antidepressants are commonly used to treat anxiety and depressive disorders. Reports suggest that over half of the individuals prescribed antidepressants for these conditions are affected by weight gain. [1]
Some antidepressants are more likely than others to cause weight gain, and individual differences can also impact this likelihood. Amitriptyline is a tricyclic antidepressant (TCA), commonly associated with weight gain, which is one of the most often reported reasons for discontinuation. [1][2]
Prevalence and timeline
Reports of the prevalence and amount of weight gain associated with amitriptyline vary. Many reports suggest that it is linear, steadily increasing over time, with increases continuing over 24 months. [1][2]
Many studies, involving varying durations, show an average increase of 1.3 to 7 kg, and around two-thirds of participants experience increased cravings for sweets. [2][3]
Why amitriptyline can lead to weight gain
Several factors can contribute to an increased likelihood of weight gain during amitriptyline treatment. For example, if the individual experiences reduced appetite as a symptom of depression, treatment for their condition might help their appetite return to normal, thus causing an increase in weight. [2][3]
Additionally, TCAs cause various impacts on neurotransmitter systems and metabolism, including: [2][3][4]
- Increased serotonin levels, which are linked to increased appetite and carbohydrate cravings.
- Increased cortisol levels, which can increase appetite and weight gain.
- Impaired insulin sensitivity, which can disrupt metabolic functioning, increasing the risk of diabetes and potentially leading to weight gain.
- Changes in dopamine levels, which could impact the reward circuit, potentially causing more food-related reward-seeking behaviors.
Amitriptyline weight rebound and safe discontinuation
People who have gained weight during treatment are likely to experience a weight reduction following discontinuation of amitriptyline treatment. This generally means a return to one’s previous weight, rather than a continual weight loss, and can be due to the return of normal appetite and neurotransmitter functioning. [2]
It is important not to stop taking amitriptyline without professional advice, as this can lead to a risk of withdrawal symptoms and a worsening of mental health symptoms. A doctor will advise on a safe tapering schedule and whether alternative medications need to be implemented. [5]
Amitriptyline weight risk vs. Other antidepressants
Studies show differing results regarding the risk of weight changes among antidepressants, and these risks can vary depending on the individual, as well as the type, duration, and dosage of treatment.Â
Generally, newer antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are less likely to cause weight gain than older antidepressants, such as TCAs and monoamine oxidase inhibitors (MAOIs). However, long-term SSRI use may result in weight gain. [1][3][6]
The antidepressants most likely to cause weight gain include: [1][3]
- Amitriptyline
- Mirtazapine
- Paroxetine
- Escitalopram
The antidepressants least likely to cause weight gain, and could also cause weight loss, include: [1][3]
- Bupropion
- Fluoxetine
Who is more likely to experience weight gain?
Weight gain is most likely to occur, and in the greatest severity, when people remain on amitriptyline as a long-term treatment. Weight gain can occur within the first few weeks or months of treatment, and is likely to continue to increase with longer treatment durations. [1] Similarly, the dosage can also impact the likelihood and severity of weight gain, as higher doses may be more likely to cause a greater increase. [4]
People might also be more likely to gain weight on amitriptyline if they have a high body weight prior to treatment, eat an unhealthy diet, and do not exercise regularly. [1]
Strategies to manage weight gain
Weight can be managed during amitriptyline treatment by implementing or maintaining a healthy lifestyle, including:
- Adequate hydration.
- Avoiding or limiting alcohol intake.
- Eating a healthy diet low in added sugars and saturated fats.
- Engaging in regular physical activity.
- Getting good quality and quantity of sleep.
- Utilizing stress management skills.
Implementing these strategies can be helpful to those utilizing amitriptyline to help with weight changes, while also providing benefits to physical and mental well-being.
When to seek medical advice
If you are taking amitriptyline, it might be advisable to seek medical advice if you notice a significant increase in weight of 5% or more over a short period. This could increase the risk of obesity, diabetes, and other health issues.
It is also important to seek medical advice if you notice extreme weight gain that results in a desire to stop taking amitriptyline. Stopping amitriptyline without professional guidance, especially if it is stopped suddenly, can increase the risk of withdrawal symptoms and unmanaged mental health conditions. Your doctor can advise on safe tapering schedules and suitable alternative medications.
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