Posted by King Vultan on January 3, 2005, at 8:11:05
In reply to TCAs and Weight Gain, posted by tygereyes on January 3, 2005, at 0:35:43
> I'm sure this has been asked before, but which tricyclic antidepressant is the least likely to cause weight gain?
>
> I was just released from an inpatient eating disorders unit and I'm in the early stages of recovery from anorexia nervosa, and I think Nortriptyline is making my constant hunger even worse. I know it's caused me to gain weight in the past.
>
> And I have to take a tricyclic because I have Interstitial Cystitis, which is activated by SSRIs. It also activates mood stabilizers, to a lesser degree, so a tricyclic is necessary in order to keep the bladder problems caused by Trileptal (my other med) in check.
>
> I've heard that Desipramine is fairly neutral in terms of weight gain. Is this true? It's so difficult to find information on the tricyclics, because research is so focused on the newer AD drugs.
Desipramine is regarded as the tricyclic with the lowest tendency to induce weight gain. It has the weakest histamine H1 blockade and is the most powerful of the tricyclics at blockading norepinephrine reuptake. Generally, blockading histamine H1 receptors, which nortriptyline does to a noticeably greater extent than does desipramine, will tend to induce weight gain, while blockading norepinephrine reuptake has a tendency to reduce appetite.My own experience with nortriptyline and desipramine was that both lowered my appetite, but while my weight remained steady on nortriptyline--which I couldn't tolerate very well and was only on a couple of months--I actually lost a few pounds on desipramine. However, I do believe that both of these drugs slowed down my metabolism; it's just that in my own case, the appetite suppression effectively counterbalanced it. Out of the 10+ drugs I've tried, desipramine had the strongest tendency to reduce my appetite.
You might also want to consider Strattera, which is similar to desipramine, but with no histamine blockade. Reboxetine is another drug similar to Strattera but is not available in the US, if that's where you happen to live.
Todd
poster:King Vultan
thread:437085
URL: http://www.dr-bob.org/babble/20050103/msgs/437145.html