Can Amitriptyline Cause Weight Gain? How To Manage It

Last Updated: February 7, 2020

Authored by Sharon Levy, MD, MPH

Amitriptyline weight gain is one of the frequent downsides of the medication. Although reactions to amitriptyline may vary between individuals, Elavil is more likely to cause body mass increase compared to other antidepressants. That’s why it’s critical for the patients taking Elavil to know how to manage these changes.

Does Amitriptyline Cause Weight Gain?

Changes in body mass are common during depression treatment. It is one of the most frequent untoward adverse effects of amitriptyline. Several theories suggest a link between Elavil and weight gain.

One hypothesis suggests that amitriptyline weight gain may be due to hypoglycemia caused by increased circulating blood insulin. It can increase appetite.

Amitriptyline also has strong affinities for histamine receptors. Evidence shows that one of its antihistamine side effects increases appetite. Carbohydrate cravings and low satiety rates can increase calorie intake, contributing to body mass increase. The study presents that the patients taking Elavil report a high craving for such sweets as chocolates, cake, pastry, and ice-cream. Worth noting is the fact that such carbohydrate cravings are accompanied by hypoglycemia (a low blood glucose level) without any signs of faintness or dizziness.

Other factors that can contribute to amitriptyline weight gain include:

  • Overeating and lack of exercise as a result of depression.
  • Increased appetite due to improved mood and successful treatment.
  • Baseline Body Mass Index (BMI) of more than 30 when treatment begins is more likely to gain more weight with amitriptyline.
  • Older people generally tend to gain extra kilograms, regardless of amitriptyline doses and treatment duration.

Elavil weight changes

Does Amitriptyline Cause Weight Loss?

Patients respond to amitriptyline differently. Several contributing factors affect the relationship of amitriptyline with bodyweight changes, including age, gender, base-line weights, overall health condition, and treatment duration. While most users would report increased appetite, others may feel less hungry when taking the medication and experience the Elavil weight loss.

Preventing Elavil-Induced Weight Gain

Early intervention is important to prevent body mass increase during amitriptyline treatment. Patients who have metabolic risks should be given weight-neutral or weight-loss agents. While these anti-obesity drugs are not meant to be used as primary therapy, their use may be warranted for patients who cannot participate in diet and exercise programs because of severe negative symptoms.

Monitoring of body mass should be done regularly among the following patients who take Elavil: 

  • a waist circumference of > 35 and >40 inches in women and men, respectively;
  • hyperlipidemia;
  • elevated BMI;
  • diabetes mellitus;
  • history of stroke or other cardiovascular diseases;
  • family history of obesity, hypertension, diabetes, or hyperlipidemia.

Switching Medications Or Decreasing Dosage

Switching from Elavil to other drugs can make a huge difference in preventing amitriptyline weight gain. Other antidepressants have a lower potential to cause extra kilograms gaining. That’s why the patient may consider alternative medications with their doctor. Decreasing the dosage may also help control gaining extra kilos. However, the use of a new agent or a low-dose drug may not deliver the same effects to control symptoms. It is best to consult a doctor before making a switch to make a transition safe and effective.

Eating A Healthy Diet And Exercising Regularly

Not surprisingly, switching to a more nutritious diet, cutting calories, and exercising can help prevent gaining extra kilograms.  Moreover, increasing daily physical activity may help to avoid not just amitriptyline weight loss, but also depression. Speak with a dietician to create an eating plan that can help control body mass increase without impacting depression in a bad way.

recovering afted Elavil body mass increase

Attending CBT

Lifestyle modification based on cognitive Behavioral Therapy (CBT) can help treat amitriptyline-induced weight gain. CBT can help increase motivation to do lifestyle modification. By practicing healthier eating habits, exercising more, setting realistic goals, and providing coping skills, one can make the body fit week by week.

Treatment Options In Case of Elavil Misuse

Elavil uses cover pain treatment by producing a sedative effect and possible high feelings, hence prone to abuse. It is always best to consult a doctor before coming off amitriptyline to prevent body mass changes. The weaning period will depend on how long a person has been taking Elavil and at what dosage, with the decrease being slower if the body has been used to it for a long time.

In some cases, both medical detox and behavioral therapies are needed to help a patient stop taking amitriptyline safely. Addiction treatment programs at rehabilitation facilities can help patients learn the mechanisms of a tapering schedule to prevent harmful withdrawal symptoms. The staff in the rehab centers provides supervision around the clock during inpatient and residential treatment so as patients feel safe.


Page Sources

  1. Paykel ES, Mueller PS, De la Vergne PM. Amitriptyline, weight gain and carbohydrate craving: a side effect. British Journal of Psychiatry. 1973; 123(576): 501-7. https://www.ncbi.nlm.nih.gov/pubmed/4588039.
  2. Thour A, Marwaha R. Amitriptyline. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK537225/.

Published on: February 7th, 2020

Updated on: February 7th, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

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