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Changes in weight during treatment for depression.

D J Kupfer, P A Coble, D Rubinstein

    Psychosomatic Medicine
    |November 1, 1979
    PubMed
    Summary
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    This study found that while amitriptyline aided weight gain in depressed patients, it did not correlate with improved appetite or clinical outcomes. Weight changes alone are not reliable indicators of treatment effectiveness for depression.

    Area of Science:

    • Psychiatry
    • Clinical Pharmacology

    Background:

    • Depression often involves appetite and weight changes.
    • Tricyclic antidepressants (TCAs) like amitriptyline are used to treat depression.
    • Clinical observations suggest weight gain during TCA treatment may indicate positive response.

    Purpose of the Study:

    • To investigate the relationship between amitriptyline treatment, appetite changes, and weight fluctuations in primary depressives.
    • To determine if weight gain is a reliable indicator of treatment response in depression.

    Main Methods:

    • A randomized controlled trial involving 47 primary depressive patients over 35 days.
    • Patients received either placebo (N=17) or amitriptyline (N=30).
    • Appetite and weight changes were monitored and analyzed in relation to treatment response and depression severity.

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    Main Results:

    • The amitriptyline group showed significantly greater weight gain (4.5 lbs) compared to the placebo group (0.5 lbs).
    • No significant correlation was found between weight change and treatment response (drug responders vs. nonresponders).
    • Appetite changes did not consistently correlate with weight changes in drug-treated patients, though a link was observed in the placebo group.

    Conclusions:

    • Weight gain during amitriptyline treatment for depression does not necessarily correlate with improved appetite or clinical improvement.
    • The common clinical belief that weight gain signifies a "good" treatment response to TCAs was not supported by these findings.
    • Appetite and weight changes should be interpreted cautiously as indicators of treatment efficacy in depression.