Amitriptyline stimulates weight gain in hemodialysis patients

Sixteen chronic hemodialysis patients were enrolled in a double blind 13 week study of amitriptyline vs. placebo in non-crossover design. Patients receiving active drug reached therapeutic serum concentrations at doses of 50 to 200 mg/day, but antidepressant effect was not demonstrable. Patients receiving active drug had slightly greater fluctuation in weight pre- vs. Post-dialysis and had slightly greater postural hypotension post-dialysis than control patients. The trend in post-dialysis weight indicated gain in the active drug group and loss in the placebo group; this difference was highly statistically significant. Weight gain in depression and anorexia nervosa patients treated with amitriptyline is reviewed and it is suggested that amitriptyline may be a useful agent in stimulating appetite in other diseases also.