Effect of naltrexone on weight gain and food craving induced by tricyclic antidepressants and lithium: An open study

Abstract

An unwanted increase in body weight frequently occurs during treatment with tricyclic antidepressants (TCAs) and lithium (Garland et al 1988; Baptista et al 1995), which is often accompanied by continuous hunger or episodes of craving for sweet and fatty food (Fernstrom and Kupfer 1988). A considerable number of patients discontinue drug treatment because of these side effects (Garland et al 1988). Appetite regulation is under opioidergic control, as acute administration of exogenous opiates to human volunteers increases spontaneous food intake (Levine and Billington 1989), and pleasantness ratings of ingested sucrose solutions (Drewnowski et al 1992). Conversely, acute blockade of opiate receptors results in decreased food ingestion (Levine and Billington 1989), especially of highly palatable food, decreases pleasantness ratings of palatable foodstuffs (Drewnowski et al 1992; Yeomans and Wright 1991), and diminishes subjective feeling of hunger (Bertino et al 1991). Chronic opiate receptor blockade using high dosages of naltrexone can effectively reduce frequency and severity of binge eating in bulimic patients (Jonas and Gold 1987). Opioid peptidergic function might be modulated by TCAs,