Increased Appetite Side Effect
Tricyclic antidepressants (imipramine, amitriptyline, and doxepin) cause carbohydrate craving and increased appetite1. First-generation antihistamines, most antipsychotics and systemic corticosteroids also may cause increased appetite.
There is evidence that those drugs, which either antagonize or downregulate serotonin receptors, are more likely to stimulate carbohydrate craving and appetite, and promote weight gain8.
List of medications with orexigenic effects that cause increased appetite (polyphagia) and excessive food intake:
| Drug | Incidence |
|---|---|
| Abilify | < 1% |
| Aceon | 0.3% to 1% |
| Aciphex | |
| AeroBid | 1% to 3% |
| Alinia | < 1% |
| Ambien | Rare |
| Aricept | Infrequent |
| Aromasin | 3% |
| Asacol | |
| Astelin | Infrequent |
| Bextra | 0.1% to 1.9% |
| Carbamazepine (Tegretol®)11 | |
| Caduet | < 2% |
| Campral | 1% to 10% |
| Celebrex | 0.1% to 1.9% |
| Celexa | Frequent |
| Cinnarizine (®Stugeron)12 | |
| Clomid | < 1% |
| Clozapine (Clozaril®) | < 1% |
| Copaxone | Infrequent |
| Crinone | 5% |
| Crixivan | 2.1% |
| Cymbalta | 3% to 11% |
| Cyproheptadine (Periactin®)5 | Increases appetite through antiserotonergic effect on 5-HT2 receptors in the brain6 |
| Depacon | 1% to 5% |
| Depakene | 1% to 5% |
| Depakote | 1% to 6% |
| Diovan | > 0.2% |
| Doxil | < 1% |
| DynaCirc | 0.5% to 1% |
| Evoxac | < 1% |
| FazaClo | < 1% |
| Gabitril | 2% |
| Gengraf | 1% to 3% |
| Intron A | < 5% |
| Kaletra | < 2% |
| Ketotifen | |
| Klonopin | Infrequent |
| Lamictal | Infrequent |
| Levothroid | |
| Levoxyl | |
| Lexapro | Frequent |
| Lipitor | < 2% |
| Lofibra | |
| Lupron | < 5% |
| Maxalt | Rare |
| Meridia | 8.7% |
| Miacalcin | < 1% |
| Mirtazapine (Remeron®)2 | 11% |
| Namenda | Infrequent |
| Neoral | 1% to 3% |
| Nexium | < 1% |
| Norvasc | < 0.1% |
| Olanzapine (Zyprexa®)3 | upto 14.9% 7 |
| Oncaspar | < 1% |
| Orap | |
| Orapred | |
| Ovrette | |
| OxyContin | < 1% |
| Paxil | 3% to 4% |
| Permax | Infrequent |
| Prevacid | < 1% |
| Prevpac | < 1% |
| ProSom | Infrequent |
| Prochieve | |
| Prograf | 3% to 15% |
| Prometrium | |
| Protonix | < 1% |
| Provigil | > 1% |
| Prozac | 1% to 10% |
| Quetiapine (Seroquel®)4 | |
| Relafen | < 1% |
| Relpax | Rare |
| Rescriptor | |
| Reyataz | < 3% |
| Rilutek | Infrequent |
| Risperdal | Infrequent |
| Salagen | < 1% |
| Sonata | Infrequent |
| Soriatane | 1% to 10% |
| Spectracef | 0.1% to 1% |
| Sporanox | 2% |
| Sular | < 1% |
| Symbyax | 5% to 16% |
| Testim | < 1% |
| Thalomid | |
| Thiothixene | |
| Topamax | 1% |
| Toradol | < 1% |
| Tricor | |
| Trileptal | |
| Trimipramine (Stangyl®)10 | |
| Uniretic | < 1% |
| Vigabatrin (Sabril®)9 | 1% |
| Xanax | 7% to 32.7% |
| Zelnorm | |
| Zoladex | 2% |
| Zoloft | Frequent |
| Zomig | Infrequent |
| Zyban | 2% |
| Zyrtec | < 2% |
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References
- 1. Yeragani VK, Pohl R, Aleem A, Balon R, Sherwood P, Lycaki H. Carbohydrate craving and increased appetite associated with antidepressant therapy. Can J Psychiatry. 1988 Oct;33(7):606-10. PubMed
- 2. Hilas O, Avena-Woods C. Potential role of mirtazapine in underweight older adults. Consult Pharm. 2014 Feb;29(2):124-30. PubMed
- 3. Murashita M, Kusumi I, Inoue T, et al. Olanzapine increases plasma ghrelin level in patients with schizophrenia. Psychoneuroendocrinology. 2005 Jan;30(1):106-10. PubMed
- 4. Suttajit S, Srisurapanont M1, Maneeton N1, Maneeton B. Quetiapine for acute bipolar depression: a systematic review and meta-analysis. Drug Des Devel Ther. 2014 Jun 25;8:827-38.
- 5. Silverstone T, Schuyler D. The effect of cyproheptadine on hunger, calorie intake and body weight in man. Psychopharmacologia. 1975;40(4):335-40. PubMed
- 6. Calka O, Metin A, Dülger H, Erkoç R. Effect of cyproheptadine on serum leptin levels. Adv Ther. 2005 Sep-Oct;22(5):424-8. PubMed
- 7. Costa e Silva JA, Alvarez N, Mazzotti G, et al. Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: results of a multicenter, collaborative trial in Latin America. J Clin Psychopharmacol. 2001 Aug;21(4):375-81. PubMed
- 8. Bernstein JG. Psychotropic drug induced weight gain: mechanisms and management. Clin Neuropharmacol. 1988;11 Suppl 1:S194-206.
- 9. Turanli G, Celebi A, Yalnizoğlu D, Topçu M, Topaloğlu H, Banu A, Aysun S. Vigabatrin in pediatric patients with refractory epilepsy. Turk J Pediatr. 2006 Jan-Mar;48(1):25-30.
- 10. Harris B, Young J, Hughes B. Comparative effects of seven antidepressant regimes on appetite, weight and carbohydrate preference. Br J Psychiatry. 1986 May;148:590-2.
- 11. Lampl Y, Eshel Y, Rapaport A, Sarova-Pinhas I. Weight gain, increased appetite, and excessive food intake induced by carbamazepine. Clin Neuropharmacol. 1991 Jun;14(3):251-5. PubMed
- 12. Navarro-Badenes J, Martínez-Mir I, Palop V, Rubio E, Morales-Olivas FJ. Weight gain associated with cinnarizine. Ann Pharmacother. 1992 Jul-Aug;26(7-8):928-30.
Published: May 28, 2008
Last updated: July 21, 2016
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