Which tricyclic antidepressants (TCAs) are considered weight neutral?

Nortriptyline and Desipramine are identified as weight neutral tricyclic antidepressants (TCAs) because they tend to have a lesser impact on weight gain compared to other TCAs. This distinction is particularly important in clinical practice, especially when treating patients who may be concerned about weight changes due to their medication regimen.

Nortriptyline is often preferred for patients needing antidepressant treatment without the added complication of significant weight gain. Its side effect profile is generally more favorable in terms of weight management compared to other tricyclics, which frequently contribute to increased appetite and weight gain.

Similarly, Desipramine is recognized for its comparatively lower propensity to cause weight gain. It has a stimulating effect and is thought to have a more favorable influence on weight compared to other TCA options.

Understanding the weight effects of different medications is crucial, especially in managing patients at risk for obesity or metabolic syndrome. This makes the combination of Nortriptyline and Desipramine optimal for those who require antidepressant therapy without exacerbating weight issues.