Weight gain is a frequent side effect observed during drug treatment of psychiatric disorders.1) It often contributes towards patient non-compliance and discontinuation of the pharmacological treatment.2) Weight gain may also contribute to comorbidities such as hypertension, coronary heart disease, diabetes, and stroke. 3,4) Weight gain is also a relatively common problem during both acute and long-term treatment with antidepressants. It appears that tricyclic antidepressants (TCA) may be more likely to cause weight gain as compared to selective serotonin reuptake inhibitors (SSRIs), a class of antidepressant widely used in clinical practice. 5,6) Among them amitriptiline, doxepin, imipramine, trimipramine, maprotiline, nortriptyline, and clomipramine are reported to cause marked weight gain.
2)TCA may affect appetite by blocking the reuptake of serotonin and noradrenaline. Serotonin is recognized to have an influence on food intake and macronutrient selection. 7,8) Noradrenaline has also been shown to have an effect on food intake that opposes the effects of serotonin, but its effects on macronutrient selection are not clear. 7,9,10) TCA may also affect appetite by blocking histaminergic (H1) pathways.
11)However, the mechanisms underlying the weight gain induced by antidepressants treatment have yet to be understood. In clinical studies, it has been found that antidepressant drugs alter nutrient selection, inducing in particular a preference for high-carbohydrate or sweet foods. [12][13][14] Early efforts to model these effects in rats have led to contradictory results. For example, it has been shown that acute systemic injections of clomipramine selectively enhance carbohydrate intake.15) On the other hand, it has been reported that food intake was initially and significantly decreased by desmethylimipramine treatment but this effect progressively returned towards pretreatment levels over the course of the drug administration (30 d).16) Such discrepancies may be related to brain monoamine receptor neuroadaptations following chronic treatment with antidepressants.17-21) Nobrega and Coscina 22) evaluated the effects of the chronic treatment with two other TCA, amitriptyline and desipramine on food selection. They showed that desipramine decreased food intake and body weight, while amitriptiline did not change food intake and body weight or slightly reduced them in comparison to vehicle-treated controls. However, strict macronutrient protocols (using separate sources of pure macronutrients) have rarely been tested in rats following the chronic treatment with TCA. Therefore, it remains unclear whether this class of antidepressants change macronutrient selection and weight gain in rats. Given that and there is only limited evidence on the effects of TCA on macronutrient selection especially over long periods of drug treatment, the present study was carried out to explore the effects of chronic treatment with clomipramine (CMI) on food intake, macronutrient selection and body weight in male rats allowed to self-sel...