Agents such as
clozapine,
olanzapine and
mirtazapine frequently trigger an increase in
body weight. Though the mechanisms have not been thoroughly clarified, recent studies indicate a role for
ghrelin in regulation of appetite and
weight gain. We investigated the relation of
maprotiline induced
weight gain to serum
ghrelin and
adiponectin levels, as well as
insulin resistance in lean subjects with
depressive disorder. A total of 40 male lean subjects with
depressive disorder were treated with
maprotiline (150 mg/day) for 30-days. Clinical data, fasting plasma
glucose,
lipids,
insulin levels, serum
ghrelin and
adiponectin concentrations were determined before and
after treatment.
Insulin resistance was estimated using the homeostasis model assessment (HOMA) formula. After 30 days of treatment with
maprotiline, mean body mass index increased significantly. Blood
ghrelin and
insulin levels and HOMA indexes increased, and
adiponectin concentration decreased (p<0.001, for all) after the treatment period. Changes in
ghrelin levels correlated neither of the parameters tested; whereas decrease in plasma
adiponectin was associated with an increase in BMI (r=-0.671, p<0.001). In conclusion, the results indicate that treatment of lean patients with
depressive disorder with
maprotiline results in an increase in serum
ghrelin and reduction in
adiponectin levels.
Weight gain due to
maprotiline treatment may be related to its negative effects on the metabolic variables.