Geriatric sweet tooth. A problem with tricyclics.

Ninety-three consecutive outpatients receiving tricyclic antidepressants for at least one month were asked about medication side effects, including excessive appetite and craving for sweets. Prevalence of these side effects and their relationship (Pearson r) to type of medication, dosage, patient characteristics, diagnoses, weight gain, and clinical improvement were examined. More than one-third (38%) reported excessive appetite, 34% had a craving for sweets, and about one-half (48%) had either one or the other of these reactions. These adverse side effects were related significantly to weight gain (P less than .001) and a higher dose of medication, but not to clinical improvement. Clinical improvement was in the moderate-to-good range but was not related to medication dose. Because increasing degrees of overweight can pose serious health risks, especially for the elderly, it is critical for future research to examine ways of maintaining therapeutic benefit while minimizing food craving side effects. Methods of dealing with these issues clinically are suggested.