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two others that also appeared to have less weight gain were amitriptyline and nortriptyline.
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in extensive metabolizers, elimination of amitriptyline and its metabolites should occur within 1 week post-discontinuation, rather than 3 weeks post-cessation as may occur in a poor or intermediate metabolizer.
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5- nortriptyline and or s-amitriptyline may be measured at initiation of the combination therapy and after one week.
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other metabolites such as cis- and trans-10-hydroxyamitriptyline and cis- and trans-10-hydroxynortriptyline have the same profile as nortriptyline but is considerably weaker.
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since amitriptyline is one of the more sedating tcas on the market, some speculate that more weight gain is common.
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