Can propranolol cause weight gain
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Propranolol and Weight Gain: A Comprehensive Review
Long-Term Propranolol Treatment and Weight Gain
Propranolol and Myocardial Infarction Patients
Research has shown that long-term treatment with propranolol can lead to significant weight gain. A study involving 3,837 men and women who were treated with propranolol after a myocardial infarction found that patients gained more weight compared to those given a placebo. Specifically, at the first annual visit, the propranolol group had an average weight gain of 2.3 kg, compared to 1.2 kg in the placebo group. This trend continued over subsequent annual visits, indicating a sustained weight gain associated with long-term propranolol use .
Short-Term Propranolol Use and Weight Gain
Case Study on Short-Term Low-Dose Propranolol
Even short-term use of propranolol can result in weight gain. A case study reported a 34-year-old woman who experienced a sharp increase in weight (3 kg) after just two weeks of taking low-dose propranolol (20 mg twice daily). The weight gain was attributed to uncontrollable overeating, which ceased when the medication was discontinued and resumed upon restarting the drug .
Mechanisms Behind Propranolol-Induced Weight Gain
Animal Studies on Propranolol and Metabolism
Animal studies provide insights into the mechanisms behind propranolol-induced weight gain. In one study, rats treated with propranolol showed significant weight gain over six weeks. The propranolol-treated rats had higher insulin levels, higher blood glucose and free fatty acids, and lower muscle glycogen. These findings suggest that propranolol may cause insulin resistance and reduce the activity of lipolytic enzymes, leading to weight gain .
Impact on Satiety and Energy Expenditure
Propranolol may also affect satiety and energy expenditure. The drug has been shown to reduce the body's thermogenic response to food, which could contribute to weight gain by decreasing total energy expenditure .
Propranolol and Weight Gain in Specific Populations
Patients with Chronic Liver Disease
In patients with chronic liver disease, propranolol treatment was associated with a significant rise in body weight, skinfold thickness, and body fat over a 12-month period. This suggests that propranolol can influence body composition and weight even in populations with underlying health conditions .
Pregnant Rats and Propranolol
Studies on pregnant rats treated with high doses of propranolol showed that the drug markedly influenced weight gain during pregnancy. The treated rats gave birth to smaller neonates, indicating that propranolol may affect nutrient transport and metabolism during pregnancy .
Propranolol and Migraine Prevention
Weight Gain in Migraine Patients
Propranolol is also used for migraine prevention, and weight gain is a noted side effect. Clinical studies have shown that patients using propranolol for migraine prophylaxis often experience weight gain, although the incidence is lower compared to other medications like amitriptyline and divalproex sodium .
Conclusion
In summary, both long-term and short-term use of propranolol can lead to significant weight gain. This effect is observed across various populations, including myocardial infarction patients, individuals with chronic liver disease, and even in animal models. The mechanisms behind this weight gain may involve changes in metabolism, insulin resistance, and reduced energy expenditure. These findings highlight the importance of monitoring weight in patients prescribed propranolol and considering alternative treatments when weight gain is a concern.
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