Weight gain with propranolol
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Weight Gain with Propranolol: A Comprehensive Review
Introduction to Propranolol and Weight Gain
Propranolol, a non-selective beta-blocker, is widely used for various medical conditions, including hypertension, anxiety, and migraine prevention. However, one of the notable side effects associated with its use is weight gain. This article synthesizes findings from multiple studies to provide a clear understanding of the relationship between propranolol and weight gain.
Long-Term Propranolol Use and Weight Gain
Clinical Trials and Observations
Several studies have documented weight gain as a significant side effect of long-term propranolol use. A retrospective analysis of a placebo-controlled, randomized double-blind clinical trial involving 3,837 patients who had experienced a myocardial infarction revealed that those treated with propranolol gained more weight compared to those on placebo. Specifically, the mean weight gain was 2.3 kg for the propranolol group versus 1.2 kg for the placebo group, with the difference remaining consistent over multiple annual follow-ups .
Mechanisms Behind Weight Gain
The exact mechanisms by which propranolol induces weight gain are not entirely clear. However, it is suggested that propranolol may reduce the body's thermogenic response to food and total energy expenditure, leading to increased fat accumulation . Additionally, propranolol has been associated with increased appetite and overeating in some cases, further contributing to weight gain 23.
Short-Term Propranolol Use and Rapid Weight Gain
Case Reports
There are also reports of rapid weight gain with short-term, low-dose propranolol use. For instance, a case study of a 34-year-old woman treated with propranolol for anxiety-related tremors noted a significant weight gain of 3 kg within two weeks of starting the medication. This rapid weight gain was attributed to uncontrollable overeating triggered by the drug .
Comparative Studies with Other Beta-Blockers
Animal Studies
Animal studies have provided additional insights into the effects of propranolol on weight. In a study involving Wistar rats, those treated with propranolol showed significant weight gain over a six-week period compared to control groups. The propranolol-treated rats also exhibited higher insulin levels and reduced activity of lipolytic enzymes, which are crucial for fat breakdown .
Human Studies
In humans, propranolol has been compared with other beta-blockers like atenolol. While both drugs are effective in managing hypertension, propranolol is more likely to cause weight gain due to its non-selective action on beta-adrenergic receptors, which affects metabolic processes differently than cardio-selective beta-blockers like atenolol .
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 may affect salt and water homeostasis, contributing to weight gain in this population .
Pregnant Women
Propranolol use during pregnancy has also been linked to adverse effects on weight gain. Pregnant rats treated with high doses of propranolol gave birth to smaller neonates and exhibited reduced weight gain, indicating potential risks for fetal development and maternal health .
Conclusion
The evidence clearly indicates that propranolol is associated with weight gain, both in short-term and long-term use. This side effect is observed across different populations and is likely due to a combination of increased appetite, reduced energy expenditure, and metabolic changes. When prescribing propranolol, healthcare providers should consider these potential side effects and monitor patients' weight closely to manage any adverse outcomes effectively.
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