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It is a primary driver of cardiovascular disease (CVD), including hypertension, dyslipidemia, coronary heart disease, heart failure, and stroke, as excess adipose tissue, particularly visceral fat, promotes inflammation, endothelial dysfunction, and insulin resistance [7]

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Indeed, amitriptyline and imipramine (which are metabolized to nortriptyline and desipramine respectively) potently inhibit this response, as does nortriptyline itself, maproptiline, clomipramine (which is metabolized to the potent NE reuptake inhibitor desmethyl-clomipramine), and the nontricyclic NE reuptake inhibitors tomoxetine (now denoted atomoxetine) and reboxetine (Gobbi et al., 2003

Taste changes may relate to delayed gastric emptying, GLP-1 receptor activity in taste buds and brain reward centres, or accompanying gastrointestinal symptoms like nausea

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