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In support of these results, Appelman et al

J Investig Dermatol Symp Proc 1999 Sep;4(1):35-40 Available from: Markovic SN, Erickson LA, Rao RD, Weenig RH, Pockaj BA, Bardia A, et al

(More information) Impaired antioxidant protection in selenium-deficient individuals may affect physiological responses to stress

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Importantly, tricyclic antidepressants, especially amitriptyline and nortriptyline, worsen the metabolic profile, increasing insulin resistance, contributing to weight gain and causing hyperglycemia, thereby increasing the risk of diabetes with prolonged use [77]