Dd has been prescribed Mirtazapine and is refusing to take them in case they make her gain weight - anyone around who can advise?

[PaperScissorsRock]

After years of mental health stuff - anxiety, depression, ocd and more recently an eating disorder (currently lower end of healthy weight range), dd (18) has been prescribed Mirtazapine.

She’s googled it and has found that this is the most likely to make her gain weight as it’ll increase her appetite (which is probably why the gp prescribed it), so she won’t take it.

Does anyone have experience with Mirtazapine? Any reassurance?

Is it worth her talking to the gp about it?

Obviously I can’t force her to take it, but I do think she needs something. Are there other options which she might more easily consider?

Thanks

Mirtazapine worked really well for me. It did make me gain weight as I was starving all the time and have little willpower!

It helped me sleep and really helped with my depression. I know it doesn't make everyone gain weight.

Was amazing for me, I did gain weight to begin with as it increases your appetite a lot, but it wasn’t a huge amount of weight and the increased appetite was only temporary.

Unfortunately in my case it caused me a lot of harm. If she doesn't have any CFS/M.E or Fibromyalgia then she may be OK.

On top of that, it made me crave food so much that I began eating things I didn't like.

I take it and I haven't gained any weight or had any cravings!

I’ve taken it for about 5 years. Without being melodramatic, it saved my life. I couldn’t sleep and had severe insomnia. On a good night I’d get about an hour sleep, on a bad night I’d go 2/3 nights without any sleep at all.

I have put weight on but after the initial weight increase it stabilised and it hasn’t continued increasing.

I did gain some weight on mirtazapine, but not a lot and it overall it was so so worth it. When things improved and I came off it, the weight fell off again very easily.

Sorry to derail op

But @MumsDirtyTeaTowel I also had a CFS diagnosis and a very severe reaction to mirtazipine, is this a known phenomenon? :(

I like was your daughter and refused mirtazipine when being treated for AN. They changed it to another drug.

Thank you for the replies.

Dd doesn’t have cfs/fibro, but she does have constant pain thought to stem from anxiety and an old sporting injury.

The eating disordered brain is telling her she cannot take this. She struggles to take prescribed iron supplements as she read some obscure article that suggested they caused weight gain. It’s so difficult to know how to help her.

@AtleastitsnotMonday I think that’s what will probably happen.

Duloxetine I think has a better profile than many antidepressants as far as weight gain goes so if she really won't tolerate Mirtazpine it could be worth considering. It can also help some sorts of chronic pain. As with anything her own doctor should know her best and be able to discuss pros and cons of different options.

They are brilliant pills especially when suffering from insomnia due to depression/anxiety. However, you do gain weight on them. I've been a size 6 my whole life, could never gain weight even when desperately trying, and I think I put on about 6-8kg.

The thing is that they give you intense sugar cravings from what I remember. If she has an eating disorder she might be able to "fight the cravings" as she's probably already doing that with normal food.

@MumsDirtyTeaTowel can you expand on the CFS/ME & Fibromyalgia connection please ? I have both conditions, awaiting phone consultation with Dr who wants to take me off Duloxetine & put me on this instead. Predominantly to help diabolical sleep problems.
Appreciate any advice you can give me.

@PaperScissorsRock can I ask how much she has been prescribed? 15mg? That might help

@Butterfly3105 yes 15 mg

My understanding of mirtazapine is the way you gain weight is because it TEMPORARILY increases appetite. It does not change your metabolism.

I went on it years ago and the GP weighed me because if weight gain concerns. I was careful what I ate in the first few weeks and didn't gain any weight. The hunger wore off.

Hmm, the thing is eating disorders are more about control than food/weight. So trying to persevere with a drug that makes her feel even more desperately out of control all day long seems likely to be counterproductive. Heightened stress leads to more cortisol in her body, leads to more mental and physical problems (like chronic pain).

Most likely, it would leave her fighting constant hunger and cravings, and that I suspect would be exhausting, distressing, stressful and demoralising - I know it often is for people without eating disorders, so it would be amplified in her position. In which case, any benefits the drug might have had will be more than undone by the problems it causes or aggravates.

Whereas if she can get to a point where she feels more in control, the prospect of her body changing becomes less frightening and less distressing.

My inclination would be to find a drug that won't cause this problem, because they do exist.

(I have been on mirtazapine and known others who were.)

I only took these for a few days...I was utterly zoned out...couldn't stay awake at work... couldn't cross the street safely...I also ate until my stomach hurt because I was RAVENOUS. Horrible drug for me. Citalopram worked much better.

@user15368536798589 this is what she’s worried about.

As she’s 18 any AD has to be approved by the mental health team, I don’t know whether there is a great deal of choice available to her.

I was prescribed this at a&e. Down the line I was asked by a cpn why I wasn't on fluoxotine (Prozac) instead. I didn't have a clue. I didn't change because the mertazapine worked although I put on a tiny bit of weight (better fat than dead). But if she won't take the mertazapine she needs to go back and request alternative.

I wasn't ravenous,btw.i just never reached satiety.

i just never reached satiety

That's a better was of putting it actually. My stomach was hurting from eating so much but I just couldn't get full.

@Love51 from stuff I’ve read fluoxetine seems to be more effective for ocd, but as I’m not a dr I don’t feel I can query that decision.