Mirtazapine and weight gain?

[cupofteaplease]

I've taken citalopram on and off for 7 years, but after my dd died in October they didn't seem to work anymore. Eventually I went to the dr as I was terrified- I was having night terrors, hallucinations, couldn't understand what people were saying to me... My counsellor said I was in shock.
Anyway, GP put me on mirtazapine. The switch from one drug to the other was awful, blurred vision, confusion, drowsiness... But almost instantly I noticed I was gaining weight (something which at a size 14 I can't afford to do). So I started Slimming World and upped my running. It's been 4 weeks tomorrow and despite sticking to the plan, I've not lost, or gained, any weight.
I Googled and realised that mirtazapine can cause massive weight gain. Is that 'just because' or a side effect of increased appetite?
I want to go back to dr as I don't want to be this size, I want to feel better in my skin. But the good thing about mirtazapine is that I sleep through the night.
What could I ask for instead of mirtazapine or citalopram?

Hi, I had the same problem on mirtazapine - I take Valdoxan (agomelatine) now and literally 3 stones melted off me PLUS I find it works much better - feel less drugged etc. it's new-ish but worth trying in my opinion.

Should have added that it is taken before bed and I sleep really well because of it xxxxxxx big hugs xxxxx

Trazodone is considered to be fairly similar to Mirtazapine. It is another sedative anti depressant, and acts in a similar way. Some people gain weight on it, but it isn't notorious for it in the way that Mirtazapine is. However, there are problems getting hold of it at the moment, so I don't know if a Dr would want to prescribe it until the problem with that is sorted. My psychiatrist actually suggested switching me to Mirtazapine last week as a result of this but I laughed in her face

There are loads of anti depressants out there though. Others I have taken include Sertraline, Prozac, and Venlafaxine, but there are so many that people naming random drugs is unlikely to be helpful really.

Thanks for the replies- so mirtazapine can literally make you gain weight even without excess eating? I need to make a GP appointment ASAP...

Yes it definitely can. Did with me despite no massive dietary changes.

Dr wouldn't prescribe anything else instead of mirtazapine He said it causes increased appetite, but as I'm controlling my appetite by doing slimming world, I'm not over eating. So how to explain the weight gain?! He said I've got to give it another 3 months to settle down. Feel a bit grumpy now.

We use it as an appetite stimulant in dogs and cats, v effective. I am amazed it is so often prescribed in humans as such a side effect is so significant.

It leads to weight gain and the mechanism by which it does so (e.g., increased appetite, or metabolic changes) is not known for sure. Your GP is a t*t - if it isn't suiting you then why on earth can't you try something else??

Having said that, the weight gain will probably settle down after a few months. I plateaued at about 15 lb over my base weight, but I am a greedy thing anyway.

Can you see different GP and explain that you feel weight gain will adversely effect your mental health in itself? In my experience nothing stopped the mirtazapine weight gain, not slimming world, nothing and I've been (annoying I know) size 8 forever.

He said I need to focus on getting better- sleeping, being able to be around other people without panicking... He said once that's settled down for a prolonged period, then I can think about my self-image and weight. The problem for me is, the anxiety links in with my weight gain, always has done.
It's soul destroying, dieting constantly and still not being able to fit into my clothes.

I see what he is saying but I think that some (male) GPs don't understand that sometimes to feel better around people and deal with anxiety we need to feel good about ourselves. Can you go back and see a female GP?

Alternatively what I did as I didn't know there was an alternative to mirtazapine and at that point was glad i wasnt being sectioned as had been v ill was to wait a couple of months, give up trying to lose weight as it was soul destroying and nothing worked and buy a new wardrobe (cheap from primark) two sizes bigger and pack all my old clothes away into loft.

I only found out about Valdoxan when mirtazapine stopped working for me after a year. V v v few GPs know about Valdoxan - it is new and mainly prescribed by psychiatrists but frankly it's saved my life and has no side effects that I've had. It is only allowed for severe depression. Maybe if you can ask a female GP to just look it up for you she might let you try.

Thinking of you x

I think it's fair to say that all antidepressants have the propensity to cause weight gain to a greater or lesser extent. I have been on loads of different ones and they all increased my appetite, am currently on paroxetine, which is for me one of the less hungry ones.

I think weight gain on mirt is due to appetite stimulation and doesn't,t just happen. I found it awful, felt constantly hungry.

Reboxetine is meant to be the only one with no weight gain potential, as it doesn't work on the serotonin receptors. Ones that do work on serotonin also stimulate the appetite receptors.

Of course they will affect different people differently, and may not affect some people at all. The least hungry ones I believe are trazadone. Be aware thati the ones that ,are you sleepy also may make you hungry, they tend to go together. I take 7.5mg mirt on top of the paroxetine for sleep, but it doesn't make me hungry at that dose.

I found mirt a crap ad too.

Hope this helps, you need to feel better. Go and see another gp. I went through 6 different ones until I found one that worked.