Alternative to Mirtazapine - any ideas?

[chopin33]

Hi all just wondering if anyone can help me please. I'm due to see my GP this Friday. I've been taking Mirtazapine for about 18 months and it works very well for the depression, however I am less happy about the stone and a half weight gain! I tried to get off it last Autumn - my GP put me on sertraline which made me feel awful - agitated, suicidal and totally unable to sleep. I am quite torn - a big part of me thinks the Mirtazapine is a bit of a wonder drug and I should be grateful that something has worked. The other part of me feels cross that I have been put on this drug. I was on citalopram/escitalopram for a few years was then on prozac for ages until it stopped working hence being put on mirtazapine. One thought I had had was to ask Gp to put me on an SSRI such as citalopram/fluoxetine and at the same time add on trycyclic as that would add on some sedating/sleep enhancing properties - do you think GP would buy this? I am so torn I don't know whether to keep to the appointment or not. WWYD?

It is a very tough situation you find yourself, as it seems all anti-depressants either have some sort of side effect, or just don't seem effective. Mirtazapine is well known for causing weight gain, I know I get so hungry in the evenings when I'm on it. One medication which worked well for my mental wellbeing, but not for my physical health, was Venlafaxine which is an SNRI. As long as you don't have issues with blood pressure or migraines, it might be worth giving that a whirl.

I think I should make it clear though that I don't have experience of dealing with GPs when it comes to changing medication, it is always the psychiatrist that alters my medication. Saying that, I don't think it would do any harm asking your GP if he can suggest alternative medication for you. Surely the worst he can say is no. My psychiatrist wanted to try me out on the different medications on their own first, before moving me on to combinations. I am currently on a low dose of Mirtazapine combined with Sertraline. Neither worked particularly well separately, but they are doing a better job combined.