Mirtazapine and weight gain?

[Thefirsttulip]

Hello,

I have been prescribed mirazapine to help with my depression and anxiety. One of the reasons the GP prescribed this one is because of my difficulty sleeping.

I've been reading the side effects and saw one was weight gain.

I looked it up on the internet and lots of people have experienced weight gain on it and there are some comments such as no matter what they do (watch what they eat etc) it doesn't stop the weight gain.

I know if I gain weight I will feel even worse and become very down about it.

Has anyone experienced this drug? If so, what was your experience on it?

Thank you

Firsttulip, I was prescribed Mirtazapine by my GP for horrible depression/insomnia/anorexia (and by anorexia, I mean "nervous loss of appetite", not "desire to be thin"). I am 5 foot 2 and was then just over 6 stone. Even I realise that this is not my ideal weight.

The first dose of Mirtazapine (about 18 months ago) knocked me out completely. But I evidently built up a tolerance to it, and am now trying to wean myself off it (now taking a quarter of a pill every 5 days - the GP prescribed the equivalent of 1.5 pills per day). The main reason for this is that I can't cope with feeling fat as well as feeling depressed.

I want to eat because I am happy and healthy, not because I am craving carbs thanks to Mirtazapine. I am determined to wean myself off it completely. I do not need this extra problem in my life.

The first few days are the worst - it does get better.

As for weight gain - I'll say it again, you only gain weight by eating more due to feeling hungry, not some sort of fat retention properties within the drug or anything.

You just need to be disciplined. Easier said that done I know, but it CAN be done if you chose to.

It's good for sleep, I had proper sleeping pills for 8 years and Dr was desperate to get me off them and I was desperate to stay on them.

I have put weight on, but that's due to the amount of food I put in my mouth and the wrong sort of food, not down to the medication .

I feel better than I have for years and will continue to take it.

Willwork ^^ disagree. I Googled Mirtazapine extensively, as Being Fat was even worse than being depressed. It apparently slows your metabolism down, and this on its own leads to weight gain. Which is why I am tapering it off...

I was on it. I did put on weight. The weight came off really easily after I came off it, easier than baby weight or the other time I put on weight since. If it helps you, think of the weight as a temporary thing. I decided better fat than depressed then eventually wasn't either!

Sorry to ramble on your thread, OP.

Personally I don't care whether the effect is on the metabolism or the appetite. The end result for me will be the same. I'm not a person who can feel constantly hungry, yet ignore that and eat according to a sensible meal plan (trust me, seven years of therapy haven't got me there). I'm trying to find a longterm medication that would suit, as there's very little chance of me every being mentally well.

Reading on various drugs and their side effects, I think I might go back to the GP and ask to try Venlafaxine. It seems to be one of the few non-SSRIs with no weight gain side effects...

@Love51 The weight has come off me, too, since I cut back to quarter of a tablet every four days (would have cut it out completely, but not sure it is good to go cold turkey). If I am depressed anyway, I'll be blowed if I'm going to add an extra level of depression (relative fatness) to my problems.

@Gertie You are quite correct, but ultimately the standard golden rules apply - eat less, do more.

Exercise will help speed your metabolism back up again.

It is hard though when you're depressed and desperate for some comfort food - especially anything beige. LOL

I put on about a stone before I called 'enough' and made the decision to do something about it - took about 10 weeks, but I got the weight off and became fitter in the process.

Fitter, thinner and still depressed.

@WillWorKForFood

I don't want to hijack this thread. But wondering how "eat less, do more" works with someone who's 6 stone (BMI only 17, so not really underweight).

Mirtazapine is no doubt great. But it isn't the ideal solution for anyone who has problems with weight. One of the reasons I initially saw my GP was that I couldn't sleep or eat. He said Mirtaz would solve both problems. It might, but it doesn't take into account all the complex issues around not eating.

@WillWorkForFood I have read your post again. I am a bit baffled. Effing Mirtaz. I run about 10 miles a day. Walk another 10 miles. But have put on weight, having taken Mirtaz. Hence trying to taper it off. I have an almost 40-history of ascetism and weight loss. Exercise doesn't cut the mustard.

Finally @willworkforfood - sorry: I should have acknowledged your difficuties sooner.

^^40 year history. Blimey. I am old.

Sorry, I'm being rather broad sweeping with my comments.

Most people report putting excessive weight on with Mirt, this can usually be combated with a very disciplined diet and more exercise - I did this myself.

If you're under weight, the increased appetite caused by Mirt would typically help in this areas to put some weight on due to extra calorie intake.

Of course everybody is different and we all respond differently to various meds, so there is seldom a one size fits all answer or solution.

@WillWorkForFood I appreciate your comments. I struggle with being anything under "a bit underweight", though would love more feedback on this, and don't want to de-rail this thread.

I am very interested in reading about this drug, my son is on it, and only reading these comments has made me realize why he has gained so much weight, which incidentally he needed to,he was skinny, he looks so well now,but is thinking of coming off it though, not because of the weight gain,he hasnt connected it, and neither did i

Hi OP I've been on Mirtazapine continuously for 2 and a half years. I'm also on quetiapine, which usually makes people gain weight.

I put on a bit of weight...about a stone but I think that was more due to lack of exercise and too much alcohol. I ended up losing 1.5 stones going through another depressive period, and only regained 1/2 a stone. I don't get carb cravings/sugar cravings now and I think that this was due to the alcohol rather than the mirtazapine. If I have alcohol I end up eating like a horse. If I avoid it, I eat like a normal person, do a normal amount of exercise and feel (at the moment) normal. I have a BMI of 20, which isn't massive, and I eat a reasonably healthy vegan diet.

Mirtazapine has been really helpful with sleep and anxiety. I wouldn't let the weight gain issue put you off.

I'm not sure I agree with seeing weight gain due to the medication as temporary because clinical depression isn't temporary, it's a life long disease of the brain. For me it has come in waves over a number of years where sometimes I've needed help with medication or CBT and sometimes I've battled through it. But it's not something that you take a medicine for then your better indefinitely. If I had a curable disease and the medication meant weight gain whilst I was on it until the disease was cured then I could deal with that. But depression isn't curable, only manageable.

Sorry if my post comes across as snipey but clinical depression isn't something that will go away for life after a cycle of anti depressants so to put your body through several cycles of weight gain over the years isn't helping if you have issues surrounding a fear of weight gain (like me.)

Thefirsttulip - Yes, I agree. A completely different scenario if you're on a medication for a relatively short term, can recover and be meds free later. Obviously this is how some people's depression is, and they'll only have one or two periods of depression in an otherwise mentally healthy life.

For a lot of us the medication is supposed to be a lifelong thing. (I say "supposed to", as I do tend to ditch meds every few years, and the results usually aren't good. Hence now starting again after a few months' break.) I'm just thankful I'm more or less managing without needing antipsychotics right now (well... at least enough to appear to manage). The hunger and weight gain on quetiapine was unreal for me, and I put on 5st in two years, despite trying my best (which of course isn't always that good).

Its not something you can cure for alot of ppl it does come and go but doesnt mean you need to stay on medication the rest of your life. I understand you re under that horrible feeling of hopelessness, but I can say ive came out the other side and so have many others dont lose hope. Ive had slip ups and needed to go back on the meds sure but doesnt mean its forever, for me personally accepting that was hard but I think it is the key to being kinder to yourself its a chemical inbalance that needs treatment.

That being said if its something that needs lifelong treatment i can understand why you would want to try different meds am i even making sense?lol

I suffered from clinical depression for around 17 years now and been on and off medication. I haven't been on meds for 2 years now but feel I need to be at the moment. During those 2 years my depression felt manageable where I would have a spell of depressive days but it lifted. This time it hasn't but I have accepted the depression is a life long disease for me and I manage it as and when. I may have a few years where I might feel ok but it's always going to be lingering because it's not curable, only manageable.

I've been taking half a tablet of this and the doctor warned me I might have cravings. I did feel more hungry for a while but I'm peri menopausal and already a bit over weight. I've not really put weight on, usual few pounds off/on, but right now mental health is my priority. It helped with sleep which was the main thing as I was only getting 2-4 hours a night.

My GP is planning on weaning me off it starting July so I'll see what happens there. I'm more worried about emotional stuff than weight tbh even though I need to lose a couple of stone.

I took Mirtazepine for 6 months stopping last month. I did put on a bit of weight but it's coming off now. It is a brilliant drug for anxiety - I had very bad panic attacks multiple times a day - and it helped me to sleep and feel like I could cope with the therapy I also had (CBT). I also took up mindfulness. I got over the brain fog within a week and the loss of panic and the great sleep made it worthwhile. I think if you have depression more than anxiety symptoms you may be better on a different drug and your doctor should be able to help. It really is trial and error but don't give up hope. Dothiepin is an old but very effective drug that might be worth discussing with your GP.

OP I expect to be on mirtazapine long term, as I’ve always had issues with sleep, since I was a teen, and have been on ADs most of the past 20 odd years. I’ve also had issues with weight (anorexia and bulimia). Studies show that any weight gain tends to level off...as I mentioned I’ve managed to lose a lot of weight whilst still being on the max dose. I think the ‘hungry’ side effect wears off TBH. Well, it did for me anyway.

I’m on venlafaxine too- and I personally think that was worse for the munchies (I’ve been in it 2 separate occasions) but apparently that’s not a common side effect. I think all the drugs have the capacity to affect your appetite, whether increase or decrease. If you aren’t sleeping venlafaxine might make that worse as it apparently has a stimulating effect. Well, that’s what my psych says anyhoo...