Why does the NHS insist on only prescribing antidepressants which cause weight gain as one of their side effects?

[MsBellows]

I have chronic winter blues (SAD) and there's a certain medication which is known for having much less in the way of side effects, which I'm desperately trying to get and is standard issue for people with my condition in other parts of the world. One of these side effects is weight gain.

However, any GP I speak to will only offer me mirtazapine. Mirtazapine is infamous for causing weight gain. I've taken it before (for years, due to a sleep disorder) and I was horrified as to what it did to me. Terrifyingly, it can alter your metabolism so that even if you don't eat more, you still end up being a big girl. There are people out there, who since stopping taking it are convinced that it made them permanently find it difficult to lose weight, even after they stopped taking it.

When I stopped taking, luckily things went back to normal for me but that was years ago so I don't want to risk it this time as I'm a little older now so maybe my metabolic rate is a bit more vulnerable.

Also, they work almost too good for sleep, they used to make me need 9-10 hours sleep and I still feel like a zoned out zombie the next day and I'd like to avoid that also.

Im just wondering about this. I'm very frustrated being railroaded to take medication that I know will cause me damage (although I know it helps some people) and I'd appreciate any insight. 🙏

It’s probably a cost issue.
My daughter was diagnosed Quetiapine for sleep issues and she put on a lot of weight, so I really feel for you. DD became almost unrecognisable over 3 years to the point that family friends were a bit confused as to who she was at my mum’s funeral.
She weaned herself off eventually. I hope someone with more knowledge can wade in with answers.

I wish I knew. I was always slim till I started ADs. Now I get drs lecturing me about my weight.

I also struggle with this, I’ve been on mirtazapine for 5 years, and had sertraline added in August. I now weigh 23 stone and I’m struggling. CMHT have said they’re not willing to support me to come off my meds but I can’t eat without gaining. It’s hell.

OP is it Wellbutrin you wanted? I wish I knew the answer. I was given it in the US and it really helps SAD.

Yes it's Wellbutrin. It's not just because it doesn't significantly cause weight gain, but also doesn't make you so tired and unresponsive the next day.

It's a sick joke, you should be able to explain what dirty mirtazapine has done to you, and that should be enough to consider alternatives.

Will no one even consider prescribing you a standard SSRI like citalopram or sertraline? Have you considered using a daylight SAD lamp type thing?

Generally SSRIs .. like citalopram and sertraline .. cause weight loss. Mirtazapine notorious for wt gain.

Mirtazipine was given to anorexia patients to make them eat!

Many things suggest weight gain as a side effect but as PP said most SSRIs don't for most people

(I've been on both)

I am on Mirtazapine, have been for years, not much weight gain, about a stone but I was very underweight when I started. I just eat 3 meals a day and no snacks

Wellbutrin has its own side effects. Weight gain is one of the most difficult side effects of so much medication. It's really frustrating but other side effects may be more serious.

Have you thought about looking out to see if there are vacancies on a relevant NICE committee to share your views?

https://www.nice.org.uk/get-involved/our-committees