Do higher doses cause even greater weight gain?

Treatment and medication
1

Hi guys

I have only just found that this forum exists and it has been a revelation to me to find all of this information, and to find that other people are experiencing similar things.

I've recently been switched to 15mg Mirtazapine from 40mg Citalopram as the Cit was having no notable affect on me.

I started the mirt 6 days ago and have already put on just under 3/4 stone as i cannot stop eating. I made the comment yesterday at the dinner table that I am only stopping eating now out of politeness after having devoured the most enormous plate of food imaginable. I always have had a large apetite, despite being thin, but I'm convinced that this apetite has doubled since being on Mirtazapine.

My quandry is that I began feeling positive affects on my mood in the beginning, but my body seems to have gotten used to it. I'm still having great dreams, but my mood has dropped again. I have a review with my GP next week and feel that I should be asking her to increase my dose as in the beginning it felt like it was really working, yet I'm terrified that an increased dose will increase my apetite and weight even more.

Does anyone have any experience of affect of higher doses on weight gain?

Many thanks for your time

2

Hi Reg

I was on Mirtazapine for around six months and it didn't matter what dose I was on, 15, 30 or 45 mg, my appetite was enormous. I really craved carbs and my weight ballooned by two stone.

As soon as I came off the drug, my appeteite went back to normal and I have been able to shift the weight I put on with exercise.

If Mirtazapine is helping your depression, you may need to balance it's positive quality with the likelyhood that your appetite may remain high. It may be worth talking through with your doctor an exercise programme (if you are able to do so) to help manage the weight gain but in my experience, the actual dose in itsself made no difference.

Good luck and best regards.

3

Thank you very much for your swift reply.

Its actually very reassuring to read your post. I genuinely feel that this drug is the one that could help me out of this hole at the correct dose. It is reassuring to read that in your experience, the level of side effect isn't proportional to the dosage.

I guess I'm worried that asking my GP (who I have to say is brilliant, and seems to be genuinely longing for my treatment to work - very much unlike others I have had before who essentially told me to pull myself together) for an increase, in order to regain the positive affects, is going to turn me into Mr Creosote!

4

Hi Reg,

I've been on 30mg now for about 6 months, my experience seems to be exactly the same as yours. I'm constantly hungry and it doesn't seem to subside no matter how much i eat. I've now decided enough is enough and will be coming off the Mirt with the assistance of my GP. My mood has significantly improved with Mirt but i can't seem to justify the side-effects any longer.

I feel that finally it's time for me to tackle my mood head on and no longer rely meds as i've found, at least for me, that it seems to only perpetuate the problem.

I wish you the best with whatever course you and your GP decide on..

5

hi

i too have come off citalopram - 30mg and onto mirtazapine.

I have not noticed an improvement yet (day 12) and in fact i think i have crashed from th Citalopram (thats why i was keen to reply, to se how you are) I think my head feels f**k*d if tou know what i mean. When i turn, my head carries on. Feels surreal, almost like im drunk and everyone else is sober. Also low mood, irritable, crying, no patience and yes, weight gain.

But last 2 days, i have tried to control blood sugar, so not eting any sugar, white carbs etc, sticking to less processed refined food (wholemeal porridge oats, protein, veg etc) and the cravings have calmed down.

The doc has started me on 15, moving up gradually to 45mg. On 30mg just now. Sleepiness has calmed down.

I initially tought the dizziness wooshy feeling was mirt, but reading about cit withdrawal its def that. Hope my mood lifts soon too, but i know it can take 2-4 weeks. So not happy at the min, what with withdrawal and waiting for these to work.

Im worried about weight gain, i tink i am having to be strict (only day 3) or ill out on more weight than i ever have and that will depress me!

6

Thank you both He-Man and Amber, and of course my best wishes to you both fighting this.

I've been on the Mirtazapine for two weeks now, and everything has stopped. The mood lift I had at the beginning has dropped back to how I was before, and my sleep pattern is all deranged again with the vivid dreams missing. Still eating tonnes though, and living very close to a supermarket doesn't help that at all!

I saw my GP yesterday and explained all this to her, and she was reluctant to up my dose. Her reasoning was that I have a few things coming up in the next couple of weeks that she wants to see how I get on with first. I start therapy on Monday, and I have a couple of sessions of work booked (I haven't worked for months which being self employed is pretty damaging), so I understand what she is saying.

Its just all so frustrating. Today is a particularly bad day due to my associations with the date, and I'm tearing myself apart over things so I'm just crying out for some light really.

Amber, I know exactly what you mean with your description. I was finding Cit was making me constantly tired, and the higher the dose I was given, the more I slept. I don't have that on Mirt, it stabilised it brilliantly for a bit, but has buggered up again now. I am wondering whether what I'm experienceing now is the citalopram crash. I don't think I know enough to recognise it if I'm honest. At the moment it all feels pretty empty.

I'm quite lucky with regards weight gain as I was underweight befre, and at the moment I'm at quite a healthy weight. If this continues though, it is going to start to worry me a lot. I feel for you Amber, I hope you manage to contain it. The last thing you need right now is another thing to worry about.

Apologies for the rambling nonsense I've written. I think some of it makes sense!

7

Hi again Reg,

Like yourself my ravenous appetite is very hard to control, the more i began to control it the worse it got, as it became a daily focus for me. I found keeping myself busy and taking \"treats\" out my cupboards helped at least contain it a little. I'm now in the tapering stage and on 7.5mg of mirt, next week i'll completely stop it. I'm a little nervous and apprehensive, more so because i'm afraid i'll see a return to the severe sleep deprivation i had prior to Mirt. So i can also relate to your sleeping difficulties, i used to go nights without any sleep at all, facing the next day was an arduous task to say the least. I'd often break down trying to fight it, i found that just letting it go and dismissing it helped aleviate it. Monitoring my sleep really was counter-productive.

I hope your course of Mirt kicks back in again and helps with your mood, highs and lows are common so maybe its just a temporary phase. Good luck with the therapy, i found therapy helped with me more so than the meds. It's nice to be able to communicate your problems with someone that isn't going to judge you, but help you. Let us know how you get on...

8

Hi smile

I'm 15 and have been on Mirtazapine since mid november and at the begining i was constantly eating and never being full but then later at night ending up feeling incredibly ill, it was like there was a big delay between my stomach and my brain realising i was full. I think at the begining when i was on 15mg i noticed the eating more but when i went up to 30 i didn't feel like i was eating a lot but then i thought about it, and i was eating 6 slices of bread a day. Now on 45mg i don't see the eating as much. But i guess it works different for different people. I havn't noticed many other effects with Mirtazapine so in a couple of weeks i will probably change over to fluxotene and give that a go. I hope Mirtazapine works for you :D

9

[quote:8fd5ea2b24=\"He-Man\"]Hi again Reg,

Like yourself my ravenous appetite is very hard to control, the more i began to control it the worse it got, as it became a daily focus for me. I found keeping myself busy and taking \"treats\" out my cupboards helped at least contain it a little. I'm now in the tapering stage and on 7.5mg of mirt, next week i'll completely stop it. I'm a little nervous and apprehensive, more so because i'm afraid i'll see a return to the severe sleep deprivation i had prior to Mirt. So i can also relate to your sleeping difficulties, i used to go nights without any sleep at all, facing the next day was an arduous task to say the least. I'd often break down trying to fight it, i found that just letting it go and dismissing it helped aleviate it. Monitoring my sleep really was counter-productive.

I hope your course of Mirt kicks back in again and helps with your mood, highs and lows are common so maybe its just a temporary phase. Good luck with the therapy, i found therapy helped with me more so than the meds. It's nice to be able to communicate your problems with someone that isn't going to judge you, but help you. Let us know how you get on...

Hi He-Man

How are you getting on? Have you come of of the Mirt entirely now? How has your sleep been affected by it?

I've been upped to 30mg and am not really noticing a massive difference. My GP seemed to be pleased with my progress though and said that I was beginning to show some insight. I guess its easier for people who only see you once a week or so to see a difference.

I started therapy properly this week and came out feeling physically sick. Its surprisingly hard work, and of course its only very early stages, but I'm interested to see where this takes me. I haven't reached the stage where I can completly open up to him yet, but I'm sure I'll get there.

10

[quote:cd0970a7cd=\"Rachel-4732985\"]Hi smile

I'm 15 and have been on Mirtazapine since mid november and at the begining i was constantly eating and never being full but then later at night ending up feeling incredibly ill, it was like there was a big delay between my stomach and my brain realising i was full. I think at the begining when i was on 15mg i noticed the eating more but when i went up to 30 i didn't feel like i was eating a lot but then i thought about it, and i was eating 6 slices of bread a day. Now on 45mg i don't see the eating as much. But i guess it works different for different people. I havn't noticed many other effects with Mirtazapine so in a couple of weeks i will probably change over to fluxotene and give that a go. I hope Mirtazapine works for you :D

Hi Rachel,

How are you getting on? Have you switched over to the Fluoxetine?

I'm now on 30mg and like you noticing very little from it other than a ridiculous appetite. I too get the feeling of not getting full, but then finding it uncomfortable later on. An odd experience!

How long have you been on Mirtazapine for?

11

[quote:ea51ec1102=\"Reg\"]

Hi He-Man

How are you getting on? Have you come of of the Mirt entirely now? How has your sleep been affected by it?

I've been upped to 30mg and am not really noticing a massive difference. My GP seemed to be pleased with my progress though and said that I was beginning to show some insight. I guess its easier for people who only see you once a week or so to see a difference.

I started therapy properly this week and came out feeling physically sick. Its surprisingly hard work, and of course its only very early stages, but I'm interested to see where this takes me. I haven't reached the stage where I can completly open up to him yet, but I'm sure I'll get there.

Hi Reg,

After a 4 week tapering process off Mirtazapine i have now completely come off it. My sleep has unfortunately been affected, it is very broken and my mood has also become rather erratic. I'm hoping these are merely initial withdrawl symptoms and that i can soon adjust to life without the meds. My appetite is still quite big, but i seem more able to control it now, maybe its a gradual process..

How often do you have therapy? Do you go private or through the NHS? Therapy did help for me although like yourself, i found myself never completely at ease with opening up. I'd often beat myself up for it afterwards and pledge to be more open, but it never really happened. It was however paramount in tackling my depression, there is no doubt it significantly helped. Often i'd walk away after my session(s) in tears, it was extremely hard at times.

12

[quote:c54b4cc5aa=\"He-Man\"][quote:c54b4cc5aa=\"Reg\"]

Hi He-Man

How are you getting on? Have you come of of the Mirt entirely now? How has your sleep been affected by it?

I've been upped to 30mg and am not really noticing a massive difference. My GP seemed to be pleased with my progress though and said that I was beginning to show some insight. I guess its easier for people who only see you once a week or so to see a difference.

I started therapy properly this week and came out feeling physically sick. Its surprisingly hard work, and of course its only very early stages, but I'm interested to see where this takes me. I haven't reached the stage where I can completly open up to him yet, but I'm sure I'll get there.

Hi Reg,

After a 4 week tapering process off Mirtazapine i have now completely come off it. My sleep has unfortunately been affected, it is very broken and my mood has also become rather erratic. I'm hoping these are merely initial withdrawl symptoms and that i can soon adjust to life without the meds. My appetite is still quite big, but i seem more able to control it now, maybe its a gradual process..

How often do you have therapy? Do you go private or through the NHS? Therapy did help for me although like yourself, i found myself never completely at ease with opening up. I'd often beat myself up for it afterwards and pledge to be more open, but it never really happened. It was however paramount in tackling my depression, there is no doubt it significantly helped. Often i'd walk away after my session(s) in tears, it was extremely hard at times.

I'm sorry to hear that. As you say, it may well be the affects of coming off the meds after so long.

I'm having it once a week currently, though came out yesterday feeling that 1 hour wasn't enough. I had a very odd mix of feelings, and actually felt physically sick. I wasn't expecting that at all.

I did beat myself up a little over a few things that I didn't bring up, but it is of course early days. There are some things I don't want to bring up, but get the sense that they are important enough that they ought to be discussed and explored no matter how painful that will be in the short term. I kind of feel like avoiding stuff like this defeats the whole object so will certainly try to confront it.

13

I forgot to mention that I'm having to go private for this as it isn't available on the NHS down here.

14

Hi Reg, really glad the therapy seems like a postive move for you. The main reason for me holding back stuff in therapy was the fear of being judged. Later i realised that the role of the therapist is not to judge but to assist, it took many sessions before i really felt comfortable enough to discuss the more personal aspects of my life. Credit to my psychologist though, he was fantastic.