Mirtazapine - can you lose weight?

Treatment and medication
1

For those of you struggling with your weight loss whilst taking this drug, I thought I’d tell you about my experience and conclusions.

I started on mirtazapine around 4 years ago for major depression and nausea/lack of appetite, and it worked really well for me, banishing my depression within days, and reviving my appetite and enjoyment of food. It also virtually cured my migraines, stopped my itching and IBS, and helped me sleep and cut my temazepam right back to around once a fortnight.

I quickly gained weight which I put down entirely to my increased appetite. I thought all those stories you here about not being able to lose weight despite cutting calories were just people underestimating how much they consumed. I was wrong.

After 6 months on the drug I had gained 26lb and none of my clothes fitted me. Despite cutting my food intake down, I kept gaining weight. In desperation, I came off mirtazapine cold turkey and suffered the most awful withdrawals. After ten days of ■■■■, I was forced to go back on it. But I had dropped 7 lbs. I managed to keep my weight stable at 152-154lbs for two years. I couldn’t eat what I used to eat, but at least I was no longer gaining weight. Then in January this year, I saw a picture of myself in a bikini and hated the way I looked. I decided to seriously slim.

January 2015 I weighed 152lbs and cut my calories to between 1500 and 1800 a day. The weight fell off and I got down to 143lbs by March. I thought once again that mirtazapine was not affecting me being able to slim. I was wrong.

April 2015 I stalled, despite keeping to my diet. So I added a daily cardio work out. I actually GAINED weight!

July 2015 I still weighed in at around 143lbs as I had lost the weight I gained in April but after 7 months was no further on than I was back in March. I was forced to recalculate my maintenance level of calories from 2000 down to 1800. I have an active job and being 5 ft 10, I should need more calories than this to maintain my weight. I realised then that mirtazapine was interfering with either my metabolic rate, or my ability to burn fat or both. I still couldn’t lose any weight.

August 2015 I cut out alcohol which meant that I had effectively cut my calories still further and I have lost a further 2lbs. I now weigh 141 lbs.

Conclusion:

Mirtazapine affected my weight by increasing my appetite AND by some other means, probably slowing my metabolism and interfering with my fat burning process. You CAN lose weight on mirtazapine, but it is much harder than if you are not on it. Is it worth it? Well yes, for me it is. It has turned my life around for the better. I love it, and I hate it. I love it for helping me fight my depression, sleep well, be free of migraines and IBS, and not have to take antihistamines daily for my itching. I hate it for forcing me to stay on a rigid diet with very few indulgences, and for being such a difficult drug to kick.

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Sorry typo 'here' should be 'hear'.

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Thanks for the info for people suffer. I'm one of the lucky ones who has actually lost weight almost 2 stone on this. I have been going the gym but I don't get the hunger off it a sign in think this isn't working for me proper wd is very hard I tried it aswell and failed. I'm very interested in what you said about the ibs though. I have ibs and ibd and in fact I think matazapine has made it 10 times worse so I'm rather jealous lol I didn't see an improvement like yourself. But living with this I say if it working for you it's worth the strict diet to be free. X

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That is really interesting. I'm sorry it hasn't worked very well for you. You may be right that the fact you have lost weight and had IBS, and you haven't experienced the extra appetite on mirtazapine, may well mean that it isn't working as it should for you. I hope you are able to get free of it. I don't mind so much being stuck on it if it is helping me, but would hate it if it wasn't. I think that mirtazapine works extremely quickly if it is going to work. I always tell people to get off it quickly if it isn't working for them within a couple of weeks or so, because it is such an awful drug to come off.

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I've been on it since Feb had a bit of a bad time with ads sides effects ect. But matazapine seems to be OK for me. I'm on 30mg I can't go up as it sends me manic it has worked improving my mood but a lot of that has been work on my behalf aswell but does nothing for the aniexty. Currently I'm in theraphy but after that I am going to wd and swap ads. I've cold turkey an ssri at highest dose before medical life or death reasons not through choice that was he'll but it was over within a week so not too bad. But matazapine even though wd is mild Compared to that believe me it just lasts so long you give in. BTW wd from ssri I was having fits most the day. So I can't afford to be I'll for that long and miss my theraphy I waited 6 months for it and single mum to 3 kids x

6

Very well stated. For some reason this medication causes weight gain for most. Myself included. For me that was a good thing as I'm quite slim, as well as the effect it has for making a person sleep better. I'm now free of the medicationas as of one year, but coming off of it is quite difficult. Sounds like you are doing well and good to hear that you're able to lose weight despite what the drug is known to be causing as a side effect.

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Thanks, Ryan. I am pleased that you managed to get off it successfully. I am dreading trying to.

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Absolute graft and dedication to lose weight

Perhaps there is a little bit of hope here. I have been on mirtazapine for many years (mainly 30 mg). Weight gain was a problem as I was always slim. Although not massively overweight (BMI 28) no matter what I did I had a potbelly (which I hated), which was leading to pre-cursor to Type II diabetes (results indicated impaired glucose tolerance).  Also had high cholesterol and triglycerides. Not great. At 50 (male) with an office job, lifestyle changes were needed.

For the first time ever I counted calories and stuck to 1900 goal via a well-known app. Weight loss was stubborn and painfully slow with demoralising fluctuations.   I blamed the mirtazapine so I cut from 30 to 15 mg. I was not overeating and had had no increase in appetite as reported here; I strongly agree there is something in this little tablet that affects metabolism/storage of fat.

Cutting to 15 mg and becoming more strict and honest with calorie counting weight loss started, albeit too slow for me!

I felt I needed to do more than just diet so I bought a bicycle. After three months my average distance is now 15 miles a day of moderate cycling. Indeed, this greatly helped with my depression and I have found a new hobby.

With the very strict calorie counting, extensive cycling and reduction to 15 mg I have lost in past five months 15.5 kg (or 34 lbs to our American friends). I can honestly say this has been absolute graft and understand not everyone can do or is able to do such high levels of cardio. BMI is now 23.8, cholesterol and other tests due in Oct (or the Fall!).

I have no intention of stopping mirtazapine as I cannot sleep and was losing time off work due to severe insomnia when trying to stop them. Hopefully, with the ongoing diet maintenance and cycling it is under control. I sleep and manage ok on the 15 mg.

Top tips:

•Weigh yourself at a set time once a week ONLY and look at long term trend.

•Get a fitness tracker or pedometer

•Don’t cheat and underestimate calories

Good luck everyone

9

Excellent post, Philip. You really have done very well. I agree that it is all too easy to underestimate your calories, but in the end you are only cheating yourself. It is a long hard slog, but it's worth it. It means changing your eating habits for ever, and that may be too hard for some. But for me, I'm actually starting to like it. I am now used to feeling hungry for much of the day, and it isn't so bad. As Kate Moss says 'nothing tastes as good as skinny feels'.

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I hear you.

I was a painful 84lbs prior to Mirtazapine. I went on this drug due to anxiety caused by a very traumatic time in my life and I guess I had mild depression, I was far from happy with being stuck at home anxious. 

Mirtazapine helped me feel calmer and happier but with it I gained weight. Much needed weight of course and I went up to 128lbs. Now at 5ft tall that was alot for me. I am now at about 116lbs I have managed to lose some weight but like you I have hit a stumbling block and cannot lose anymore weight. I have to watch everything I eat and I cannot have many treats. If I do I gain alot of weight. 

I lost weight by excessive exercise and a low carb diet to boost my metabolism. It helped and it did work but now it has hit a stop and i  cannot lose anymore weight. I can't workout due to some other health issues at the moment and I am gaining again. It sucks. I would come off this drug if I wasn't so scared of withdrawal.

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You have done really well! It really is a tough drug. You makemore and more cuts to your intake, each time you lose a bit and then you stall again. It is as though the drug tries to sabatage any attempts to lose weight that you make. I would love to come off it because of this, but it is easy to forget what a mess I was mentally and physically before mirtazapine. The only withdrawal I am afraid of is the insomnia. If I sleep well, I can cope with most things.

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Hi Evergreen

I've often wondered, if cutting right down to minimal calories has the effect of making the mirt stronger ? Just starting my we'd now ! Here we go, it's been a year & ive put on about 20 lbs ggrrrrrr

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Thank you for this post .... it makes very intersting reading for anyone on mirt smile

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im hoping and praying that the weight will come off now im off this drug. Been 7 days off it now, had a six pack, worked out etc. got out on mirtaz for 5 months, gained a stone in complete tummy fat. never been so depressed because of it. before taking it; i could eat anything and everything and just turn to muscle! im so hoping that the weight will go. and i havent destroyed my metabolism forever and it will return to normal. someone please reach out to me!

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i am in your boat maam i am on mirtazapine and trazadone for sleep and i have gained 100 lbs over the years. i am ready to quit mirtazpine cold turkey and pray the Jesus I sleep still.

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Great post Evergreen. I've been on Mirtrazapine for about 16 months now - initially at 15mg then slowly tapered over 1 year down to 3mg. Then had a relapse (I have severe but episodic insomnia that then causes extreme anxiety meltdowns). Now I'm back at around 18mg after a rocky summer of bouts of insomnia. On the weight side, you are 100% right that it doesn't only cause weight gain due to an increased appetite. I've always been on the slim side (around 119 pounds) and watched what I eat. Without a shadow of a doubt I eat better/less now than I did before being on Mirt and I have still put on 28 pounds since taking it that I absolutely cannot shift. I went on a very strict low carb diet in Jan 2020 when my dose was around 5mg and managed to lose about 8 pounds but it was such hard graft. As I got down to 3mg I started to see a few pounds more come off and I was probably down to about 16 pounds over my natural weight at that point. Then after this summer of needing to increase back to 18mg, it's all gone back on despite again not making any changes to what I eat.

As for the Mirt itself - at first it quite literally saved my life after my mental health deteriorated severely after nearly 7 nights of not sleeping at ALL. It was the only thing that worked for my insomnia. 15 months on however and it has now lost that effect . I wondered if you (or anyone else) has experienced that loss of efficacy on sleep? I'm very aware that it's supposed to be more sedating at lower doses but I can't seem to get any lower at the moment without having another episode of insomnia and upping the dose in desperation at the time to help me sleep! It seems such a cruel twist of fate that all ADs that are sedating also cause weight gain through their mechanism. Evergreen have you experienced any changes in how it works for your sleep?

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I have arrived here as i am now taking Mirtazapine 45mg. This is a new drug for me as i was previously taking sertraline but it wasnt doing much for me. Before starting on Mirtazapine i began to lose weight but now i have gained what i lost and more. I am currently at the heaviest i have ever been and i hate it. Side affect wise it has been rough at times. I have the increased appetite. i am hungry all the time and my sweet tooth has gone crazy. I get fluid retention and swelling of my legs it can feel like the skin wants to burst when I try to walk when this happens. It’s made my joint pain worse and for a while it did really affect my orthostatic hypotension. For the first week of being on 45mg I couldn’t be sat upright for long periods. Despite these side affects it has helped my mood and I am feeling better although slightly down because of the side affects. I hate that I’m gaining weight while on this drug but im trying what I can to at least stop gaining and maintain what im at. I have other health conditions too which make me worry too as I have orthostatic hypotension, hypermobility and PCOS. My biggest concern is gaining weight and not being able to shift it because of the PCOS. I am as active as I can be with the increase joint pain and hypermobility. The pain is sometimes unbearable and will wake me up and keep me up at night.

After reading how strict you guys have had to be with exercise and diet just to maintain and lose some weight I’m starting to think that I may have to try a different drug and risk getting bad again. I have shared my concerns with my doctor and they want me to see how I go for longer in hope that the side affects will settle down. But Before I got really bad they kept going on about how fat I was before and how I needed to lose weight because of the PCOs. I understand that alive and fat is better than the alternative but surly they should be sharing my concerns too

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Hi to all,

i hope i will not gain weight on it i need to loose weight not gain it as i am loosing weight now i dont want to gain it back hopefully i wont. Dose it help with Sleep at all.

Irene37678.

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Hi Irene. My doctor warned me about the weight gain when I went on so it is a recognised side effect. it is, however, good for sleep. Strangely the lower doses are known to be more sedating. Hope it works out for you

20

thank you so much for your help. I was wondering if I would stick to diet what would happen to my weight since I am struggling so bad with this thing. now I think I have to try to stop it.