Mirtazapine dosage and effect on weight

Dose the amount off mirtazapine you take affect how much weight you gain? I thought I would start a new thread for people wanting answers to a question that so many ask, so that it could perhaps serve as a reference for people searching for an answer to this question when using search engines such as google. I want to invite as many people as possible to add their experiences regarding mirtazapine and possible dose related weight issues.

So my answer to this question is 'yes, to an extent.' I was on 15mg for a month and it was then increased to 30mg for four years. In that period I gained a total of two stone. Most of that happened shortly after increasing to 30mg, although I gained around 6 pounds in the first month whilst I was on 15mg.

I did manage to shift 1.5 stone of it whilst I was on 30mg though, but it was VERY hard. I worked out daily on the cross trainer, and cared for several horses, and walked dogs etc. I calculated that my body only needed 1800 calories a day to do all this. Any more, and I gained weight. And for a 5'10" woman, that is very little indeed. I reckon that mirtazapine influenced my body so that I needed around 500 calories LESS than I previously needed to maintain weight.

So what happened when I reduced my dose? Well nothing noticable until I was under 15mg. When on 11.25mg I noticed that it was much easier to resist previously tempting treats. I also noticed that I could up my calorie intake by around 200 calories a day, and also not work out every single day, yet still stay the same weight. I am now on 7.5 mg and will have to see if there is further improvement.

Hi - here are my two pennies for this discussion. This is part of the reason why I came off Mirtazapine along with the fluctuation between extreme anxiety and sedation. My GP told me that it is often used as a treatment for the elderly who don't sleep or eat. So it has appetite stimulant properties. In the week that I took it and the longer it has stayed in my system, I went up a dress size. I also CRAVED sugar. So, this initially shocked me, until I realised that older peoples' metabolisms are a lot slower than mine (I'm 32) so they'd obviously need more of a 'kick'. I was getting that in the extreme because I was younger.

Because of my lifestyle (I work full time and study for a PhD), an SSRI was no longer viable for me so my GP suggested Mirt because it works Noradrenaline. I appreciated that benefit of the Mirt but the adverse effects massively outweighed the benefits (ie I was working much more effectively - just constantly accompanied by biscuits and sweet tea!). I've since looked up other options which work noradrenaline and have found SNRIs - really want to try these as they still work noradrenaline just without a the appetite stimulation. Fluoxetine and Trazodone just doesn't suit my lifestyle needs now.

Evergreen - well done for getting the weight off cos you're working against everything Mirt does - I seriously take my hat off to you. My appetite is starting to slow down now, but I need to lose what I've put on too - I will go walking a lot!

Hope everyone is well!!! Xxxxxx

Blimey, a whole dress size in a week. No wonder you came off it. I think the weight gain with mirtazapine is two pronged. Firstly it gives you a huge appetite, particularly for carbs, and secondly it does something either to your metabolism, or the way you store fat, or both, so that you actually need fewer calories per day to stay the same weight. It really is a double whammy!

My contribution to the discussion, briefly. I've been on mirtazapine for several years, first on 15mg and then on 30mg, and I haven't gained a pound in that time. So weight gain may be likely, but it is not inevitable.

That's true - everything affects everyone differently. I'm glad you didn't gain weight. That's the thing with mental health drugs tho - it's so much a case of trial and error. Things like weight gain are something not to be taken lightly (boom boom!) because sometimes mental health and physicality are interlinked be it either as cause or symptom of mental illness. Hope you're ok xxxxxx

Hi you sound very disciplined. I was on 30 piled on two stone over 8 months. Craved sugary carbs first time in my life. Down to 15mg for three months still gained weight. Stopped and changed to sertraline and immediately cravings stopped. Lost 9 lbs straight away. Levelled out now at 10 10 my original weight before I got ill and lost stone. So basically gained 2 and lost half stone which I am happy with. Took up yoga so feel. I'm getting toned now too.

So pleased you are now at a weight yoou are happy with. I am too but it is so difficult staying there whilst on mirtazapine. Did you have any trouble coming off it? Did you taper or just stop? I am down to 7.5mg now and it hasn't been difficult so far, although I am taking it slowly, especially this final bit. I can't wait to be off it though, so I can return to my normal metabolism (hopefully).

 

You are very lucky not to have gained weight. Are you planning to stay on mirtazapine? Is it still working well for you?

Much the same as most 2 1/2 stone to flab since starting 39mg Mirt a year ago.  Feel I have another kind of despair to deal with now as whatever I wear looks dreadful and will not go out socially because of this.

I am seriously going to request that Psych changes these pills.

Please may I ask if anybody has found a suitable effective alternative.

Many thanks.

Sorry that was 30mg not 39

After four years on mirtazapine, it suddenly stopped working for me and I was plunged into depression, severe anxiety and insomnia once again. So I am coming off the mirtazapine with the help of a supplement called inositol (or vitamin B8). I take 12-18 grams daily in my morning tea and I feel amazing. So happy. My husband is also taking it and it has really helped him with work related stress.

Sorry to say had awful wd but was starting sertraline same time. Doc took me off ,15 mg by missing one a day for two weeks. Way too quick. Ended up on diazepam for two weeks. Not to be recommended. All doc says now is I did warn you, no you didn't. And everyone is different. Are you aiming for no drugs?

I switched to sertraline backed up temporarily with low dose of quetiapine. Feel brilliant as, same ad you, weight freaking me out. I am 53 and size 12 since my twenties. Leaped to size 14 (UK) and it was still heading up. Lost my cravings straight away and still can't believe the way I ate sugary things having never liked them. Change but do it slowly. Mirtazapine is given to anorexic cats, says it all. It's your body you choose what to take not docs. Good luck

Hi after you wrote about it before I researched it and it sounds great. Keep meaning to check with my doc if it's compatible with my meds. Definitely on the cards when I come off altogether. Glad it's working for you.

Hi evergreen (sorry all for cutting into your thread)

well I'm now on day 8 of mirt and feel alive for the first time in six months! I noticed this weight thread and I must say my appetite has gone from zero to unstoppable! But right now it's not a problem as I need to put on some extra pounds! I am still groggy in the mornings but hope this will pass. I'm on 15mg and feel well but have a sneaky suspicion on seeing my doctor tomorrow she will increase my dose to 30 will this make me more sleepy? Would very much welcome your advice. Btw how is your tapering going?

warmest wishes to you and all on this thread xxxx

No, it won't make you more sleepy. Some people actually find 15mg more sedating than a higher dose. I am so pleased that the mirt is helping you. It's a really good anti depressant for many people. But do keep an eye on the weight; I started off too skinny, but soon was too fat! You can control it though if you are ready for it.

Awww thank you so much evergreen xx

how is your tapering going are you feeling of with it? X

It's going really well except for the most terrible insomnia. I thought it was bad enough before I dropped to 7.5mg but now nothing seems to send me to sleep. But the rest of the withdrawal has been a breeze so far.

Really pleased to hear that. I think the way you have gone about it is the way to do it. I managed to reduce from 40mg citalopram to 5mg in three weeks. Strangely enough 10mg to 5mg has been the trickiest. Not awful but hand tremors all day. I imagine once the doctor ups my mirt, she will tell me to drop the 5 mg cit.

Thank youso much for your support and kindness xxx