Alternative toMirtazapine which helps sleep

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I have an appointment with the doctor next week to discuss possibly changing to a different AD. I love mirtazapine in every way but for the weight gain. I need to lose a stone and am dieting. I have lost 2 lbs in a week, but if I can't sustain it, I need to change drugs. Last time I tried to come off mirtazapine I suffered terrible nausea and insomnia (I tend to sleep badly in any case but mirtazapine has really helped). Can anyone suggest a different AD that really helps with sleep but does not cause weightgain? I don't get on with SSRIs. Thanks

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  • Posted

    Amitryptaline is an older tri-cyclic AD which also tends to cause sleepiness.  Indeed it is not foten presecribed as an AD these days but used for insomnia/pain.

    Afraid I don't know whether it tends to cause weight gain or not.

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    • Posted

      As a general rule of thumb if an AD causes sleepiness it will probably cause weight gain. The reason is the sleepiness is (usually) caused by the H1 receptor blockage. This causes sedation and acts as an appitite stimulant. And this is how most otc sleep meds work (Nytol for example).  Amitryptaline will most likely have the same affect as Mirt on weight and appitite it has a very strong affect on H1 like Mirtazipine.

      Mirtazipine is fairly unique but if you google NaSSA antidepressants you will find similar drugs which may have less affect on the h1 receptor?

      Sorry if that seemed in depth, I just wanted to explain the reason behind my answer.

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    • Posted

      Thanks for explaining that. Looks like I might be stuck with it then. I'll chat with the doctor as it's only really the insomnia that is scaring me from coming off them all together, though no doubt I will sink back into depression if I come off all together.

      Thanks all of you for your very helpful answers.

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  • Posted

    Hi you don't say what Mg you are on.  I've been on 45mg and I gained a lot of weight .recently I've been tapering off it,( with a lot of distress ) Im now down to 15mg and I've lost over a stone. So I think it may be down to what your Mg is.
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    • Posted

      I don't know if you know but the lower the dose of Mirtazapine the more sedative it is. Maybe that's something you could discusse with your GP
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    • Posted

      Thanks for that bit of info, on Mirtazapine , I've jus started, on it, 

      at 15mg. At night, I couldn't understand, why I've been sleeping most of the days away as well.. rolleyes

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    • Posted

      Check it out with your GP. I know it sounds rediculuse but it's true. Look back on some other posts. Or check it out with CITA.
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    • Posted

      That is one of the side effects of Remeron sleepy during the day.  They say once your body adjusts should go away but then again everyone is different.
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  • Posted

    It might be a case of finding what works best for you. I don't think any antidepressant will make everyone gain weight. I've been on mirtazapine and venlafaxine together for several years and not gained any weight in that time. So everyone is different in how their body reacts. For example I can't take amytriptiline or similar tricyclics . I find it best to take the doctor's advice. I could take one SSRI Seroxat until it stopped working but when I tried another one (can't remember name) it made me lurch around as if drunk!
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  • Posted

    I think you should stay with miratrazipine if it suites you and you are happy with it. The only way to keep the pounds off is to eat less and do a daily walk( if you can!) I get hunger pangs in the evening so I try to eat some fruit or tea or something. If it's working for you I would stay with it and keep happy. biggrin)) 
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    • Posted

      Thanks, I am starting to see a bit more weight loss now so may stick with it. My sleeping has been very poor, even with the mirt lately. My main problem is I have to be up very early for my job and then stay up late because I have to fetch my son from work sometimes as late as 11.30 12 pm. Then I panic that I won't get the sleep I need because I have to get up by 6.30 am and I will be unsafe to drive the following evening. I also have to delay taking the mirtazapine until after I pick my son up which firther delays my sleep. sad
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    • Posted

      Here is some advice I gave to another user regarding sleep problems. Though with all this below in mind how old is your son? Your health shouldn't suffer in order help others.

      I used to suffer bad insomnia. The first thing to do is not to worry about not sleeping. The worry will tire you out the next day much more than the not sleeping to the point that if you got 4 hours sleep but were stressing over it at night you will feel worse than if you got only 2 hours but didn't worry about it.

      Secondly consider moving any clocks so that you cant see them. This stops the clock watching. I always found myself looking at the clock and working out how much sleep I would get and stressing over it- 7 hours, 6 hours, 5 hours (oh I'm gonna feel rough now), 4 hours (how can I work on 4 hours sleep?!) and so on.

      Finally, just go to bed later. I always found going to bed later and not worrying about it was a lot better than going to bed on time and laying awake staring at the ceiling stressed out. Also because I went to bed later I was often more tired and fell to sleep quicker.

      Other tips,

      No tv in the bedroom,

      Leave a light on! I know this sounds odd but I found that when I turned the light off I was suddenly under pressure to fall asleep which made it harder to sleep but with a lamp or side light on I didn't feel that pressure and found I could more easily just relax and doze.

      No electric devices the bright screen stimulates the brain. Maybe just read a book or magazine.

      I hope this helps. Goodluck!

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    • Posted

      That must be a problem taking it so late in the day. How much are you on? But I truly believe if it's working for you don't switch to something else and just try hard with regards your weight. I can see a lot of people on the forum complain about weight gain. So I do realise it's a problem for many. I have only been on it for about 3 months and take 15mgs. I do feel v tired during the day.  Tony advice about sleep is very true. 
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  • Posted

    Trasadone is also the same "family" as Mirtazapine -ie, it's a sedative antidepressant
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    • Posted

      Thanks. Unfortunately I did try coming off mirtazapine onto trazadone and could not sleep at all, plus I was so nauseous.

      However, the good news is, I have started to lose weight again on my diet. I have carefully logged every single calorie and it turns out I am actually losing the expected amount of weight that a person not on any medication would lose. I have just been expecting too much. I think I will start a new thread for people who want to lose weight on mirtazapine with some useful links to work out how many calories you should eat to maintain or lose weight.

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    • Posted

      It does make sense. After all, the weight can only come from what you eat, although I wonder whether mirtazapine could slow down the metabolism so you don't digest the food so quickly? Anyway, it's good news that you're succeeding in losing weight now, success is good for your mood!
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