Mirtazapine diet club

Posted , 48 users are following.

I thought I would start a thread about trying to lose weight on this drug. If others are currently dieting, please add your experiences here. I would like to discover whether we gain weight on mirtazapine purely because it increases our appetite, or whether other factors are at play. I certainly gained weight quickly when I started on mirtazapine (around 1.5 stone). My appetite was revenous, especially for sugary foods. I tried to com off mirtazapine around 6 months in and failed. I lost half a stone in the week I waas off it, but most of that was due to severe nausea. When I went back on the drug I did not gain more than a couple of pounds, but I was being very careful what I ate. My weight has been steady now for two years.

I am not happy carrying around the extra stone however, and so have decided to diet. I am on day 8 and it is VERY hard. But I have lost two pounds so far. This is with me still eating 1700 - 1800 calories a day. I have a very active physical job and so my daily calorie requirement is 2100.

I have also started taking raspberry ketones and green coffee bean extract as of this morning in the hope that it will help me to burn fat. The interesting thing is, the amouont of weight I have lost is the same as would be expected from a person who is not on mirtazapine.

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  • Edited

    Hi everyone!

    So just wanted to throw in another update. I had been on Mirt for a week, gained 4 lbs, stopped taking it until I had a script for Metformin and then took Mirt with Metformin for a month (April 1-28).

    I gained "only" 2 lbs. So stayed pretty much the same, which was thanks to the Metformin (confirmed by a psychiatrist who specializes in these kind of things).

    I stopped taking Mirtazapine on April 29 and started with Trintellix (vortioxetine). Originally I was told it was the same chemical structure, but without the weight gain issue.

    Now I've been told that Trintellix is a new AD but NOT comparable to Mirtazapine.

    Well... I know that I have lost 6.4 lbs since April 28th. It's nice, but it doesnt make me happy enough to lose the suicidal thoughts that I had last week.

    For that, I had to take 1 Mirtazapine on Wednesday. And they vanished overnight!

    I have now an agreement with my pdoc that I am going to take Trintellix 10mg, Wellbutrin 450 mg, Metformin 1000 mg, Clonazepam 2mg and if needed (PRN) 15mg Mirtazapine.

    I hope to be able to take mirt only once a week or even less. Or only when things are getting emotionally rough.

    Will keep you in the loop.

    Obviously my scale shot up 3 lbs after that one tiny pill of Mirt, but I am expecting it to go down just as quickly over the weekend.

    • Edited

      It is such a shame that it has this awful side effect. As you know, I am working really hard with diet and exercise just to say the same. So pleased you are back on here. Was getting worried about you.
    • Posted

      Awww thanks Evergreen! Yeah... I was a bit worried myself there. It's been a rough two weeks. 

      To recap - last Wednesday I realized that Trintellix is NOT the same as Mirtazapine and the likelyhood that my suicidal thoughts would come back after stopping Mirt were fairly high (which they did the week before).

      I took 15 mg Mirt last wednesday (exactly 7 days ago) and "gained" 3 lbs overnight, but I was happy and my old self again. 

      Thursday and Friday were great, Saturday was good, Sunday was meh and Monday I was sitting there, crying in front of the Mirtazapine bottle because I KNEW I should take Mirt to make me feel "me" again. But I also knew I could kiss my weight loss good bye.

      Thanks to my psychologist I made it through Monday without taking Mirt. Tuesday at work was pretty much a blank. I was just staring at my computer, trying not to cry. But I was able to get a "squeeze in" appointment with my psychiatrist for today.

      So ... I used yesterday and this morning to do some more research and to find a mood stabilizer that doesnt make me gain weight and that can replace Mirtazapine, because Trintellix does not do the job.

      From the number of options out there I read the medical monographs and a few studies on the following: 

      Lithium

      Valproate

      Topiramate

      Lamotrigine

      Lithium as one of the oldest mood stabilizers out there is the drug of choice for most pdocs. But it also comes with a slew of side effects. That's why regular blood and urine tests are necessary to make sure there is no accidental overdose.

      Lithium and Valproate both may or may not be weight neutral, Lithium may help losing weight, but not for everyone. 

      Both of these drugs have side effects like slurred speech, word finding issues, drowsiness, disorientation etc etc. So not necessarily something I would want to experience while working a full time job. 

      Topiramate and Lamotrigine apparently are fairly new drugs and have shown mood stabilizing effects in the past.

      Topiramate is actually specifically used to negate psychotropic induced weight gain. It also is great for PTSD and people with Bipolar. BUT apparently it helps more to get Bipolar patients down from manic episodes and stabilize them. For people who are in the depressive phase or generally depressed, Topiramate can even intensify the depression. Soo.... thanks but no thanks. 

      Lamotrigine though is used (off label) as a mood stabilizer for unipolar depression and also for bipolar patients in depressive episodes. It apparently increases sleep stability and supports weight loss (or is at least weight neutral). The side effects are fairly benign compared to the other mood stabilizers (especially Lithium and Valproate). Lamotrigine also has very few negative drug interactions. Past tests with patients have shown about a 65% chance of reacting positive to it, which was partially calculated based on the improvement of "Quality of Life" scores.

      Me thinks: a 2/3 chance is better than what I am going through now. I want a life and I want my brain to stop trying to kill me. 

      So.... this is what I am trying next. In addition to 10 mg Trintellix, 450 mg Wellbutrin (bupropion) and 4x0.5mg Clonazepam.

      I'll keep you guys updated. Crossing fingers that my pdoc plays along and gives me a script today! 

       

    • Posted

      my doctor told me i had 2 options take it or dont 😦 i have a love hate relationship with this drug..i didnt know it could be a PRN medicine??? i think i would be happier doing that because the aide effect s with the weigjt gain are crazy amd im hungry 24 7

  • Posted

    Oh and I forgot: 

    The 15 mg Mirtazapine had a positive influence on my mood for 4 days. During that time I did not lose weight (instead I was ravenous).

    As soon as it wore off (Day 5-7) I started losing the added "water weight" and the 1-2 lbs I should have lost this past week.

    But 2 lbs less really dont make me happy enough to go through 3 days of full blown clinical depression.

  • Posted

    Ugh. My pdoc was not very accomodating. He wants to wait and see if I improve with a higher dose of Trintellix instead of adding Lamotrigine as mood stabilizer.

    Well... So I am up to 20 mg Trintellix (vortioxetine) now. We'll see how it goes. Sadly he is not willing to help with anything else since he now knows that I am going to see a different pdoc in 3 weeks. She seems to be a bit better informed and willing to try more things to help. At least that's my impression.

    Anyway. He pretty much made clear that he wont give me anything else other than the stuff I am on and it's now up to the new pdoc.

    Feel free to read between the lines.... sad

    • Posted

      Oh heck, Mermaid, that is awfull. I hope the increased dose starts to help you soon. I am fed up with working so hard to lose weight and getting nowhere with mirtazapine, but at least I;m not putting it on. Just a way of life now. I just can't eat very much or I will put the weight back on. But I am loath to come off the mirt because it helps me in so many ways.
    • Posted

      Hey Evergreen!

      I am still here and actually.... doing much better!! 

      After seeing the old psychiatrist (what a prick) I was able to make a much earlier appointment with my new psychiatrist (the one who suggested Trintellix in the first place). I saw her on Monday and she was great!

      I am now on 

      450 mg Wellbutrin

      4x0.5mg Clonazepam over the day

      30 mg Trintellix at night

      2.5 mg Zolpidem for sleep

      And as soon as I went up to 20mg Trintellix I felt  a bit better and as soon as I started 30 mg I was like myself again. Just like on Mirtazapine, but without the sedation and without the weight gain.

      Think about it.... maybe it's worth a try to switch. You wont even have to reduce Mirtazapine to less than 15 mg. The monograph of Trintellix suggests 15 mg and then an immediate switch to 10 mg Trintellix if you are taking other SSRI's. Otherwise you can do 10 mg for a week and then go up to 20 mg, which is the official "therapeutic dosis". 

      Oh I just so wish that you feel better and are not so unhappy with the weight gain. It's so frustrating and surely not helpful if you are depressed anyway.

    • Posted

      So pleased you are feeling better, Mermaid. I'm a little happier now too. My sleep has improved and I have started to lose weight again.
    • Posted

      Oh that's wonderful! And did you change anything in your meds or did you change some behaviours that stressed you? I mean... did you make yourself go to bed at a decent time, did you practice yoga, mindfulness meditation? It would be interesting to know what helped you get better.

      Afterall I suppose that's what my therapist means when she says "you will always have good and bad days and that's normal." Sometimes they are phases, but they are not real episodes that last for weeks and weeks...

  • Posted

    The good news though is - while I feel rather suicidal and awful - that my weight dropped another 2 lbs. Probably because I am not hungry at all and get the runs when agitated / nervous.
  • Posted

    Hihi, do you have some news about weight loss?

    I have been now on reduced dose - 15 mg - for more than a month and actually staying at the same weight (more or less). Honestly, I do not get it how I can have this ugly fat belly if I do sports for 5 hours a day and do not eat a lot. This mirtazapine must be a very weird drug to mess up with human body so much..

    • Posted

      Hello everyone. Sorry for the delay in answering. I have been busy with a shoulder operation amongst other things.

      My news is that I have not been trying to lose weight for the last 8 weeks. But I HAVE kept my calories in to match my calories out. I have therefore remained the same weight during this time. It is a weight I am very happy with. I can't eat as many calories as I would be able to if I were not on mirtazapine. I reckon that on the days I don't work out, I probably need arouns 1650 calories a day, and on the days I work out it is around 1900 a day. I will have to stick to this rigorously for the entire time I am on mirtazapine if I don't wish to lose weight. But it isn't unduly hard to do. I have just got used to it. If I over eat one day, I cut down the next. I look nice and slim and healthy, and feel fit as a fiddle. So losing weight and maintaining the loss whilst on mirt, is perfectly possible. It's not easy, I won't lie. I often think back to the times when I could eat a lot more, like most people who are not on this drug, but the mantra 'nothing tastes as good as skinny feels,' is so true.

       

    • Posted

      Sorry, I meant to say 'I will have to stick to this rigorously... if I don't wish to GAIN weight.'
  • Posted

    Update:

    Started off at 152 lbs Jan 1st 2015.

    Lost 7 lbs by end of March then stalled despite sticking rigidly to my diet.

    ​Cut my calories by a further 1200 calories and got down to 143lbs by May.

    ​Stalled again so added rigorous daily cardio and cut my calories further. Lost 2lbs and then stalled AGAIN.

    ​Gained the 2 lbs back despite keeping to diet and working out daily.

    ​2 weeks ago cut out all alcohol and lost 1.5 lbs.

    Current weight 141.5lbs.

    Conclusion:

    ​You can lose weight on mirtazapine but it appears to have a serious effect on your metabolic rate and fat storage mechanism. It works against all efforts to lose weight so that you have to work far harder than if you are not on the drug to lose weight or stay the same.

    • Posted

      Third line down should read 200 not 1200!

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