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Remeron (Mirtazapine) and Weight Gain: What Causes It?

Remeron (Mirtazapine) is an atypical antidepressant that is technically classified as an “NaSSA” (noradrenergic and specific serotonergic) drug. It is considered a highly effective antidepressant, and some have posited that Remeron is superior in efficacy compared to other antidepressants. In a meta-analysis from 2009, it was found to be more effective than all SSRIs, SNRIs, and a couple other atypicals like Wellbutrin and Reboxetine.

Despite being considered the drug with the highest efficacy in that particular meta-analysis, most would agree that “the most effective antidepressant” is subject to significant variation based on the individual. Remeron is considered “fair” in terms of tolerability, with some patients having significantly less side effects than others. Unfortunately most people who take the drug notice that it significantly increases their appetite, which inevitably leads to weight gain.

Remeron and Weight Gain

Most professionals should be aware of the fact that people taking Remeron are likely to gain weight. Unlike most antidepressants in which short-term weight gain may not be as common, with Remeron it is likely that you’ll gain weight over the short and long term. Some argue that this is likely due to developing an increased appetite, but there are other theories.

How Remeron Causes Weight Gain (Theories)

Below is a list of theories and possible factors to consider that may contribute to weight gain while taking Remeron. Understand that although not everyone will gain weight from this medication, a significant number of people do. While it is known that a significant number of people gain weight as a result of appetite increase, there are other potential causal possibilities.

  • Fat mass increase: Some researchers believe that Remeron may cause weight gain by increasing fat stores throughout the body. If you notice that you’re developing fat in parts of the body that were previously thinner, it’s likely from the drug. It has been hypothesized that Remeron may be causing these fat storage changes by altering levels of leptin and TNF-alpha (tumor necrosis factor-alpha) cytokine system. In small-scale studies, it was found that plasma levels of TNF-alpha had markedly increased after a patients had taken Remeron for a month.
  • Food cravings (carbohydrates): Many people notice after they start taking Remeron, they develop food cravings. If there’s a particular food or type of food that you start to crave after you begin treatment with this antidepressant, it’s likely an effect of taking this drug. Most people notice that they crave unhealthy foods such as refined carbohydrates and sugars. It is believed that craving carbs can be influenced by altering levels of various neurotransmitters as well as glucose levels.
  • Hormone levels (Leptin): It is possible that Remeron may be altering levels of various hormones to produce weight changes. One that is clearly documented in research with this drug is the hormone “Leptin” which regulates fat storage.  The hormonal changes may become more significant over the course of a long-term, which may account for more substantial weight changes among long-term users.
  • Increased appetite: In some cases people are prescribed Remeron if they are underweight and/or under-eating. This drug is highly effective at increasing appetite to the point that people pack on a significant chunk of weight within the first month of treatment. It has been estimated that approximately 17% of those taking Remeron experience an increased appetite.
  • Metabolism decrease: It is fairly well-established that those taking antidepressants experience a decrease in metabolism. The decrease in metabolism means that even if you are eating the same number of calories that you were prior to taking the drug, you’re going to pack on weight while taking it. If the Remeron makes you fatigued or tired, this generally leads to less physical movement, which is also capable of slowing metabolism.
  • Interaction effects: Keep in mind that if you are taking any other medications, it may increase your propensity to gain weight as a result of interaction effects. Sometimes medications elicit synergistic “weight gaining” effects, leading to substantial weight gain in a short period of time. A common example would be prescribing Remeron with an atypical antipsychotic like Zyprexa. While it is unknown if there are synergistic effects of medications, some speculate that it is a possibility.
  • Social eating: Those who were seriously depressed or anxious prior to taking Remeron, but are now feeling happier (or less anxious) are more likely to hang out with friends and/or participate in social activities. If you notice that you start going out to eat with friends a lot after you began Remeron, keep in mind that this may be a direct reason as to why you are gaining weight. Eating out typically doesn’t (generally) provide the healthiest nor the most nutritious options and it increases the tendency that we will overeat.
  • Side effects: Another reason people likely gain weight on Remeron is that it can make certain individuals feel drowsy or fatigued. If you feel more fatigued than usual, you’re probably less likely to exercise and get adequate physical activity to keep your metabolism up. If your appetite increases and you feel fatigued, you are essentially going to eat more food and move around less; a common recipe for weight gain.
  • Taste improvement: In some cases, after a person starts taking Remeron, food tastes better. Some people who are depressed complain that food doesn’t taste good or tastes bland. If their depression is treated, they may experience an improvement in the way food tastes, which could lead them to eat more than they were in the past. The improvement in taste is believed to be caused by neurotransmitter alterations.

Note: For some people, there may be one specific factor that is leading them to gain weight. For others, it may be a combination of factor such as slowed metabolism, craving carbs, and an increased amount of social eating.

Factors that influence weight gain on Remeron

If you are gaining weight on Remeron, it is important to realize that a variety of other individualized factors should be considered. This includes things like: dosage you’re taking, your dietary intake, exercise habits, stress level, how long you’ve been on the drug, as well as whether you are taking other medications.

1. Dosage

Most people end up taking Remeron within the dose range of 15 mg to 45 mg on a daily basis. In general, the greater your dose in relation to your overall size and pre-treatment weight, the more likely it is that you’re going to gain weight. Those who are on substantially higher doses are considerably more likely to gain weight than individuals taking low doses.

Some have made the argument that low dosing with Remeron may be more likely to trigger weight gain due to more stimulation of the H1 (histamine) receptor.  They claim that the effects of H1 stimulation are counteracted by norepinephrine increases at higher levels.  Whether there is credibility to this theory remains to be true, but if you gain more weight at the low dose than the higher one, it may be somewhat valid.

It should still be assumed that at higher doses the drug will further alter your neurochemistry as well as physiological functions.  The greater the alterations as a result of the increased dose, the more likely it is that your homeostatic fat regulation, glucose levels, and leptin levels will be altered as a result of the drug.  This is why it is still recommended to take the minimal effective dose of most drugs, including Remeron.

2. Individual factors

It is also important to hold yourself accountable for any habits you’ve developed that may also be increasing your weight. While Remeron is very likely to cause weight, the foods that you choose to eat, how much sleep you get, your stress level, and amount of exercise you get can influence whether you gain weight. If you aren’t taking proper care of yourself and living a healthy lifestyle, you may gain weight as a result of the drug AND as the result of your unhealthy lifestyle.

Individual genetics may also influence whether you’re going to gain weight. If you are interested in determining how your genetics may be influencing your reaction to certain psychiatric medications, you may want to look into “GeneSight” testing. This test takes a sample of your genetic code and is able to determine whether you are likely to have a favorable reaction to a particular drug in terms of efficacy and side effects.

3. Time span

The length of time that you’ve been taking Remeron is another factor that may contribute to weight gain. The longer the duration over which you’ve been taking this drug, the more likely it is that you’ve built up some sort of tolerance. When people build up a tolerance, they typically increase the dosage (which we already know can lead to further weight gain).

Although in the case of Remeron people are likely to gain weight over the short term (i.e. 1 month), they may pack on even more pounds over the long-term. This is largely due to neurobiological changes as a result of long-term treatment. The drug will have altered your neurochemistry and disrupted homeostatic functioning to a significant extent which will cause you to gain even more weight.

4. Other medications

Do you currently take any other medications with Remeron? It is easy to blame Remeron for your weight gain, but do you know whether the other drugs your taking could also cause weight gain? Many people fail to investigate whether their other drugs may be an additional culprit for the amount of weight they’ve packed on while taking Remeron. In some cases, the other drugs that you’re taking may be causing more weight gain than your antidepressant.

In other cases the other drug(s) that you’re taking may be having a synergistic effect with Remeron to further enhance the amount of weight you gain. In other cases, the other drug(s) you’re taking may be the primary cause of your weight gain – especially if you are taking an antipsychotic.

How much weight will you gain from Remeron?

Since everyone responds to Remeron on an individual basis, there’s no telling specifically how much weight you’ll stand to gain. Most studies indicate that you will be likely to gain weight on both short-term and long-term treatment with Remeron. A number of factors mentioned above such as dosage and how long you’ve been taking the drug will influence the number of pounds you pack on.

In one small-scale 6-week study involving seven women, the average weight gain after 6 weeks was roughly 8 lbs; they also gained over half-a-pound of fat mass in this period. Some have gone as far as to speculate that lower doses have a higher affinity for the H1 histamine receptor which triggers an increase in appetite. At higher doses, norepinephrine levels tend to increase and counteract this effect – in some cases leading to no further weight gain.

Some people will end up gaining 10 lbs. others may gain up to 30 lbs. – responses tend to vary based on the individual. Just know that you’re probably going to gain anywhere from 5 to 10 lbs. throughout your treatment. For many people, their initial weight gain will hit a plateau and fortunately this weight is generally easily lost when the medication is discontinued.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/16649829

Will everyone gain weight while taking Remeron?

While not everyone may report weight gain on this medication, most people will gain some weight during treatment. Whether the amount of weight should be considered “significant” is up for individual interpretation. Formal studies have reported that nearly 30% of patients taking Remeron self-reported that they gained weight when on the drug for 10 months.

Over the course of a short-term (i.e. 12 weeks) approximately 20% of people report weight gain. Unless you are taking other medications to offset the weight gain, it is highly likely that you will gain weight on this medication. This antidepressant is extremely well known to cause an increase in weight. Fortunately, most people do not tend to gain additional weight after the first several months of treatment.

Remeron: Comparing Efficacy vs. Weight Gain

When taking any drug, it is important to conduct a cost-benefit analysis. This involves evaluating the severity of side effects (costs) and comparing them to the efficacy of the medication (benefits). If you have packed on a significant amount of weight to the point that the weight gain is making your depression worse, you may want to consider switching medications or talking to your psychiatrist about Remeron withdrawal.

In the event that the drug is working great, but you’ve gained some weight, it’s probably a good idea to continue treatment. It can be incredibly difficult to find a medication that effectively treats conditions like anxiety and depression. Finally, if the drug isn’t working well and you are experiencing an array of unwanted side effects, it’s probably a sign that you should pursue other options.

Did you gain weight while taking Remeron?

If you have experience taking Remeron or are currently taking it, feel free to share how much weight you gained. It would also be helpful to know the dosage you have been taking, as well as if you switched dosages (i.e. increased), how the dosage change affected your weight. Be sure to also discuss how long you’ve been on the medication, whether you’ve noticed any changes throughout the long-term and consider noting any other factors that you believe may have influenced your weight. Understand that sharing your experience may help someone else who has gone through (or is currently dealing with) something similar.

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107 thoughts on “Remeron (Mirtazapine) and Weight Gain: What Causes It?”

  1. I’ve been taking 30mg of Mirtazapine for about almost 2 weeks. Before I took it I weigh about 135 and now I weigh about 145. Before I took Mirtazapine I took Zoloft but the side effects were too strong. From taking Mirtazapine My appetite increased majorly. I became very drowsy and could barely walk after taking it.

    I’m taking it for major depressive disorder and from that point of view it has worked but, from the major weight gain in the short amount of time I’m no longer going to take it. It makes me feel worse about my body from the weight gain I feel very self conscious and would rather not go buy bigger clothes.

  2. I’ve been taking remeron for 10 months now. I initially started out on 15mg once daily at bedtime. Though it helped me sleep in the beginning, I had little improvement with my depression. After about a month or two taking 15mg, I was bumped up to 30mg, which is my current dosage. It no longer effected my sleep but the first few weeks of the higher dose, when I’d lay down to go to bed, I began to have sensations of what I can only describe as similar to the feeling of having a bug crawling on your bare skin.

    Of course, there was nothing there but the occurrence kept up for a few weeks before disappearing. Overall, from taking remeron for the last ten months, I went from 92lbs to 120lbs. At this point I am fairly certain that my weight gain has plateaued. I did manage to lose 2lbs since, currently weighing 118lbs. I admit that in the last ten months, I put more focus on my emotional health than my physical health but still have maintained a healthy, active lifestyle.

    My issue with the weight gain is not in the amount of weight I’ve gained but in the way I’ve developed obvious fat around my stomach and hips, which I’ve never had before a day in my life. I’ve started a vigorous daily workout/cardio routine and I am adding a fish oil supplement to my regimen to combat the article mentioned increased fat storage and slowed metabolism to get rid of this newly aquired and very unwelcome fat. I want to feel good mentally and physically, not to make improvements with my depression just to take two steps back because I’m feeling bad about my body.

  3. I’ve been taking Mirtazapine 22.5mgs now, but started off on 15mg, for around four weeks. Since a week after starting this medication my appetite has been ridiculous. I feel hungry constantly and crave bad foods all the time. I feel like I really can’t stop eating. I’ve made healthy meals but I’m just not feeling satisfied and I reach for bread and all sorts to stop what I feel like is – a powerful craving.

    Before taking this I was really quite skinny and didn’t really eat in the day time, I’ve always loved food but when my depression and anxiety hit me I barely ate, so when I began taking this I only weighed seven and a half stone. I’m already wanting to stop due to how my body feels, I haven’t weighed myself but I can see the weight I’m gaining already and although my panic attacks have stopped I’m feeling guilty and obsessive over food intake now.

    I am also feeling quite exhausted a lot of the time. Very lethargic. After reading the previous comments I’m unsure if this is something I want to continue with. I’m twenty four and a single mum to twin boys so I can’t afford to be sluggish and overweight. I do desperately want to fix the depression and anxiety but I’m not sure gaining lots of weight and feeling low in energy is going to help?

    Does the feeling of having no energy stop once you’ve been taking it a while? Does your appetite remain like this for the entire time you take this medication? Just want some honest answers from people who’ve been taking this a while? I’m worried I’ll get fat because after all that’s not healthy and I’m finding it mere impossible to resist the urge to stuff my face! Feedback hugely appreciated as I’m so new to this! Thank you.

  4. I started taking Mirtazapine at the beginning of December 2015. I have gained 9lbs in weight over a 3 month period. I did find it made me want to eat more and I indulged that without thinking about it – so part of that weight gain could be because I was taking in more calories. I’m an active person and thought any weight gain would be balanced out by exercise. In my case it appears not.

    Mirtazapine is working for me from a depression and anxiety point of view and I’m reluctant to try something else. What I am doing is monitoring my food intake over a 4 week period to see if I can l shift a few pounds. If not my aim would be to not put any further weight on and look to lose it easily when I come off the drug.

    • An update – 4 months on. My experiment with counting calories enabled me to shift 6lbs in 4 weeks. I stayed this weight despite continuing to monitor my food intake. Although I liked the results, to me counting calories didn’t feel mentally healthy so I worked on eating healthy meals and cutting down on snacks. I put 4lbs back on and have stayed there.

      After a discussion with my doctor we agreed my mood was stable enough and had been for 6 months for me to start withdrawal. I’m now on 15mg (I was on 30mg), the next phase is 15mg every other day for 4 weeks and then completely stop. I hope that once the drug is out of my system my weight will return to normal and have to a large degree accepted weight gain as a side effect.

      Everyone’s experience will be different, from my point of view the relief from insomnia, anxiety and depression far outweighs any weight gain. I wish you all the best of luck.

  5. I started taking Mirtazapine (Remeron) about 2.5 months ago for severe depression and anxiety. My depression/anxiety/panic attacks have been so bad for the last 10 years that I can’t hold a job for more than 6 months at a time, and can hardly leave my house to do anything. I’ve tried tons of different pills and pill combinations and never really seen much improvement until Mirtazapine, and wow did it help!

    I started on 15 mg of Mirtazapine each night for the first 1.5 months, and saw a huge improvement in my mood after about 3 weeks. I was able to get up and clean my house, go out visiting friends and family, and started getting back into some hobbies. That first month I blamed my weight gain on Christmas and Thanksgiving, thought it was just a few pounds from overindulging.

    Then I couldn’t fit into any of my clothes, and even my sweats and leggings felt very tight. I went in for a doctor appointment and found out that after a little over a month I had gained 20 lbs. I normally fall between 115 and 125 lbs depending on season and depression. I had been 115 in late November and suddenly in January I was up to 138.5 – SO NOT OK!!!

    I stayed on Mirtazapine, but tapered to 7.5 mg nightly, and started working out and limiting myself to 1000 calories per day, but still gained. This month I weighed in at 146, so I’ve gained another 8 lbs, and I’m switching to Wellbutrin. I was very impressed at how great Mirtazapine made me feel in the beginning, but being this fat has cancelled out the positive effects because now I don’t want to go out or let people see me this way, and I can’t fit into any clothes and won’t buy fatter ones.

    I’d recommend using Mirtazapine if you really need it, but start out with a strict diet and exercise plan and try to control the cravings for junk food. I don’t keep junk food at my house anyway, but when visiting my parents the Little Debbie Oatmeal Cream Pies were trying to murder me – I ate 2 big boxes to myself in a week. Just be super careful about food in general, but Mirtazapine can give you hope if you’re so depressed you literally can’t function.

  6. I was ok for years on 30 mg. But since increasing to 45 mg two years ago, my weight has climbed a stone and a half. I am eating about a third of what I used to. It’s very upsetting… plus water retention, bad nightmares every night, joint pain, extreme tiredness, and I went on it to help me sleep. I get to sleep, but for 2 to 3 hours. I wish I hadn’t gone on it.

  7. I took 30mg daily not for depression but to help me sleep. I’ve gained so much weight that none of my clothes fit anymore. I’m going to have to stop taking it because I can’t stand being chubby… but now I will never be able to sleep. I’m so stuck. If anyone has any advice then hit me.

  8. Hi folks, I was prescribed Mirtazapine 15mgs once daily for a loss of appetite due to a succession of very unpleasant life events. I am generally very slim around 47kgs steady weight for the last 30 years. Within one month of using Mirtazapine I noticed I had a propensity to eating a whole box of sugary fudge in one evening, this was extremely unusual for me.

    Over time I noticed I was feeling as though I was gaining weight, weighed myself and had gained 3kgs in two months. Unbelievable and a little worrying as I wasn’t sure if this was going to continue. Attend Zumba once per week and walk for 60mins 5 days out of 7 so there is no problem with exercise. I am going to stop this medication and up the exercise to boost appetite as I think the drug has kick started my appetite again which is a plus point, although feel out of control on this chemical.

    Have not had to diet in my 54 years, not intending starting now, due to a medication. This is not for me… hope this helps you guys out there with the same issues as many others on Mirtazapine, I guess it is a case of weighing up the pros and cons for each individual. Thanks for reading. All the best.

  9. I have been on remeron 15mg for 7 months now I was 98lbs when I started now I’m 122lbs I’m also 5″4 and 29 yrs old. I was underweight and doc said remeron will increase my appetite. Which it has, all I do is eat. I eat till I have to vomit cause I don’t get full. My butt and thighs are bigger which is OK, but my belly is so fat and bloated ppl think I’m pregnant.? I want to be 130lbs without the belly. I’m going to start exercising.

  10. I have stopped taking mirtazapine 2 days ago due to weight gain (only in my abdominals… a 6cm gain in 2 months). I am very into fitness and nutrition and track all my meals and work out regularly and am very active so I know I haven’t eaten anymore, or been lounging around more than before. I feel like it’s more bloating than fat, but I’m not sure. Has anyone else discontinued mirtazapine and lost weight successfully? And if so how long did it take?

  11. I’ve been taking 15 mg of Razapina (trade name for Mirtazapina here in Brazil) for 01 month. After that, the doctor increased the dose to 30 mg. After three months of treatment I gained about 5 kilograms. The symptoms of depression and anxiety improved, but I’m worried about how much more weight I’m going to gain.

  12. From reading these it is not clear how many extra calories have been consumed. In other words, does significant weight gain occur if one does not eat more food? Or does Remeron slow the metabolism enough so that no change in calorie intake (or calorie expenditures through exercise), will still cause weight gain. I suspect some combination of slowed metabolism plus additional calorie intake occurs in most patients. But perhaps someone knows the proportions of the two factors better.

    • In my case, I have only taken Remeron for two weeks but noticed fat deposits on my tummy that were never there in my life, even when I weighed more. On remeron, I do not feel food cravings. I have eaten what I consider to be small amounts of food. (For reference, I am 43. Before I started taking it, I was 130lbs at 5’9″). In my case I believe the remeron is impacting how fat deposits in my body. Also, the dose I’m on is 7.5 mg every night.

  13. Works wonders for anxiety and insomnia. Also if you’re underweight it is a godsend. I was underweight my whole life and then developed terrible anxiety so doctor put me on this. 7.5mg at night. I go off and on it for years now…at the highest I gained 34lbs, but I welcomed the weight and I am not ashamed one bit.

  14. I started taking 7.5 mg of remeron last spring. I was also taking 20 mg of cymbalta/duloxetine at the time. On the cymbalta, I went from 145 lbs to about 155-160 lbs., but then it leveled off. Once I started taking remeron, I started gaining weight rapidly. In the first week of May 2015 I weighed 160 lbs. Now I weigh 180. I’ve gone from size 10-12 to size 16, and I barely even fit my size 16 clothes.

    I have fat rolls along my back that make it hard to stretch. My actual food intake hasn’t increased much – I eat slightly more sweets than I used to, but not by much. My exercise levels have gone down, but again, not by much – I don’t go to the gym, but I walk everywhere and get in at least 30 minutes of fast walking every day.

    I discontinued the cymbalta six weeks ago, and I’m hoping that that will allow me to lose some of the weight, or at least stop gaining! I’m hoping to start exercising and losing some weight that way as well. On the plus side, it has worked miracles for my anxiety, depression, and insomnia. So I don’t want to give it up. If my weight gets above 185 I might consider it, but I’m willing to gain 25 lbs for sanity’s sake.

  15. Female, 34. Put on Mirtazipine to help with alcohol withdrawal sleeplessness and depression. Dose 100mg/night. Weight gain in exactly 3 weeks, 41.6 lbs. Disgusting. Unable to work due to suits not fitting. Can do nothing except think of food and eat. I dream of food, spend all waking hours eating. It’s become an obsession. The weight gain depresses me more than anything.

    This medication is pure evil. I can see it helping if you are Ana/mia but otherwise, stay away. I’m a hardcore cyclist, averaged 50-75km per day, and still gained all that weight. Now cycling is damn near impossible because I am fat and lethargic and can’t think of anything except mashed potatoes. I hate Mirtazipine.

  16. I have been taking 15 to 30 mg’s of Remeron over the course of 7 months. I did not notice any weight gain until about 4 or 5 months into taking it. I have currently gained 10 pounds. Having been at 110 pounds due to weight loss from having C. Diff and having been skinny my whole life, I am actually pleased with the weight gain. I do realize though with increased weight gain I will need to start an exercise program. But, I’m hoping to sustain the weight I gained. I also have been craving sweets like crazy.

  17. I have put on a solid 20 lbs since starting this medication. I am on 15mg. I was so relieved to read about weight gain as a likely side effect. I have chosen to go off of it due to the weight gain.

  18. I was just put on 7.5 mg to gain weight. I am 5’4″ and had dropped to 100.4 pounds. Dr. put me on this to gain weight and increase appetite. I had gained up to 107 prior to starting Rx and now after 2 doses, 109.4. I seem to crave carbs now. Any suggestions or warnings?

  19. I’ve been taking Mirtazapine 15mg every night since April. It has helped with my lack of sleep immensely but I have gained 25 kg. I went to the doctor hating myself with the lowest self esteem and getting by on no sleep. I wasn’t warned about the weight gain. Now I hate myself even more and no matter how hard I try I can’t budge the weight. I’ve changed my diet, I exercise every day and the scales are still going up. I have an appointment with my doctor to the change it next week. I cant handle this anymore!!

  20. I’ve been on a low dose (7.5) and have gained 20 lbs over the last year. My appetite is especially insatiable at night. The taste of a bowl of cereal is unbelievably addicting and I often have two bowls and want more even though I am bloated. I worry about stopping because I am sleeping better and feel less anxious.

    • Rose, I just received a prescription for Remeron and am terrified by all the stories of weight gain. Have you followed a diet plan while you took the medication? I want to try the Remeron since I’ve tried almost everything else, but the tremendous weight gain is not something I think I could handle.

    • What is the dosage (15, 30, 45mg) you are taking and was it for insomnia or more complex psychiatric reasons? It’s great to read you; I have started only a week ago (15mg) and am already noticing a gain in appetite (put on perhaps 1 lb). Did you control your appetite or you just didn’t feel any change prior to starting the medication? Thanks for your reply.

  21. I’ve never taken Mirtazapine but you all have inspired me to try it! I’ve been in a funk since a break up recently and loss of appetite is always something that happens to me during stressful times, and the loss of appetite actually adds to the stress. Hopefully a low dose of 7.5 will be enough to do the trick for my woes. Thanks to everyone who left comments!

  22. I just started my third bottle of Remeron yesterday. In the first month of taking I gained about 10-15 pounds. While taking my second bottle I gained around 5-10. I started at 90 lbs. and now I am 110. My stomach has a layer of fat that was NEVER there before. My bottom and thighs are bigger. I went from a size 0 to a size 5/7. It’s pretty depressing in itself but everyone says I look great. I am hoping the weight doesn’t keep increasing. It has slowed but it’s still on the rise. I really hope I don’t keep gaining.

  23. I’ve gained 10 pounds in one week since starting at 15mg. I was underweight, getting down to 108 at my lowest (I’m 5’6″), so my psych thought this would kill two birds with one stone since I stop eating when I’m angry at others/depressed. I’m concerned that I’ve gained so much so quickly. I never seem to get full. I think about food all the time. My portions have tripled and I’m finding myself closet eating because I’m ashamed of how MUCH I’m consuming.

  24. This mirtazapine is intense for the munchies and weight gain. For two weeks starting this drug I was eating 8-10 bowls of cereal through the night. The craving was intense very intense. You eat something then sleep wake eat sleep wake eat sleep wake eat sleep.. I mean I was a skinny guy weighing 9st I went from 9-13 stone within a few months you pack on some serious pounds with this. I did stop it but my anxiety and depression has come back. So I’m now back on the stuff eating like crazy.

    I’m sure that’s why it helps you sleep because you eat like mad so your belly is super full and just pass out. And if you wake up it craves you to eat more. But has helped me so I’m sticking with it I will just have to push myself to train more this time round as you will gain weight it’s most guaranteed without a doubt.

  25. I was prescribed Remeron by my doctor for mild depression, insomnia, and fatigue. My depression was in part due to a small amount of weight gain (20 lbs) caused by my fatigue and inability to exercise. I was also prescribed Phentermine for energy and weight loss because it had worked for me before, helping me lose 25 lbs very easily.

    So, over the course of 6 months, I saw a very rapid and steady weight gain that I couldn’t believe or explain, since I had started running again and was eating a strict whole/clean foods diet with a significant reduction in my sugar intake. While I was gaining weight, I also experienced 3 mos. Of feet and hand swelling, which I have never experienced before.

    I experienced hot flashes throughout night and day, even though blood work showed that my hormone levels were normal. I the 6 – 7 mos I was taking Remeron, I gained 27 more lbs!! Keep in mind, I was very active during this period of time. Only when another doctor pointed out the weight gain relationship to Remeron, did I discontinue it. I could not believe my doctor ignored my rapid increase in weight and my swelling, which was obviously due to my taking Remeron.

    I stopped taking it that very day, (which is not recommended) and immediately felt better the next day. My brain fog and dizziness cleared, as well as my hot flashes. Now, instead of 20 lbs to lose, I have 47 to lose. I’m very disheartened!! I will continue taking the Phentermine for energy and weight loss to see if that will help my new challenge.

  26. I weighed around 140lbs when I began taking Remeron 15mg. After 4 years, I weighed 165lbs. I also became close to developing diabetes. Since I have stopped taking the drug over the past 10 months, my weight has fallen to 150lbs (most of the weight was lost in the first 2 months). This drug does wonders, and my current depression is causing me to consider taking it again.

    Bottom line, this drug makes life enjoyable. Music, conversations, studying, smells, dreams, napping, drinking alcohol – ALL these things became very thrilling and enjoyable. Even eating raw vegetables was a pleasant experience. BUT cookies, cake and fried foods are euphoric! I doubt the drug causes weight gain on its own. It simply makes eating a wickedly delightful hobby.

    I never had enough self-control to avoid eating before bed…or even in the middle of the night. As mentioned, the social aspect is powerful too. If you are feeling great, making friends and out and about, it’s much easier to eat for the sake of being a good guest and a participant in life. I actually did more exercise while taking the drug than I do now, but believe me, I hated my body then. I guess you have to take the good with the bad.

    • “I doubt the drug causes weight gain on its own. It simply makes eating a wickedly delightful hobby.” Sorry but I’m afraid that is grossly incorrect. If I skipped a meal or even delayed a meal by an hour my body would shake. And I don’t mean tremble, I mean shake.

      I needed more food (greater portions) than I normally did just to control the shaking. My doctor said this was because my body was slipping into a seizure. I was never full. After about an hour I would start getting hungry again, and it would quickly escalate, several times faster than I would without the medication.

      I gained 70 pounds over five years and have not been able to lose the weight. Of course it helped with my depression and my sleep but it was pretty awful and I’d only take it again as a last resort. Your experience sounds comparatively enjoyable, however.

  27. I just got script 7.5 mg. to take for weight gain. Lost approx 23 lbs due to having to be on a fiber diet to ease my pain issues. The fiber diet has worked, but I am concerned of weight loss. Originally weighed approx. 105 lbs, got down to 83 lbs. I need to gain some weight, but how can it all tie in with a high fiber diet to work?

  28. I’ve been taking 45mg of mirtazapine for about 3 years and have gone from 70 to 100 Kg (or 154 to 220 pounds.) I do very little exercise, although I didn’t do much before I started taking it and didn’t have any weight issues then. I would be interested to know if anyone has managed to lose weight by going onto a lower drug dosage or has managed to find a different medication which has still addressed their anti-depression needs and at the same time helped with weight loss. I have a family history of cardiac issues so I need to do something to address the weight issue sooner rather than later. Thanks in advance for any advice :-)

  29. I have been on Zoloft for almost 2 years. For the first year and a half, I was at 50 mg. Then I began seeing a new doctor who increased my dosage to 150mg. Within 2-3 months of the increase in my Zoloft dosage I was put on mirtazapine- 7.5 to 15mg. Since my Zoloft increase and addition of mirtazapine I have gained 70 lbs. Before these medications I had been at 120 lbs with a 5-15 lbs fluctuation for 10 years… I have now stopped taking the Zoloft altogether and am thinking about stopping the mirtazapine, although I like the effect of being able to sleep.

    Gaining that much weight in less than a year is doing serious harm not only to my mental state but physically my body is not able to compensate for the additional weight- my shins hurt when I walk, my ankles are swollen and I limp all the time, not to mention my clothes no longer fit me- period. How do I lose the weight? I know they say sanity over vanity but this is not vanity. This is my body or should I say lack there of, and I honestly can not bare it any longer…. Help please!!!!

  30. I initially started on Remeron after having severe anxiety/depression coupled with insomnia. I was not able to sleep for weeks, so I first tried Paxil (made me a major zombie), and then Celexa (extreme reaction with burning sensations on my scalp). Finally I found Remeron, and it worked beautifully for my anxiety, depression, and insomnia. However, I gained 30 lbs. and suffered from terrible self-esteem over the weight gain.

    The craving for carbs was insatiable, but I figured better to be heavy with good mental health than skinny and nearly suicidal. I had been on Remeron for 3 years, and chose to wean off over the past year. I went from taking 45 mg to going off the drug entirely in the spring. I thought I would lose a lot of weight going off the drug, but I have only lost 5 lbs. In June and July I did well with anxiety and depression with only 1 major bout of insomnia.

    Now in August, I have hit a brick wall. I noticed the depression creeping back in with some days where it was hard to leave the house or even get off the couch. I am in the middle of some pretty nasty insomnia, so I took the Remeron to be able to sleep last night and was able to get in 5 hours of sleep. I’m starting to wonder if I need to go back on the med regularly even though I do not want to do so I’m facing some tough decisions right now, and to make matters worse, my psych left private practice, so I’m searching for a new one with only 1 bottle of meds left. Hoping for some answers.

  31. I’ve been on this drug for a year and a half. Initially gained 70 lbs when I first started the drug, but I have stopped gaining for the most part. The food cravings wear off after a while. I haven’t tried to diet on it yet, but I plan on it. Despite the weight gain, this drug gave me my life back. I was riddled with anxiety. I was only sleeping 2 and 3 hours a night. Now, I’m a normal human being, albeit a fat one.

    • LNW: your story sounds almost exactly like mine. I gained about the same amount of weight in the same span of time as you. Physically, I feel pretty crappy because the weight gain makes EVERYTHING harder.

      Any kind of exertion is exhausting because it’s like carrying a mid-sized child around everywhere you go. That part really sucks. I’m finally starting to *try* to regulate my diet a bit more, & at least walk around as much as I’m able (I also have MS so most exercise is super hard/painful).

      I have maybe lost a few pounds in the last month, but I’m really hoping I can shave off at least HALF of what I gained (pref. more). But you’re right… I have gotten my life back since I started it.

      I had some SEVERE anxiety related “issues” as well as severe depression when I started it. Cleared up immediately. Now rather than being in constant panic mode, whenever something really bad happens, it’s like… like someone put a blanket over it.

      Like it’s almost a muffled murmur rather than hysterical screaming in my head. Does that make sense? :) I’m also on two other antidepressants as well as other meds, so I’m sure that there’s a whole bunch of interaction stuff going on, but I’ve had to do what I have to do, in order to “live my life” & just enjoy what I have right NOW, rather than thinking 10 or 20 years down the road.

      Sad but true. I am still hoping & praying that they will discover the “obesity gene” soon & find a way to cure us all. :D

  32. I was given mirtazapine for 2 weeks for insomnia. I go days without sleeping. When I went to the Dr I weighed 116 at my first visit on this drug. After 2 weeks I went back to let her know I am sleeping better. I weighed in at 124. That was 8 pounds in two weeks I was a little concerned. She told me it should top off and I should stop. 2 weeks later I am at 131. So in a month I’ve gained 15 pounds. I’m sorry but that’s not normal.

    It makes me upset because I do not sleep well and I wanted this to work , but this rapid weight gain has my chest hurting I am breathing slower and feel drained through the day. I will be calling my Dr tomorrow I can not afford to buy new clothes and then get depressed because I’m too fat. I’m not taking this stuff any longer.

  33. I have been on remeron 30mg and 10mg cipralex for 2 months now, gained 15lbs in the first 2 weeks and am now up to 30lbs, I went from 120 to 150 and I’m only 5’2! I’m also suffering from edema from the medication. I’m a professional dancer and am no longer able to work due to the weight gain and lack of energy and it’s causing my depression to get worse, I’ve decided enough is enough and I’m stopping the remeron, I hope coming off the meds I’ll be able to shed the weight and finally get back to work. It’s good to know I’m not alone in feeling this way.

    • It’s a great drug, especially if you have sleep problems. However, you will gain 30 lbs. almost immediately. Once you come off of it, the weight disappears. When I told my current doctor about my experience, he said he would never prescribe Remeron without informing the patient about the drastic weight gain.

      • I was prescribed Remeron due being underweight my entire life. I’m a bit curious KayD, does the weight disappear right after stopping the medication? Look forward to your reply.

  34. I have suffered from anxiety and depression most of my adult life. Tried most of the usual meds, Prozac (made me more anxious and couldn’t swallow with itchy skin) sertraline made me have feel suicidal, citalopram gave me gastro problems, none of them made me feel better. I started on mirtazapine around 18 months ago. I’m now the weight I was when I had my first child.

    I hate my new body as had always been size 8-10 now I’m pushing a 16. This makes me feel awful about my self image. Disgusting and fat but my head is so much better. I have just finished an access course and am going to university in September, something I’d never ever thought I’d do. I have a special needs daughter (severe mental and behavioral disability) I’m on 45mg of mirtazapine, my GP suggested I come down to 30mg as I was doing so well mentally.

    I was happy to go with this, but then lots of outside issues happened and I found eye contact and panicking in public places returning. So went back up to 45mg. I’m scared to reduce dose as starting uni, so potentially big anxiety. I’ve been on 45mg for 18 months now and wonder if anyone has reduced dosage and still kept stable mentally but lost weight?

    • Dear Michelle, I’m taking 30mg of Remeron, and have taken it on and off during the last 8 years. I have social anxiety and depression stemming from family of origin issues and bullying through most of my school days. I am gaining weight on Remeron and know how this has the potential to make one feel less attractive, but I also see women all around me – who are many dress sizes larger than me – with loving partners, a wide circle of friends and respect from their community.

      I really hope that you can get help for your body issues. I know that there is a huge amount of pressure on us women to be thin in order to be beautiful – but maybe it would be helpful to you to know that the truth is that this is a marketing ploy that is designed to sustain a weight-loss industry worth billions upon billions of dollars. Yes, there are some men who prefer muscular, skinny, super-fit slim women, but there are also lots of men out there who prefer women who are soft, curvy and cuddly!

      You have not suddenly become a “disgusting” person because you aren’t a size 8 anymore! You are someone who is studying to improve yourself, you are a self-aware person who has taken sensible steps to overcome social anxiety and depression in order to achieve your goals and better fulfill your potential. I hope that you will also feel comfortable to seek help to develop a healthy self love and self worth – so that you will know that your value as a human being has absolutely nothing to do with your dress size.

      My very best wishes for your health – including a healthy and happy sense of yourself – whatever your weight!

  35. I have severe depression/anxiety, bad combination. Either my past just still hurts too much to move forward OR I have a chemical imbalance that is very treatment-resistant. Tried all the tricyclics, Zoloft/Prozac, Cymbalta and although Remeron gives SOME degree of relief and helps me sleep, every time I’ve started taking it I gain 10 pounds in 2 months. Losing 110 lbs. years back feels so good I keep hoping I’ll just fall asleep and not wake up. So I plan to try Remeron once again and just see if I go beyond 10 lbs. Something has to work, this has been going on for far too many years.

  36. I gained 30 pounds over a six month period. Due to other factors, menopause, estrogen supplements, etc., it took me that long to identify the problem. I was taking it for insomnia and anxiety and my doctor never mentioned the possibility of weight gain. I finally googled remeron and weight gain and immediately stopped taking the drug – by that point I had become obese, very uncomfortable, and almost a hermit. I spent the following 4-6 weeks in withdrawal, much of which was spent in bed. I do not recommend taking this drug unless all other options have been exhausted. (I started dropping the weight immediately when I stopped taking the drug, and eventually lost all of it without dieting or exercise.)

  37. Been on 7.5 for 18 months for insomnia. No weight gain or increase in appetite. Works wonders for restorative sleep! I am grateful!

  38. I’ve been taking 3.25mg mirtazapine (Remeron) and 20mg vortioxetine (Brintellix) daily for the last 8 months. During the first three months, I went from 88lbs (underweight with a BMI of 13 at 5’9″) to 118lbs at the same time I went through recovery from Anorexia nervosa with a binge/purge subtype. Then I began taking 45mg buspirone (Buspar) daily in three doses for anxiety and have continued that way for the past 5 months, where my weight has raised slowly and plateau’d at a healthy 132lbs. I believe mirtazapine aided me a lot in recovery as I was able to reestablish regular hunger signals and reduce nausea after meals which would initially have been difficult to ‘keep down’, in addition to helping my major depressive disorder.

  39. I have been taking mirtazapine (30mg) for 3 years now and up until 6 months ago had gained 6 stone 7lbs!! My appetite was insatiable. However the majority of the time I ate healthily and even if I tried to lose weight the pounds just wouldn’t budge. The weight gain added to my depression and anxiety and I became more self conscious. I avoided social situations because of the embarrassment of my weight gain.

    In December 2014 I decided to go on a very low calorie diet and now I’ve lost 5 stone 7 lbs and feel much better. It has been difficult and I still have some “mirtazepine weight” to lose but I’m sure I’ll get there. I have noticed that since my dose of mirtazapine has been increased to 45mg my weight loss has been extremely slow and I’m still on a very low calorie diet.

    I’m considering coming off mirtazapine but I’ll have to look at the advantages and disadvantages…massively overweight and a recluse but less anxious and depressed OR slim, healthy somewhat sociable but anxious with periods of deep depression. When I’ve finished the hard job of losing all this weight I do not want it to be all in vain and so I’ll discuss other medication options with my Doctor. I’m currently in a good place with my weight and the mirtazapine really helps with my anxiety and depression…

    I just do not think I could be on a very low calorie diet indefinitely whilst taking this medication in order to stay at a healthy weight. All the while fighting an insatiable appetite. I would recommend that if you notice an increase in appetite and a high level of weight gain in a short space of time it would be better to seek advice from your doctor rather than later when feeling much worse due to the weight gain. Why have I remained on mirtazapine?

    Answer: if I’m anxious my bladder does not empty and this is extremely painful and requires self catheterization. I have a sacral-neuro modulator in my back to relax muscles in the urethra in order to empty the bladder. However if I’m extremely anxious it is not as effective due to being tense. Mirtazepine has been the most effective in reducing anxiety so for me there is not a choice at the moment. I’m positive there will be another option in the future.

  40. Been on mirtazapine 30mg for 18 months. Gained just under 4 stone. From a size 8 to 16. Enough is enough. Trying to wean off. Doc not interested in the weight gain. But it’s made me lose confidence in myself and I feel more depressed over the weight than the depression before.

    • Hi I’ve been on Remeron and Prozac for a little over a year and I’m still gaining weight. When I started I was 200 I’m now 255. Please help with any weight loss ideas.

    • I have put on over a stone in a month of taking mirtazapine. Has anyone changed to something else and if so did the weight come off? Regards, Cherry

  41. I have been on 15mg of Mirtazapine since April 1, 2015 (so, two months now). Though I’ve always been healthy & active & fairly slender, I was suffering from terrible insomnia, anxiety and negative thinking and this drug has been a godsend. However, since I’ve started this drug, I’ve gained 5 pounds. For 30 years I have remained the same weight (approx 123lb) so the idea that I’m gaining is causing me some upset.

    And this while trying to LOSE weight because I’d read about the weight-gain issue–cutting calories, exercising more, being vigilant about what I’m eating. I may have actually started gaining weight before I began the medication but I didn’t notice until recently when my clothes got tight. I’m 53 years old, so it’s the double whammy of menopause+mirtazapine. Right now I’m okay with 5 pounds but I would hate to gain more.

  42. I took remeron for 1 year. Gained 30lbs. Had severe restlessness at night. I got up and ate all through the night. This is something I have never done. Been off of remeron now for a month and lost 14 lbs. This was a horrible experience for me.

    • I experienced something very similar to Lori. Over two months I went from 105 to 125 and I’m only 5’2, so its a lot! I gained weight, my face was swollen, and started sleep-eating! Lietrally eating at night and I had no recollection. My cheeks hurt every morning from the water tetention I have slowly reduced my dose from 45 to 15 mg, but the weight is not coming off. I am going to start exercising and dieting in a strict manner and hope that I lose what I’ve gained from this pill…giving a depressed female something that makes her gain weight seems silly seems it has caused me more depression and not wanting to go out!

  43. I am now 28 and have been on mirtazapine since the age of 17 I got a bit addicted and didn’t want to stop. I was underweight under the age of 25 and now in the last year I am now overweight. Lost a stone but still eating to much. I hate my weight and feel I should stop these pills I don’t want to be on them forever.

  44. I have been on 45mg of remeron for 2 years and gained weight ( 20 lbs). Now my shrinks has added epival 375mgs. I’ve gained 10 pounds in under a month. I felt stoned. My nose is clogged steady and my sleep pattern is disrupted. Anyone else in the same boat?

  45. I’ve been on Mirtazapine for about 10 months, and have put on about 15 pounds. I started with a 15mg dose but am up to a 30mg dose, as the lower dose produced much worse drowsiness than the higher dose. During this time I’ve tried diets, low carb for 6-weeks, no results. I also tried low cal for 4-weeks, no results. It appears in my case, the weight gain is going to stick around. I’m hoping I can increase my activity level, to then stop it from continuing to grow or even drop a bit. I feel great otherwise, just starting to show a bit of a belly and some love handles that I didn’t have before. I’ll take a good mood and low anxiety over a perfect waistline, any day!

  46. I have been taking Remeron and Seroquel for at least 6 months (give or take) and I’ve gained at least sixty pounds. I’m trying to lose the weight. Any pointers, before I stop taking them?

    • Hi Angie, I was also put on this combination, some 5 years ago now. I weighed 160lbs at the time. I was 37 years old and, give or take a few pounds either way, all my adult life had weighed the same. Two years after starting the combo of Seroquel and Mirtazapine, I weighed 240lbs. The weight gain has had an effect on my physical health. I now take medication for high blood pressure and high cholesterol. I stopped exercising as much because a) I felt self-conscious, b) the weight gain has caused backache and aching knees, and c) the meds made me drowsy and I slept all the time. You can see how this became a vicious circle!

      Fourteen months ago I stopped taking Seroquel and switched to Lithium. I was expecting to lose weight but I didn’t. My weight plateaued though, for the first time in five years. Two months ago I stopped taking Mirtazapine and in that time I have lost 10lbs. I have not changed my exercise routine, but my eating habits have changed significantly. My appetite has returned to normal (I hadn’t appreciated how much I had been eating, until I realized one day I wasn’t spending every day constantly grazing on carbs. It had become the norm for me).

      I conclude from this that, for me at least, Mirtazapine was the major cause of my weight gain. The reduction in my appetite has frankly astonished me. I think I’m now eating how I used to eat, when my BMI was 24 and I was in the ‘normal’ weight range (I’m currently in the ‘obese’ range). I hope there have been no long-term effects on my metabolism as a result of this medication, but time will tell. Right now, getting back to 160lbs is not my goal – I’d be happy getting back down to around 190lbs – but of course every pound is a bonus and it is still early days yet.

      Will be interesting to see what weight I am two years after stopping Mirtazapine. In conclusion, Mirtazapine pulled me out of the deepest depression I’ve ever experienced and so it did its job and for that I am grateful. Would I ever touch it again? No. Hope that helps, and good luck.

    • I’ve been taking remeron for close to 2 years and I was 114 lbs when I started and now I’m 175 lbs. I’m lucky I’m 5’9″ – but still is making me tired. I have decided to work out now because my weight is bothering me.

      • I started Remeron 10 years ago, scary to me but true. I was only 17 at the time and under-weight at 105lbs 5’7 1/2″. It saved me from my anxiety back then. I actually hated being so skinny so I was looking forward to a little weight gain. I’ve never taken more than 30mg and for about a year now I’ve been on 15mg. I don’t think it does anything for me now but it’s hard to get off it.

        I weight about 132-135lbs currently, but much prefer 120-125lbs. It’s been a slow constant gain in weight over the years but I am still very slim so I am lucky. I don’t exercise much but I eat a pretty healthy diet and ignore cravings as much as possible. I did gain pretty quick when I started Remeron (probably because I was so anxious I was hardly eating then BAM I was starving lol) then it slowed down.

        It’s hard to say if it’s all completely Remeron’s fault for the weight gain or if it’s just me getting older and the natural slow down of my metabolism (I’m 27 now).

  47. I’ve been taking mirtazapine 30mg with venlafaxine 225mg for about 6 years and have not gained any weight in that time, so weight gain with mirtazapine isn’t inevitable.

  48. I have just started taking 7.5 mg Remeron once every night. In addition to Remeron I am on 450mg Wellbutrin, 200mg Sertraline and 3 x 0.5mg Clonazepam. After researching the side effects and the biochemical connections I have decided to follow a low calorie, low fat diet supported by an OTC supplement (PGX) that is known to lower cholesterol, control and balance blood sugar levels and reduce the glycemic index of meals. My activity level is sedentary. Exercise mostly consists of walking 5,000-10,000 steps a day, yoga once a week, aqua fit once a week and daily mindfulness meditation. I’ll give an update in a few weeks on my progress.


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