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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by displaced9 on February 12, 2012, at 10:47:25
Hi All,
I started taking Remeron / Mirtazapine about 2 months ago, starting at 30mg. I am currently up to 90 mg /day at bedtime but still gaining weight despite changing my diet, and adding Zantac / ranitidine 300mg BID. I have been at 90mg for 3 weeks, as we hoped that the higher dosage would not cause the weight gain and the weight that I had gained would come off with work.
It works well except for this effect. I've gained about 20 pounds in 2 months time.
Anyone have suggestions on what to do to stop and reverse the weight gain? Should I go to the PDoc and look to switch medications?
Posted by Phillipa on February 12, 2012, at 12:07:18
In reply to Remeron / Mirtazpine weight gain, posted by displaced9 on February 12, 2012, at 10:47:25
Two months and you gained a lot of weight? I would not be happy with this at all. It is reported that lower doses cause the weight gain I took l5mg of it once for a month and didn't gain weight nor get tired. But we are all different. I'd call your doc as too much weight gain isn't healthy either. Your're in a tough spot. Phillipa
Posted by Raisinb on February 14, 2012, at 11:10:12
In reply to Remeron / Mirtazpine weight gain, posted by displaced9 on February 12, 2012, at 10:47:25
I was on remeron once for a couple of weeks and boy, did t make me eat! I gained seven pounds in two weeks, and I never gain weight on meds (have been on 20+ different ssris, aaps, lithium, mood stabilizers, etc.).
In those two weeks I literally bought two mini fridges so I could stock pudding and brownies everywhere, and that's all I thought about--pudding and brownies.
Ask your pdoc: if remeron is a very good drug for you, maybe something can be done. From my experience, it would be *very* difficult not to gain weight on the stuff.
Posted by displaced9 on February 14, 2012, at 11:16:15
In reply to Re: Remeron / Mirtazpine weight gain, posted by Raisinb on February 14, 2012, at 11:10:12
Thanks - I left a message with him earlier. I was going to d/c Wellbutrin because we thought it might be exacerbating my anxiety but I actually think it helps. I am adding the WB XL back to my Remeron + Effexor. I don't want to be on a cocktail if at all possible, so I'm wondering if the WB XL (150 or 300) would work well with the Effexor XR?
Effexor and WB both seem to be known for weight loss.
Posted by SLS on February 14, 2012, at 14:27:55
In reply to Re: Remeron / Mirtazpine weight gain, posted by displaced9 on February 14, 2012, at 11:16:15
> Thanks - I left a message with him earlier. I was going to d/c Wellbutrin because we thought it might be exacerbating my anxiety but I actually think it helps. I am adding the WB XL back to my Remeron + Effexor. I don't want to be on a cocktail if at all possible, so I'm wondering if the WB XL (150 or 300) would work well with the Effexor XR?
Wellbutrin 300 mg + Effexor 300 mg is an excellent combination.
I would think to either discontinue the Remeron, or increase the dosage to 60 mg. That's just a guess, of course. Remeron is usually underdosed by doctors.
- Scott
Posted by displaced9 on February 14, 2012, at 14:33:49
In reply to Re: Remeron / Mirtazpine weight gain » displaced9, posted by SLS on February 14, 2012, at 14:27:55
Hi Scott,
I am 90 of Remeron currently and still have the weight gain. I don't want to go any higher, really. I will talk to the Doc about 300 Effexor + 300 WB. I am currently at 150mg on the Effexor XR, so I would think to try 225mg first?
Thanks!
Posted by avenarius on February 14, 2012, at 16:55:12
In reply to Re: Remeron / Mirtazpine weight gain, posted by displaced9 on February 14, 2012, at 14:33:49
I, and others on the Crazymeds site, have had success with 45 mg mirtazapine and adderall. Mirtazapine can cause drowsiness (especially at 30 mg and lower) so it's common to add a stimulant. The adderall might have an extra benefit of helping you control your appetite.
Posted by papillon2 on February 19, 2012, at 0:06:46
In reply to Re: Remeron / Mirtazpine weight gain, posted by avenarius on February 14, 2012, at 16:55:12
Yes, bump up the Effexor. Myself and others have experienced a near immediate anti-depressant boost from each doseage increase. 375mg was my usual dose though I did go up to 450mg on some occasions. It is likely that you will know quickly if the increased dose is helping you.
Re: Mirtazepine. I found the unbearable feeling of constant starvation to be dose dependent, in that it was slightly less unbearable at 45mg than at 60mg. I did not take any more than 60mg. If part of your weight gain is due to eating more because of the starvation factor, than a lower dose might help.
I personally did EVERYTHING humanly possible not to gain weight on Mirtazepine and I still did, at about the same rate as you. The weight gain was steady and it DID NOT STOP. If I had the same diet and exercise regime ordinarily I would have lost an unhealthy amount of weight and been accused of eating disorder relapse. I am not joking.
If weight gain is a non-negotiable for you, stop taking Mirtazepine. It does not mean that you have failed the med trial, it means that the med has failed you.
Posted by avenarius on February 19, 2012, at 21:11:09
In reply to Re: Remeron / Mirtazpine weight gain, posted by papillon2 on February 19, 2012, at 0:06:46
Chromium picolinate could possibly help curb your appetite.
Posted by displaced9 on February 25, 2012, at 16:45:26
In reply to Re: Remeron / Mirtazpine weight gain, posted by avenarius on February 19, 2012, at 21:11:09
Hi,
I just wanted to provide an update. We decreased the mirtazapine dosage to 30mg at bedtime and upped the Effexor XR to 225mg/daily. I also started taking New Chapter Organics Supercritical Diet and Energy. With these changes, I have lost 11 pounds of the 30 pound weight gain in a little over a week. Looking forward to the next 20! My appetite is definitely half of what it was (but still "normal") and my energy level has gone up. This appears to be a good combo. I stopped the Wellbutrin was it was exacerbating my anxiety.
Posted by papillon2 on February 25, 2012, at 17:06:45
In reply to Re: Remeron / Mirtazpine weight gain, posted by displaced9 on February 25, 2012, at 16:45:26
Great news! Things are looking up.
Posted by Raisinb on February 26, 2012, at 0:12:24
In reply to Re: Remeron / Mirtazpine weight gain, posted by displaced9 on February 25, 2012, at 16:45:26
Very good! I hope this provides a long term solution for you!
Posted by displaced9 on March 4, 2012, at 7:04:25
In reply to Re: Remeron / Mirtazpine weight gain, posted by Raisinb on February 26, 2012, at 0:12:24
> Very good! I hope this provides a long term solution for you!
Another update - It appears the Remeron, not the Wellbutrin, was causing my anxiety. I slowly discontinued the Remeron and added back the Wellbutrin, first at 150mg, then back to my 300MG XL daily dose along with the Effexor XR 225, and my anxiety is virtually non-existent. The only problem I have now is I had gotten used to the Remeron (90mg) putting me to sleep, so while I feel great during the day I have some trouble falling asleep. I've found that supplementing with Country Life's GABA Relaxer helps a bit, it contains GABA, Taurine, Glycine, B-6 and I think one other amino. I also take a Melatonin supplement and this helps. I just have to get used to falling asleep normally and not "passing out" whether I wanted to or not, like I did after I took the Remeron at night.
This is the end of the thread.
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