Does everyone gain weight on remeron

16 Antidepressants That Cause Weight Gain

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Medically reviewed by Alan Carter, Pharm. D. — By Jacquelyn Cafasso — Updated on April 18, 2019

Overview

Weight gain is a possible side effect of many antidepressant drugs. While each person responds to antidepressant treatment differently, the following antidepressants may be more likely to cause weight gain during your treatment.

Tricyclic antidepressants, also known as cyclic antidepressants or TCAs, may cause weight gain. These drugs include:

amitriptyline (Elavil)
amoxapine
desipramine (Norpramin)
doxepin (Adapin)
imipramine (Tofranil-PM)
nortriptyline (Pamelor)
protriptyline (Vivactil)
trimipramine (Surmontil)

TCAs were some of the first drugs approved to treat depression. They aren’t prescribed as often anymore because newer treatments cause fewer side effects.

Weight gain was a common reason people stopped treatment with these types of antidepressants, according to a 1984 study.

Still, TCAs can be effective in people who don’t respond to other types of antidepressant drugs, despite the unwanted side effects.

Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressants to be developed. MAOIs that cause weight gain include:

phenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)

Doctors prescribe MAOIs most often when other antidepressants don’t work due to certain side effects and safety concerns. Of the three MAOIs listed above, phenelzine is the most likely to result in weight gain, according to a 1988 review.

However, a newer formulation of an MAOI known as selegiline (Emsam) has been shown to result in weight loss during treatment. Emsam is a transdermal medication that’s applied to the skin with a patch.

SSRIs are the most commonly prescribed class of depression drugs. Long-term use of the following SSRIs may cause weight gain:

paroxetine (Paxil, Pexeva, Brisdelle)
sertraline (Zoloft)
fluoxetine (Prozac)
citalopram (Celexa)

Although some SSRIs are associated with weight loss at first, long-term use of SSRIs is mostly linked to weight gain. Long-term use is considered treatment that lasts longer than six months.

Of the SSRIs listed above, paroxetine is most commonly associated with weight gain with both long-term and short-term use.

Mirtazapine (Remeron) is a noradrenergic antagonist, which is a type of atypical antidepressant. The drug has been shown repeatedly to be more likely to cause weight gain and to increase appetite than other drugs.

Mirtazapine is less likely to make people gain weight compared with TCAs.

It also doesn’t result in as many other side effects as other antidepressants. However, it can cause:

nausea
vomiting
sexual dysfunction

Other antidepressants have been associated with less weight gain as a side effect. These antidepressants include:

escitalopram (Lexapro, Cipralex), an SSRI
duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor (SNRI), may cause modest weight gain with long-term use
bupropion (Wellbutrin, Forfivo, and Aplenzin), an atypical antidepressant
nefazodone (Serzone), a serotonin antagonist and reuptake inhibitor

venlafaxine (Effexor) and venlafaxine ER (Effexor XR), which are both SNRIs
desvenlafaxine (Pristiq), an SNRI
levomilnacipran (Fetzima), an SNRI
vilazodone (Viibryd), a serotonergic antidepressant
vortioxetine (Trintellix), an atypical antidepressant
selegiline (Emsam), a newer MAOI that you apply to your skin, which may lead to fewer side effects than MAOIs taken by mouth

Weight gain is also less likely to occur with the following SSRIs when they’re used for less than six months:

sertraline (Zoloft)
fluoxetine (Prozac)
citalopram (Celexa)

Not everyone taking an antidepressant will gain weight. Some people will actually lose weight.

Experts emphasize that worries about gaining weight shouldn’t influence the choice of antidepressant for most people. There are other side effects and factors to consider when choosing an antidepressant.

If you do gain some weight while taking an antidepressant, the drug may not actually be the direct cause of the weight gain. An improved mood while taking an antidepressant, for example, may increase your appetite, leading to weight gain.

Don’t stop taking your drug right away even if you do gain a little bit of weight. You’ll need to work with your doctor to find an antidepressant that helps with your depression symptoms and doesn’t result in unwanted side effects. This may take a little bit of patience.

Your doctor can also give you some tips for preventing weight gain while on antidepressant therapy.

Last medically reviewed on April 18, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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10.7326/0003-4819-155-11-201112060-00009
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Mayo Clinic Staff. (2016). Tricyclic antidepressants and tetracyclic antidepressants.
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Serretti A, et al. (2010). Antidepressants and body weight: A comprehensive review and meta-analysis [Abstract].
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Uher R, et al. (2011) Changes in body weight during pharmacological treatment of depression. DOI:
10.1017/S1461145710000933
Watanabe N, et al. (2011). Mirtazapine versus other antidepressive agents for depression. DOI:
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Wise TN, et al. (2006). Effects of the antidepressant duloxetine on body weight: Analyses of 10 clinical studies.
ncbi.nlm.nih.gov/pmc/articles/PMC1764530/

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Medically reviewed by Alan Carter, Pharm.D. — By Jacquelyn Cafasso — Updated on April 18, 2019

Mirtazapine Weight Gain: What You Should Know

Mirtazapine is an antidepressant approved by the U.S. Food and Drug Administration (FDA) for treating major depressive disorder (MDD), sometimes called clinical depression.

While it may help treat depression, mirtazapine can come with a side effect that some patients find distressing: weight gain.

Two of the most common side effects of mirtazapine are increased appetite and weight gain.

In this article, I’ll talk more about this medication, how it’s used, and other medications that it can interact with.

I’ll also explain how mirtazapine can affect your appetite, metabolism, and what you can do about managing weight gain while taking it.

What is Mirtazapine?

Mirtazapine is a type of atypical antidepressant medication that is approved by the FDA for the treatment of MDD. Mirtazapine is sold under the brand name Remeron, or as a generic.

Mirtazapine works by balancing brain chemicals called neurotransmitters and improving cellular communication in the central nervous system (CNS), which includes the brain and spinal cord.

It is not fully understood how mirtazapine works, but studies have found it to be equally as effective to other popular selective serotonin reuptake inhibitor (SSRI) medications like paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).

Mirtazapine also may work faster than these SSRI medications, and can cause fewer side effects.

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Uses

Mirtazapine is used for treating major depressive disorder and other types of depression.

Some healthcare providers may also prescribe it for sleep disorders or insomnia, social anxiety disorder, panic disorder, fibromyalgia, or post-traumatic stress disorder (PTSD).

The benefits of mirtazapine may be felt quickly. While many antidepressants take 2-4 weeks before they show beneficial effects, mirtazapine may lead to improvements within 1-2 weeks.

Patients taking mirtazapine were found to be 74% more likely to achieve remission of depression symptoms in the first two weeks compared to people taking certain SSRIs.

Dosage

Mirtazapine is available as an oral tablet or an orally dissolving tablet.

Dosages for both options are the same.

Tablets available in doses of 7.5, 15, 30, and 45 mg
Starting dose is usually 15 mg per day once daily
Usually taken before bed
May be taken with or without food

Dosage may be increased after 1-2 weeks to determine how the medication is working.

Interactions

A drug interaction is when a medication reacts to another drug or a food, herb, or supplement, causing the medication to become less effective or cause more side effects.

There are many possible interactions with mirtazapine.

Do not take mirtazapine with any of the following:

Monoamine oxidase inhibitors (MAOIs): These include medications like phenelzine, linezolid, methylene blue injection, isocarboxazid, and tranylcypromine.

Medications that change the way the brain responds to serotonin: These include lithium, triptans, or the amino acid L-tryptophan.

Heart rhythm medications: This includes amiodarone and others.

There are other possible medications that can interact with mirtazapine.

Ask your pharmacist for a complete list.

Tell your healthcare provider about all the medicines and over-the-counter drugs you take, including any dietary supplements, herbs, minerals, or vitamins.

Causes of Weight Gain

Many antidepressants have weight changes as a side effect.

Mirtazapine has a more pronounced risk of weight gain, and may even be used off-label to treat lack of appetite or to help induce weight gain.

In a small study that sought to understand how mirtazapine specifically influenced body composition, the medication led to overall body weight gain, fat mass increase, and higher leptin concentrations.

Leptin is a hormone produced by fat cells that tells your brain that you are full.

But increases in this hormone can lead to leptin resistance, a condition where the brain does not get the message that you are full.

Higher levels of leptin are associated with weight gain.

Mirtazapine did not cause changes to insulin, increase insulin resistance, affect glucose metabolism, or significantly increase lipids.

Mirtazapine can lead to weight gain because it:

Makes you feel hungrier, so you eat more
Changes the way that your body stores fat
Changes the way that your brain responds to leptin, so your brain does not get the message that you are full

How to Manage Weight Gain

Weight gain as a side effect of a medication can be frustrating.

While some weight gain may be inevitable for some people, not everyone will gain a lot of weight while taking mirtazapine.

To manage your weight while taking mirtazapine, have a plan:

Eat a healthy diet that is balanced with plenty of fiber, vegetables, whole grains, lean protein, and low-fat dairy products.
Get regular physical activity.
Stay hydrated.
If you have trouble sensing when you should be full, measure out food portions to help prevent overeating.
Ask your medical provider for a referral to a dietitian to discuss a balanced meal plan.

Don’t stress. While too much weight gain may not be ideal, stressing over your weight will worsen your mental health.

Focus on the benefits you are getting from mirtazapine and work with your healthcare provider to decrease negative side effects in the ways that you can control.

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When to See a Medical Professional

If you are taking mirtazapine and are experiencing weight gain, tell your healthcare provider.

They can recommend supportive strategies to decrease side effects and find healthy ways to manage your weight.

If you are taking mirtazapine and feel that weight gain or other side effects are too much for you, do not stop taking it suddenly.

Tell your healthcare provider that you want to consider switching medications.

Depending on how long you have taken mirtazapine and what your dosage is, you may need to be slowly tapered off the medication.

Suddenly stopping can cause serious side effects or withdrawal symptoms.

If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free 24/7 support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.

How K Health Can Help

Think you might need a prescription for mirtazapine?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if mirtazapine is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

What is the average weight gain on mirtazapine?

When patients gain weight while taking mirtazapine, weight gain is on average greater than or equal to 7% of overall body weight. So for someone who weighs 150 pounds, the average weight gain would be around 10 pounds.

Does everyone gain weight on mirtazapine?

Weight gain is one of the most commonly reported side effects of mirtazapine and is reported in 12% of patients in clinical trials. Around 8% of people who were taking mirtazapine stopped taking it because of weight gain.

Does mirtazapine cause long term weight gain?

Mirtazapine changes the way that the brain responds to appetite and hormones that regulate how full you feel after meals. While much of the weight gain with mirtazapine happens within the first four weeks, it is likely that weight gain will last as long as you are taking the medication.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

A Review of Therapeutic Uses of Mirtazapine in Psychiatric and Medical Conditions. (2013).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907331/
Mirtazapine. (2022).
https://www.ncbi.nlm.nih.gov/books/NBK519059/
Remeron (mirtazapine tablets). (2009).
https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020415s023s024.pdf
Effect of mirtazapine treatment on body composition and metabolism. (2006).
https://pubmed.ncbi.nlm.nih.gov/16649829/
Elevated leptin: consequence or cause of obesity? (2007).
https://pubmed.ncbi.nlm.nih.gov/17485319/
Remeron. (2021).
https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020415s038,021208s028lbl.pdf
What is a Drug Interaction? (2021).
https://hivinfo.nih.gov/understanding-hiv/fact-sheets/what-drug-interaction
Label: Mirtazapine tablet. (2021).
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f23631be-c7ae-46e9-b771-a70be17bc9f0

Study: antidepressants lead to weight gain

May 25, 2018, 2:58 pm

Widespread use of antidepressants may contribute to rising rates of obesity in developed countries. The risk of becoming overweight in those who take drugs to combat depression for a long time is 21% higher. This conclusion was reached by doctors at King's College London. The work was published in the medical journal The BMJ. This is reported by The Independent.

"The widespread use of antidepressants may be one of the reasons for the long-term increase in the weight of the world's population," said one of the co-authors of the work, Martin Gulliford.

The study showed that the risk of weight gain increased after 2-3 years of taking antidepressants. The risk of developing obesity and the appearance of extra pounds in such patients was 29% higher.

As noted by the authors, the findings suggest that antidepressants should be used less often in the treatment of mild forms of depression. In such cases, cognitive behavioral therapy and exercise should be a priority.

The study was based on health data from 300,000 British patients between 2004 and 2014. Information included data on patients taking antidepressants and their body mass indexes (BMI). The researchers adjusted for other factors that could influence weight, such as age, chronic illness, smoking, and other medications.

Weight gain of 5% of body weight or more within a year was 8.1% among patients not taking antidepressants. Among those who took medication to combat depression, the figure was 11.2%. After 3 years of taking antidepressants, the risk of gaining 5% of body weight per year increased to 46%. The study showed that the risk of becoming overweight is highest in the second and third years of taking antidepressants. In the next 6 years, the risk also remains elevated.

Researchers analyzed the effects of 12 common types of antidepressants on body weight. Thus, the drug mirtazapine (another name is remeron) in half of the cases led to an increase in the weight of patients by at least 5% of the body weight before taking the drugs. The drug citalopram increased the risk of weight gain by 26%.

According to the Organization for Economic Co-operation and Development (OECD), the majority of antidepressant users are in Iceland. For every 1,000 Icelanders, there are 118 people who take drugs to fight depression. The top five also included Australia, Portugal, Canada and Sweden. In the sample of the OECD study, 35 member states of the organization are noted.

Meanwhile, in the ranking of countries by the level of happiness of the World Happiness Report, the states of Northern Europe, Australia and Canada have also been occupying leading positions for several years. For example, Iceland, the leader in the consumption of antidepressants, ranked 4th in the ranking of countries in terms of happiness in 2018. In 2017 and 2016, Icelanders were the 3rd happiest country in the world.

The material was provided by the "+1" project.

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Taking antidepressants can cause weight gain!

news 06/11/2018

Taking antidepressants can cause weight gain

A new British study shows that you are more likely to gain weight if you take antidepressants.

The discovery surprised mental health experts.

"It's been ten years now that psychiatrists have known about it, written articles about it, and heard about it from their patients all the time," says Dr. Brian Keefe, psychiatrist and chief medical officer at Zucker Hills Hospital in Glen Oaks, New York, who did not participate. in conducting research.

During the experiment, according to scientists, it turned out that the risk of gaining 2-3 extra pounds in patients who took at least one antidepressant is 21 percent higher than in other subjects.

According to the lead author of the study, it was not possible to prove the existence of a direct causal relationship between the use of antidepressants and weight gain - all that can be said is that there is some connection here, and studying it can help explain the accumulation of fat in the human body .

“It is important to emphasize the following: no patient should stop taking medication because of this. If a person experiences any side effects from taking the drug, they should talk to their doctor or pharmacist about it,” says Dr. Rafael Ghafoor, a psychiatrist at King's College London, who led the study.

According to him, the peak probability of gaining weight occurs between 2-3 to 6 years of continuous use of antidepressants. Gafur says that while scientists do not know why the weight begins to grow precisely from the 2nd year of taking the remedy, and not earlier.

However, during this period of time, many people manage to gain excess weight or even become obese - when taking antidepressants, the risk of such an outcome increases by 29%.

Researchers say that in people who were already overweight before starting antidepressants, these drugs also increase the risk of obesity by 29%.

According to one of the American doctors, treatment with antidepressants always affects the form of his patients in different ways.

"I've seen some people not gain weight, some people gain a lot of extra pounds, and some even lose weight after taking antidepressants," says Dr. Jamie Kane, director of Northwell Health Hospital's Weight Management Center Syosset Hospital, New York.

In his opinion, those patients who, while taking antidepressants, notice that their weight begins to increase, should try to adjust their diet and start exercising more often.

In addition, antidepressants, according to Kane, have alternatives - psychotherapy and increased physical activity.

Gafur and his team recruited approximately 300,000 men and women between 2004 and 2014 to conduct the study, 20% of whom were taking antidepressants.

For investigators, a weight gain of at least 5% of previous body weight was significant in any of the study participants.

Research has shown that 11 out of every 100 people who take antidepressants gain weight in a year. Among those who do not take medication, about 8 out of 100 people gain weight.

Those who took antidepressants at 2-3 years of medication had an approximately 46% higher risk of gaining more than 5% of their body weight than those who did not take such drugs.

Learn more

Does everyone gain weight on remeron

16 Antidepressants That Cause Weight Gain

How we reviewed this article:

Read this next

Mirtazapine Weight Gain: What You Should Know

What is Mirtazapine?

Feeling Down?

Uses

Dosage

Interactions

Causes of Weight Gain

How to Manage Weight Gain

Feeling Down?

When to See a Medical Professional

How K Health Can Help

Frequently Asked Questions

Study: antidepressants lead to weight gain

Taking antidepressants can cause weight gain!

Taking antidepressants can cause weight gain