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Beating the weight gain of Remeron - Low carb diets?

It's no secret that I am one of many people out there that finally found a safe, effective & non-addictive medication to treat a rare form of intractable insomnia. My insomnia is a result of metabolic issues combined with your typical life stressors, which makes it difficult to treat and pretty much chronic.

For the past twelve years, I have struggled with various treatments for my insomnia in a desperate attempt to find those illusive zzzzz's. What I didn't know, was that while I was so hyper-focused on falling asleep that I didn't realize that the sleep I was getting was very poor.

After a string of ineffective, short-term medications whose side effects were worse than their cure, a new doctor I was seeing decided to try me on Remeron. Within days, I was sleeping like I had never slept before. I slept heavily those first few weeks, finding it difficult to wake up and get going in the morning. But, after I adjusted I started sleeping normally for the first time in years.

But, I (like many others) made a big mistake when I first started taking Remeron.....I ate. The doctor's will warn you that there is a risk of weight gain (mine said about 6-7 lbs), but what they should tell people is that the risk is actually reality and that most people end up putting on large amounts of weight.

I personally gained about 16 lbs, which, given my frame, is a pretty large weight gain. And, like many others, despite how much I exercised the weight kept piling on.

For weeks and weeks I was tormeted by the weight gain, as I exercised more and more. I tried to change my eating habits by not eating out, watching calories and being more aware of what I was putting in my mouth. But, the fact was that I wasn't a person who ate poorly, but was now a person who could not lose weight.

So, I started taking a hard, scientific look at Remeron and why it causes so many people to gain weight. I read up on the methods of action, the studies that link Remeron to a reduction in stress hormones (specifically cortisol) and how all of that could be connected to what was happening to people's bodies.

Here's what I noticed: I couldn't seem to build and maintain muscle mass. If I took a single day off of exercise, the fat would pile back on. After months of exercise, I had barely made a dent. But, then I also noticed that certain exercises seemed to create a bigger effect than others (more on that later) and that some days I could barely walk down the street because I felt so heavy and others I seemed to move faster and easier.

Not surprisingly, the research on Remeron talks alot about the weight gain, but, specfically, about the change in body composition. On Remeron, people tend to gain this layer of fat, or that's how I describe it. I call it the immovable layer of lard. It comes out of nowhere and is very stubborn about leaving. Walk all you want, hit that eliptical all you want....it won't move. It makes you want to give up on the drug. To hate it. To return to insomnia, if that's what will make the weight go away.

But then I happened upon some like that lead me another link. And, that's when I put together the cortisol + insulin connection.

This is how it goes: Remeron supresses the stress hormone cortisol. This is one of the reasons it helps people sleep. It basically 'powers down' your brain and slows your metabolism a bit. But, more interestingly is the relationship between cortisol and insulin. Apparently, cortisol counteracts insulin. Insulin basically grabs sugar from your bloodstream and stores it as fat. Your body needs cortisol to counteract and balance this effect of insulin, in addition to helping processing lipids (fats) and proteins.

So, as Remeron is supressing your cortisol it is also contributing to some of the effects of high insulin, specifically hypoglycemia or low blood sugar. When people say that can't stop eating carbs on Remercon, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs.

That's problem number one.

Problem number two comes from simply supressing cortisol. Because optimal levels of cortisol are neccessary for processing all macronutrients, having too little of it a night could drastically effect your body's conversion of these nutrients into energy. This could cause weight gain and would explain why people gain weight on Remeron so quickly.

That's problem number two.

So, when I rethought all of this, I actually decided to try a little experiment: To eat a 'Zone' diet that focuses on balancing fats, proteins and carbs, to increase my B-Complex vitamins, add Omegas and incorporate more muscle building activities, such as weight training.

The diet gets rid of the carbs that the Remeron are making your body store as fat. The B vitamins help metabolize macronutrients and convert them to energy, omegas can help balance fat levels and muscle building exercise burns glucose and taps your fat reserves.

Three days and I lost 4 lbs.

So, there is hope. I am going to try and keep this up over the next week and see what happens. But, so far there has been a significant difference. And, given that losing ANY weight on Remeron is almost impossible, I am hoping that this actually works.

Keep ya posted....

Comments

Bazodee Bobolee said…
Hey there, thanks for this post! I have been searching EVERYWHERE to find someone with my same story, and it seems I have finally found you. Everything I google about Remeron and weight gain brings hits from people who are using Remeron for the anti depressant effect. But my doctor used it to treat my insomnia and I couldn't find anyone else who 1. uses Remeron for insomnia and 2. is gaining weight. I gained about 10 pounds over the past 6 months, most of it over the past 2 months. And all of it is around my tummy. At 5'9" and an initial 134 pounds, it looks very obvious (at least to me) since I have a characteristic "pot belly" look. I HATE it!

What you said really hit the nail straight on the head: I have these cravings for things like Smucker's jam and chocolate. I eat and eat and eat until I am sick and then I recover and eat more! I was wondering what the hell was wrong with me, until I read this. Thanks so much for writing.

Now, tell me, how has this diet been for you? Any further success? I would try it, but I don't know how I'd fare; I think I'd eventually give in after a short time and go back to my Smucker's jam jar and just spoon it out... :-/
aluni madrid said…
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aluni madrid said…
Dear Kate, I am a Spanish professor, and i found this post on your website with the same problem that I have. I am very surprised about your capacity of explaining and analysing the problem with Rameron. I began with Rameron five year ago, and I gain 20 kg. I have been looking for solutions in the web, and the best thing I found is your post. The question is that I do not know HOW to concrete the specific diet following the general indications you suggest. Also I would like to know how was the result of your diet.
aluni madrid said…
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Paul Fitz said…
has the diet worked out for you? yours wa the first thing i have read regarding remeron weight gain that made sense...
lil said…
Anyone have any luck, I have been on the meds for nearly 2 years and gained 10 kg, I exercise most days for 1 hr.
Would love to hear from someone who has success,
Francos@westnet.com.au
Thanks
threejay2927 said…
I am about to give up on the Remeron. I have been a small person ALL of my life until I started it. I do not like the way I look since I have gained so much weight. I want the old me back and it won't happen as long as I continue this med. I do not eat anymore than I did before but I still gained weight. It is like the Remeron slowed my metab down to zilch! I just can't stand it anymore. :(
Unknown said…
Kate - did you manage to keep the weight off? I'm struggling. This is my third round w remeron. It is the only thing that helps my deep depression. I need to stay on it. Katy
Heather said…
THANK YOU!!! I have been looking everywhere for some ideas as to what I could try to help with my Remeron weight gain. I suffered terrible insomnia for many years but also suffer from Post Traumatic Stress Disorder and Depression. Remeron is the first thing that ever really helped me live a normal, happy, regular sleep patterned life. The weight gain has been horrendous!!! Enough so to make me want to quit the Remeron but I fear equally returning to my old life. I am going to try what you suggested. It's the first real lead I've ever had. How are you doing now?
katididwhat said…
Hi all,

I noticed that people are still reading this and that it has seemed to make sense to people.

Many of you have asked for an update, so here goes:

I stopped taking Remeron in 2009 because I was able to change my life to accomodate the insomnia. Apparently I have an annoying combination of DSPD and anxiety (probably acquired over years of fretting about sleep). Naturally my body will fall asleep around 2-3am and I only have problems if I know I have to get up in the morning. That's when the anxiety kicks in and make the whole thing worse - leaving me with almost no sleep.

Unfortunately, my life has switched back to getting up early and struggling to get a good night's sleep. Stupidly, I didn't revert back to Remeron immediately and saw a few doctors who went with the benzos. Everyone who has dealt with long term insomnia knows how that pans out.

I'm headed back to the doctor tomorrow, sadly, to talk about tapering off the Restoril/Xanax. I'm both frustrated and embarrassed that I let a fear of gaining weight put me in this predicament.

I will ask to go back on the Remeron and, hopefully, take some time off from work to adjust to it.

As far as the weight gain, yes, the balance of proteins, fats and carbs works. Think about it, anyone who binges on carbs will gain weight whether they are on Remeron or not. Sticking to a high quality protein diet with good fats is not only a great way to eat but it will help curb the weight gain from the drug.

If any of you ended up trying the lower-carb approach, let me know. We'd all like to hear how it went with you.
wildfruit said…
Hello there , I have just started taking remeron 4 days ago after many unsuccesful attempts to cure my depression with sari's . Was a bit dubious to begin with due to the weight gain side effects that so many seem to go thru so after reading your blog Kate I started a low carb diet 3 days before starting the med , so far no cravings and no weight gain but I guess it's still early days am also exercising every other day I am really hoping that this is the answer to maintaining or ideally losing a bit of weight on this med . Would love to hear from you Kate or anyone else on their progress with remeron and the dreaded weight gain :)
wildfruit said…
Sorry that was meant to be ssri's not sari's lol
This comment has been removed by the author.
JRL said…
I have been on Remeron since Sept. 2011. It helped immensely with my panic/anxiety/depression. I was 5'4" and 135lbs. I am now 170lbs. I did have cravings and would eat a pint of ice cream almost every night for weeks. I didn't gain weight initially. Then it seemed like my weight skyrocketed over night. The cravings are gone now, pretty much. Now I have this weight I have to get off. I tried weaning off of Remeron twice and both times it did not work out well. My symptoms came back within a week. I have decided that being mentally healthy is better than being thin. I am going to try to take in 1200 calories a day and walk on the treadmill. Hopefully, this will work with the weight gain. If not, at least I'm happy! I guess the main point I'm trying to make is to take things in perspective: weight gain is a small price to pay to get your life back!
Maybe. said…
Hi. Can I please say "thank you" and give you a big hug? I've always wondered about this and your experiences and scientific research (which, for the most part, is true) made me look at this in a new light.
Marjie said…
Thank you so much for this conversation! I've been on Remmy for 5 years. Gained 35 pounds overnight it seemed like and I have been trying to shake it for 4 years. It's slow BUT...I now take the tiniest amount possible to get to sleep and have gone after it with 5 days per week at the gym and can tell you that watching the carbs (plus no gluten, sugar, red meat, pork, fast food, soda) I have managed to lose 18 of the pounds. I do toy with the-"should I be skinny but crazy, or fat and sane" dilema. Until I figure out what the alternatives are, I battle it every day. Keep on it everyone!

Here's to a good night's sleep.
BriOnH said…
I am a type one diabetic for 36 years and on Remeron. I am also a trained Biochemist. I find your link between cortisol and insulin very interesting. I can attest that for me that could be why after I take Remeron I have to take massive amounts of insulin. My insulin to carb ratio is usually 1 unit for every 10g of carb, but at night when i literally binge eat, its almost 3:1.

I don't think hypoglycemia is a contributing factor though. When I was in college, studying biochem, people that used to smoke pot said they got the munchies from low blood sugar. I tested their blood and never found hypoglycemia to be the cause of 'getting the munchies'. Also it doesn't matter what my blood sugar is - it could be 60 mg/dl or 400 mg/dl - I crave carbs no matter what. Honestly carbs or not, I just crave food.

Lisa D said…
Hi Kate I am exactly like you, I suffered terrible insomnia for 3 years, I tried Temazepam, Zopiclone and had terrible side effects and withdrawal, my Gp then suggested Mirtazapine but I was reluctant to take an anti depressant but read that it had great sedation effects so gave in and took 15mg a night, it gave me the best sleep ever! Now 7 months on I have gained almost a stone (14lbs) in weight, I was always slim at 8 stone & 5ft2, I haven't eaten anymore than used to and go running 3x a week, no matter what I do I can't lose it. Tried tapering off the pills and now stopped completely but withdrawal is the worst, insomnia has returned, stomach cramps & nausea.. I am going to have to give in and take 1 tonight :0( what did your diet consist off? Is it cutting out carbs completely? Would love to hear how you are doing now. Lisa
Yogalover said…
Hi there! i just found this post......I am a 49 year old yoga/fitness instructor, and I have always dealt with chronic depression and insomnia. Thanks Dad! (jk) I currently take Wellbutrin 75mg/day which I have been on for 15 years, and I started Remeron 3 months ago.So, about 3 years ago my life changed dramatically in so many ways, good and bad, that I won't bore you all with details. The weight started creeping on and now I am sporting an extra 22lbs on my previously lean belly/midsection. I figured it was a combo of perimenopause and high cortisol. So, off to the expensive bio-identical hormone doc who put me on progesterone. We have been muddling around with hormones like testosterone, DHEA and pregnenolone for 2-1/2 years and I STILL have a protruding pregnant looking belly. I cannot adequately describe how much I LOATHE the way I look. I only just today found out that Remeron is a cortisol blocker! WTF? My cortisol levels are still through the roof!! I only take 15mg of Remeron/night and I do sleep fine now. Ironically, the Remeron has not caused me to eat more as I am very disciplined with food - I basically eat South Beach and as organic as possible - NOT a vegetarian. So, I went and bought some Phosphatidylserine to get my cortisol down. During my search to find an appropriate dosage, I found this post....I know a lot of folks would say "talk to your Doc", but, frankly, most doctors fail to impress me both professionally and personally. I'm sure there are tons of great Docs out there, but I cannot afford the time or money to go looking! Any ideas? I live in the Chicago area....
Unknown said…
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Anonymous said…
Hello, I have been on remeron since 1st part of June 2012.. I started it to help me come off a benzo I had been in for years.. Anyways I am almost off the Valium, I am only asking 1.5mg per day, cut three ways... So to make a long story short I have gained 15 pounds during this time.. I was really under weight when I started remeron b/c of the ibs I had from coming off the Valium.. I am 4'11 inches and went from 95 pounds to 110 pounds on the remeron... My normal weight before coming off benzo, etc was 103 pounds... Anyways, I tried several times (3) to stop remeron, but was not able to b/c it caused insomnia and made my benzo withdrawals worse, anxiety, etc.... So I went back on remeron and it doesn't help me sleep as well this time around, but I get 7 hrs off and on... I take 7.5 mg of remeron at night by the way... I have always been very fit, I've competed in 4 figure shows and have placed in each one.. So this drug definitely makes you gain weight, I have tried so hard to keep the weight off, but not much works.. It also makes me retain water... I am using myself as a test dummy, and trying different exercise regimes and I find when I do more cardio I gain more and retain more water... The week that I just weight lifted I was losing weight and then I added in cardio and it didn't help... It actually seems to make me heavier...
my Diet: I don't eat tons of carbs, just oatmeal in the morning... So I'll let you know how my testing goes... Next week I'm going to go back to just weight lifting and jumping rope to see if I start losing weight again.. I'm also in pray on this as well.. The Lord is amazing and a few pounds is nothing to him, if anyone can help me he can :-)
Unknown said…
I have been on Remeron for 7 years. I suffer with anxiety and depression and was unable to sleep at night. My weight was 155 and I'm 5'9. Over seven years I am now 210 and 8 sizes larger. I have tried to go off this medication twice only for my symptoms to return in a week. I have tried.multiple diets including vegan only...and have managed to lose 15pds max. I feel uncomfortable on the meds and off. I crave food constantly and try to eat as whole and raw as food comes. I drink water .....bottom line weight is still increasing.
Unknown said…
I have been on Remeron for 10 years since my daughter was born. I have had insomnia for 15 years. I tried Doxepin, Ambien, Sonesta, Trazedone etc. Remeron works the best. I gained weight with my pregnancy and I struggle to lose it still but for the most part I think it is worth it. I have also started to take Seriphos (Phosphytidalserine)Sp? to lower cortisol levels since mine have tested very high at night. I have made some progress in the past few months and sleep with less and less Remeron. I used to take typically 7.5 mg every other night. Now I take it less and have gone for 4-5 days, typically sleeping5-6 hours. Not too bad. When I don't sleep I wake at 3 am wired and with no ability to sleep. I am also experimenting with low card diet but have been inconsistent since I feel tired with less carbs. I wish I could get off this drug and sleep like a normal person, however, I am also grateful for Remeron since my life is mostly peaceful and I manage a busy job and life. I weigh 160 at 5'5". I exercise most days and do not eat sugar, dairy, soda, alcohol or caffeine.
Unknown said…
I have been on 45mgs of remeron for about a year. I use it as a sleep aid and for depression. I have gained over 20lbs.My gut is huge. I,too crave carbs at night time.Munching on anything available. Finding cookie crumbs, candy wrappers in the morning. Sometimes I don't even realize I have "pigged" out until the next morning. I have been told to eliminate refined sugars. Eat protein. No pasta,bread and potatoes. Gonna give this a try. Also, I am not a fitness nut so I have chosen to walk 20 minutes daily.. Any other suggestionsss?
Blahnik27 said…
I have been taking Avanza for 6 months now. (15mg at night for insomnia & post-natal depression).
I initially gained about 25lbs in the first few months because those sugar/carb cravings are indescribable! I have always tried to follow a low carb diet, so decided to get very strict with myself and last month I ate very low carb (only 40-50 grams per day) and did cardio five times a week. I lost 13 pounds in 1 month!
Needless to say I am very pleased and will continue on.
I would like nothing more than to stop taking it all together, but fear going back to sleepless nights and constant anxiety.

Low carb and lots of exercise is the only way.
Jen said…
THANK YOU!! I know this post is years old, but I'm so glad I found it. I took Remeron for about 8 months, I gained about 20 pounds no matter what I ate or how much I exercised, so I decided to stop. I forgot how badly I sleep without it - 2 full weeks went by and I slept about 1-2 hours a night. I gave in and went back to the Remeron. I've tried EVERYTHING - Lunesta, Ambien, Trazadone, Xanax, Doxepin...I can't even think of them all to be honest. I'm so tired of the weight and feeling bad about myself, but it's worse to not sleep. Remeron has been a complete miracle in that department, I sleep great and wake up feeling great. No benzo hangover at all. It's hard to beat that, even if it means I have to be a little fatter. I'm going to try the Zone type diet and see if that helps, thank you!!
gabryele said…
I've been on remeron for 2 years and I didn't know about the weight gain when I was first put on it. I've put on a good 20lbs since starting the medication, and I have the same pot belly the a few of the other posters have. I've tried so many diets and it is just so difficult to loose this weight. I'm so tired of hating the way I look. So I've decided to go off of it. It just doesn't seem worth it to me. Especially after reading all these comments and seeing how badly others are struggling.
Unknown said…
Hi all,

About 15 years ago I had extreme anxiety and insomnia that rendered me pretty much useless. I was put on every possible SSRI but they all had horrid side effects. Finally, the doc tried Remeron and it was a miracle. Within a week I felt 100% better. At the time I was very thin, 104 lbs, but gained about 35 lbs in 4 months on it. The weight gain leveled off after that. I was on it for a year and safely came off of it and all meds. I never lost the weight, and gained 40 more over two pregnancies, but it was worth every lb gained to get my life back with this drug. After 15 years I am now having similar problems with anxiety but I weigh 178 lbs, so my doc doesnt want to put me on Remeron due to weight gain. He tried Lexapro, which is EVIL stuff, at least for me. I simply cannot do SSRI drugs of any sort. I would happliy diet and exercise to stave off the Remeron weight gain but I am not sure that will help. I am a bit disheartened because I know this drug works so well but I dont want to create other health problems with being morbidly obese.
Anonymous said…
Hi
Im in the UK where remeron is called mirtazapine, i have been on it for about 18 months.
Like everyone here I initially had massive carb cravings resulting in mass carbiside. I ballooned despite training and competing in triathlons.
Last year i went on a very low carb [ketogenic] diet; this diet definitely helps with symptoms of depression but also helps with weight management; what it hasn't done [yet] is get rid of the belly and i still feel like i have a layer of fat all over my torso. Lifting heavy weights has helped with body composition but i think that as soon as spring comes and this winter weather has gone that i will continue the ketogenic diet as this appears to be my magic bullet, but not the pills; sure they helped with some issues but they have also given me some issues...catch 22 really!
I did not know about the cortisol suppression; why are we not told the full story by the pharmaceutical companies i will never understand.
Feel free to check out my twitter feed for lots of low carb and ketogenic information @colin__matthews
sixty something said…
It's helpful to find all these comments about weight gain.... I know my psychiatrist is thrilled to see me in remission from depression...I was too at first....I was euphoric and very active....now the weight gain is indeed as someone described it - a layer of aft all over my torso. After my husband died I worked so hard to lose weight and now I am fairly shattered to find I've regained all that weight. I puff...by 4pm my body feels like lead...I salivate passing food....then I eat....I try but I find the addiction to food is much worse than alcohol...Will I continue with Remeron...I'm really not sure....?
lzahart said…
THANK YOU

I know this post is oldish but I can't tell you how good it makes me feel. I have been on Remeron for about 4 months. I knew it caused weight gain because it had in the past when I had been put on the drug-- however I had rapidly asked to stop as a result. This time, my depression was so bad, the doctor wanted to try anything that works at all, so they pulled Remeron out. Well..

In the past 4 months I have gained over 30 pounds. I have always had a thin frame and am tall but have also always been slightly inclined towards thinking skinny is better. Never had an eating disorder. Never been a stress eater-- if anything I am one who doesn't want to eat when depressed or upset. At first I thought I must be doing something wrong, so I exercised more. Then I thought maybe I'm eating something wrong, so I saw a nutritionist. However after over 2 months on a strict diet of 800 calories a day and 2x serious cardio a day, I still weighed more-- and not in a muscle type of way, in a fat around my belly that I have never had before type of way.

I have been off this medicine for about a week and have already lost 4 pounds. I hate that I am going to have to work off this weight but will do it because I can't imagine going through life like this.

My doctor subbed in another antidepressant and I know that it takes time to ramp up/get the effects of the drug, but I would rather deal with the ramp up time and sleep loss and other side effects than not be able to look in the mirror when I'm getting out of the shower because it is so shocking and disturbing.

I have an excellent doctor and when I hesitated on the Remeron because of past weight gain, she convinced me that it was better to be fat and alive than skinny and not. I agree with that. But if the choice isn't life or death, if it's milder than that, then I would strongly suggest anyone going on this medication do some reading. Doctors don't seem to be anywhere near as aware of this issue as this post.

Thanks again for helping me understand I am far from the only one who has experienced this bizarre rapid weight gain and insatiable appetite!
Macco said…
I have to thank all who have posted to share their experiences with Remmy and weight gain along with the never ending munchies. I have had exactly the same issues with Remeron. I have gain an excessive amount of weight and continue to eat less and less every week only to stay the same weight.

For the past 2 years I have taken 120 of Remeron for Major Depressive Disorder and Generalized Anxiety Disorder. It has done great to help me manage both mental illnesses. I actually have not had a depressive episode for the past 9 months. It is so great to be living in a "normal" state vs being depressed for years at a time.

But the negative body image caused by the weight gaining effects of Remeron are taking its toll on me. My joints ache from the weight. I'm embarrassed to be seen by anyone or to go out in public or parties.

I don't know what will happen to my mental illnesses if I go off Remeron. I also take other antidepressants and mood stabilizer meds.

I'm going to try the weight training and low carb approach as well as asking my psychiatrist if I can start to come off Remeron. Hopefully I will be able to come off it and start to lose the 100 pounds I've gained from it.

I'm grateful to be alive and hope to see if I can live a good physical and mentally healthy life without Remeron.
Unknown said…
Remeron has definately helped me with my depression and isomnia.I have put on a lot of weight since taking the drug. At the moment I am on a strict diet and spend a lot of time at the gym and the pool. I will keep a close look on my weight in coming months. It is better to be gaining weight in comparison to being depressed and having no sleep. Watch your diet and exercise daily.If the weight gain is to significant and effecting your health then go and see a doctor. Please reply if you like? E-Mail mark.jackson4774@gmail.com.
Unknown said…
Remeron has definately helped me with my depression and isomnia.I have put on a lot of weight since taking the drug. At the moment I am on a strict diet and spend a lot of time at the gym and the pool. I will keep a close look on my weight in coming months. It is better to be gaining weight in comparison to being depressed and having no sleep. Watch your diet and exercise daily.If the weight gain is to significant and effecting your health then go and see a doctor. Please reply if you like? E-Mail mark.jackson4774@gmail.com.
Unknown said…
Stay on Remeron if it helps to prevent depression and insomnia. Weight gain is a side effect. Keep yourself physically well through diet and exercise. Don't get down if your finding hard to lose weight. Easy to say and hard to do. Feel free to contact me: mark.jackson4774@gmail.com.
Unknown said…
Hi - I've just been put on Remeron last week and am NOT happy with all the stories about weight gain etc. Especially since I am already obese and I have just lost 20 lbs. There is no way I will give those up.

So from the day I started with Remeron I also started a rigorous diet. I have upped my protein intake, but am still getting 50% of my energy from carbs, though they are natural, unrefined "good" carbs. Same with fats. Only unrefined, natural, healthy fats.

So far I have lost 1.2 lbs. I'll see what the next weeks will bring. I am trying to find a balanced calorie level that works for weightless. Right now I am going with 1500 cal with a 200 cal up or down bandwidth.

I have also added an OTC fibre product (PGX) to my diet to even out blood sugar levels and curb hunger. It's working pretty well so far.

I'll be happy to report back in a few weeks how things are going.
Marjie said…
Hi All. I too am on Remeron for sleep/anxiety issues. I gained about 35 pounds over a year's time. We tried switching the meds up but Remeron works so beautifully for me that we had to come back to it. With my doctor's help, we were able to reduce the amount I take WAY down and at this smaller dosage the weight gain/food cravings have substantially decreased. I am grateful to my doc for working with me to gradually lessen the dosage to find the balance that works well without being overly medicated. The weight has gradually come off at the lower dosage. Bottom line-Remeron works for me, so I have had to adjust my diet and exercise routine accordingly. One last thing- I only take it once a day (at night) and drinking a big glass of water with it and having a FEW crackers (carbs) or a few almonds helps. Good luck everyone!!!
Unknown said…
I have been on Mirtazapine (remeron) for 3 years and i went from 48 kgs up to 118kgs 70 kg gain in weight!! I've just started a diet 2 months ago of high protein and lots of raw veg with an olive oil French dressing. Sweet potatoes ones a week and I am taking soda Kefir which puts good bugs into your gut. I have lost 11kgs in 2 months. The kefir seems to have been the key to starting my weight loss. I no longer have a swollen stomache. I am getting rid of a lot of fluid retention too. I'm aiming to lose 4-6 kgs a month so hopefully will be down to 75 kgs by Christmas. I'm still taking Mirtazapine 30 mgs but will stop it when I get my exercise up and feel fit again. I'll let you know how I'm getting on!
Mams said…
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Mams said…
Hey everyone,

I have been on Remeron 30 mg for a year and half and I am currently diminishing the dose to 15 mg. I am taking it because my other AD (Effexor) doesn't let me sleep but is otherwise effective.

My latest depression/anxiety episode has been major so I changing meds is not an option for me.

Since I'v been feeling better, I gained 10 kg in around 1 year but I was not looking at what I ate and was only working out once to twice a week.

For the past 3 months, I have been following a Low Carb Diet and working out 4 to 5 times a week (cardio and weights). My weight has plateau but I haven't lost a pound and while I gained muscle, I still look like a pregnant man. I know that the choice of going back to my 'Crisis' state and living like this is a no-brainer, but still, I would appreciate if someone found a way to limit this side effect of this otherwise cool medication.

Cheers
Melisa said…
I take Remeron for insomnia as well as Zoloft 200 mg. I am prescribed 15mg of Remeron but take between a quarter and a half of a tablet (4-8mg) a night. However, I am 20 pounds heavier than I was since I started it taking it. I crave unhealthy foods during the day as well as the night, and for the first time in my life (except for when I was pregnant) feel out of control of my eating. It is not that I am eating so much, when I was not on the Remeron I could have eaten the same amount and not gained weight, but that I have food cravings (particularly sugar and carbs) and what I do eat seems to turn into fat immediately. When I put on weight it naturally goes on my stomach, and since I have a small frame I look like I am pregnant again. The only way to stop this weight gain and hopefully shed the pounds I have gained I believe is to stop taking the Remeron and switch to something else. Getting high quality sleep is important but having some control over what is happening to my body is important too. I want to find something else for sleep. If I do, I will post it.
Sandy6 said…
Kate how's it going now?? I just picked up a script today for insomnia and to knock the edge off of a horrific past 3 months. Actually felt depressed reading the side effects.
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Raven head77 said…
Hi! Im quiet curious about this post. Today is my 3rd day on Remeron with only 7 mg. I'm combining it with Venlafaxine (effexor) 225 mg. This is the second chance I give to this medication because the first time I just didnt like the weight gain. Now I will see how it goes with that issue because Im surprisingly amazed with the improvement on my depression by just adding this small amount of mirtazapine (remeron), it is like taking off this black curtain from your eyes to see the world in brighter colors with hope for the future. Just the weight issue keeps me nervous... I struggled a lot to shed most of the weight extra from my pregnancy so I dont want to go backwards but fowards. More now as a divorced single mom, I think my appearance can really uplift me or send me straight to the bottom as Im still trying to reach for recovery . Any experiences out there with similar combination of this medication? Has this diet worked for anyone lately? Thanks
TheCatsWhiskers said…
Hi Ave,

How are you getting on on the Remeron/ Mirtazapine now? I, like you am on Venlafaxine 225mg and added in Mirtazapine 2 days before you (only a 1/4 of the prescribed 15mg tablet as I'm so sensitive to meds).

I'd been feeling really great on only that dose (3.75mg), but the last couple of days my depression has reared it's head again .... Not sure whether to up it to half a tablet (7.5mg) or ride this out as a blip on the road to recovery. PMT might not be helping either!

Hope you're still feeling less depressed on it.

Take care.
X
Reno said…
I started Remeron two days ago, 30 mg at night. I had no idea how this medication would make me feel, but it made me feel like I was in another zip code that first morning after waking up. I slept all day, and still slept the next night. I feel better today (the second morning after taking it), and my mood feels lighter. I am taking Remeron for fibromyalgia. It hasn't helped the body pain, but I have fought for sleep for about 15 years. I really hate being on any medication at all, but my doctor finally helped me to understand that fibromyalgia pain is partly due to poor sleep; and I have had very poor sleep. I haven't experienced the weight gain, yet, as I am only on my third day of taking the Remeron, so here's the good thing....I feel like I found this post just in time! I already have a tendency to eating too many carbs, and I also have the beginnings of diabetes; so controlling carbs is a must. After reading this blog, and all of the input from the readers, I can start my Remeron journey, hopefully, easier because I know the pitfalls. If I find out this really helps with the fibromyalgia, I will let you know. I read the cortisol/insulin theory to my husband and we both feel like this blog gave us a good handle on a good beginning to Remeron. Thank you, so much, for taking the time to help out your fellow man! It is greatly appreciated!
Raven head77 said…
Hi! It is been quiet a while since I founded this post for the 1st time, by then I was feeling sad and discouraged because I had to start Mirtazapine (Remeron) again as my sole treatment with venlafaxine (effexor) was not helping enough eventhough I was taking 225mg a day. I was aware of the reputation of mirtazapine as I tried it before and I experienced these crazy cravings which would end up usually with stuffing myself with candies and all I had in the fridge to "calm down" my urge for food. By then my ex husband would just hand me the bags of candies and I would devour them obediently. After an ugly divorce and touch the bottom with my chronic depression to one of its deepest points I have slowly recovering. I wont say that mirtazapine in combination with venlafaxine have erradicate completely my depression but I feel more present and stronger to face the challenges of life. At the moment Im taking 175mg venlafaxine plus 7mg mirtazapine and feeling good, even in times where Im going through a second wave of stressful events but so far I havent had another deep fall so for me this is already sort of victory. In what refers to the gain weight, so far it is going well. Im not doing crazy diets but Im eating smaller portions, eating more often, and not eating after 19:30, I have limited as well my access to candies,a lot, and Im going 2 to 3 times per week to the gym. I cut as well my alcohol intake, as it became my secret friend when my son would spend the weekends with his father. Alcohol makes you gain weight like crazy and doesnt help to make you feel better, it just fake it for a few minutes and then it comes the wave of pain but in higher proportion. So nowadays, my weight is 64 kilos and eventhough I have not been lighter than this, I havent either gone heavier. My height is 1,60 so Im not super slim nor chubby anymore so I feel quiet comfortable. About the cravings, I have to mention the advice of one of my best friends who took as a project to make a lot of research of this fame of Remeron to make people fat. So, he went to all reliable sources and there is no scientific proof that says that Remeron alone makes you gain weight. So after his veredict, I still had the sneakiness of replying "but Im so hungry" to which he replied in a very sharp way which I still thank him: you know you have eaten and drink enough, your body doesnt need more, so the crave is just in your head, ignore it! I was like...huh... ok. The first nights my stomach was giving a free opera concert and I had to force myself to not giving to it. With the days, the gut concert got less and now it is almost fine. If Im that super hungry SOMETIMES I eat celery with lemon and salt or just drink a chamomile tea. It is been more than a year Im doing this and I can say mirtazapine has not make me gain weight. So it is possible, cheer up people, we can do this!!! God bless them all :D
Stephanie said…
I found that when I go through emotional stress, I drop weight fast (I have been on 7.5 mg of Mirtazapine for years). I lose a desire for sweets and alcohol, but I noticed last year that even though I was back to my daily chocolate routine, I maintained that lost weight (now it's coming back) despite the stress remaining high. I've had testing done in the past to show that my cortisol levels were fairly low and I decided to test while in the stressful period and my levels were showing normal.

So the trick may be to raise cortisol. Caffeine is one way (you can see a rise on my test, though still below base level, an hour or so after consuming). However, another way is licorice root (not, not the candy which has anise). I do caution that this could be a dangerous way of going about it because it can drop your potassium levels quite low. I've taken it in the past when a doctor recommended it per the testing that revealed low levels. I went out west shortly after to rock climb, which is what I do regularly where I am. Ten pounds came off. Now that could be due to elevation as well.

So, I'm going to give it a shot while carefully monitoring my cortisol. I'll let you know in a few weeks.
Unknown said…
Stephanie I am really interested in what you are saying...please keep us posted on your findings
Stephanie said…
I will do that. I am only one week in.
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Unknown said…
Hi.

I have been eating LCHF (Low carb/ High Fat ) for 1 1/2 years (check it out on line). Recently Menopause hit me with a vegence. At 56 it WAS bound to happen sooner or later. My last period was 3 month ago. Everything happened at once. Severe Anxiety and Unstoppable Insomnia. Then came the panic attacks (from 4 nights of no shut eye). I was raving mad. A lunatic. Wailing and crying. My husband stayed home from work for two days to hold me. I had heart palpation's that I was sure was a heart attack. AFter two ER visits and visits to countless doctors I was declared fit as a fiddle! Being a Fitness Professional for 25 years has definitely been a contributing factor. So the imbalance of hormones is the cause. Bio-identical hormone treatment (look that up!) is the cure. In the meantime, till I get all that sorted out I turned to our local psychiatrist for pharmaceutical help to sleep. And not happily I may add. Terrified of side effects. I began with Zolof, BAD BAD BAD. Made the aniety and insomnia even worse. He switched me to Remeron. The first three night were like having been under anesthesia! I slept so deeply and so soundly. Woke up in a daze. Took all day to snap out of it. Thankfully that past. I haven't craved grains or sugar (carbs) at all for over a year. But after taking Remeron, I suddenly became ravenous. Looked it up and yup. Munchie! OMG. Thank G-d I have been low carb, other wise it would have been pig out city for me!!! I ate some protein with good healthy fat. Then went to bed. Now that I am fully aware of the metabolic changes going on, I am being even more vigilant in keep my diet very low carb. 50 grams a day. Part of me just wants off the drug. The thought of gaining weight is so unappealing. But I can't go back to that crazy gal of last week. Couldn't leave the house. Could not work. I am banking on LCHF to see me through until hormones get balanced and I can get weaned off the stuff. (Which, from what I read is NOT easy). I urge you all to learn about Low Carb eating. Tons of info on the internet. IT's solid science. You can manage your weight eating this way.
Unknown said…
Sorry didn't post my name.

it's Shelley!
Unknown said…
Look up LCHF.

Diet Doctor.com
Banting

Everything you need to know. It works!! I NEVER Crave sugar or carbs. That is until i began Remeron!! But I am very strict low catb. So i can ovecome the cravings by eating good fats and small amount of protein
Unknown said…
This comment has been removed by the author.
Unknown said…
This comment has been removed by the author.
Unknown said…
Hi Kate,
I noticed that, too. Depleting almost all carbs from my diet combined with weightlifting really let my muscles explode. I was surprised. Thanks to your post I now know why this is happening. And I tried so much different methods in the gym with no results for years. Regarding food: For example, I have 5 scrambled or fried eggs for breakfast and therefore no longings for any carbs till lunch time. Remeron helps me to get at least 3000 kcal in per day. I take 15mg and this has always been the most difficult dosage for me as my cravings for sweets were on its maximum. The higher the dosage the need for sugar decrased but 15 mg is all I can tolerate. I gained 40 lbs after all, but luckily my body fat is quite low, after I figured out how to handle the one and only real heavy side effect of Remeron. I used to be very slim so fat or muscles, either way is not very convincing, but muscles are much more acceptable. When you try to stay slim, it requires more discipline to manage. But when you can handle this side effect, it can really support you fixing your life.
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Unknown said…
I've just started taking this. Really don't want to put weight on so I will be following your advice! Definitely! Thank you! Beth
Unknown said…
I started this med yesterday . Are you still taking it? How's it going?
Stephanie said…
Beth Rawlins,

If you can get switched to something else that would work for you, I recommend that you do it right away. Despite all the exercise (avid rock climber and distance runner) and extremely healthy diet, it's hard to take off the weight. I am now down to 5mg and just want the drug out of my life. Spend time on PubMed and search on why Mirtazapine -- it affects leptin (consequently glucose) and TNF-alpha factors (I'm wondering now if that is contributing to my arthritis nodules that popped up this year). I put on 20lbs in 6 weeks when I started this and managed to get 8 off, but it's a struggle.

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Unknown said…
Hey! I just wanted to talk about my experience with Remeron.

So first of all this forum was SO helpful. I am a 24 year old female. I have only been taking Remeron for a few weeks but I adjusted my diet and I am excited to say that I haven't had any weight gain (which CAN be easy for me). In fact I have leaned out and lost fat!

So as recommended above I do a high fat low carb diet. Specifically I do a ketogenic diet, staying under 20g of carbs a day. I don't exercise like I used to, I used to lift weights 5+ times a week. Now it's yoga some mornings and skateboarding some days and I still have had great results.

I was originally supplementing 250MG of Magnesium, I upped that to 500 MG. Also 2 weeks before starting the Remeron I started using Fit Tea. I can't say that the fit tea helped me loose size, but it definitely helped control my appetite which is a problem,I've heard with Remeron (munchies).

Another thing that I started doing almost 6 months ago, was intermittent fasting. So for me I don't eat for 2 hours after I wake up no matter if that is 8 or 10 AM. The idea is to increase your "fasting state" before breakfast. So for me? I don't eat before 11AM (sometimes I wait until 2pm) and again Fit Tea helps with hunger. And then I try not to eat after 9PM. I am pretty lax about that last one though.

The beautiful thing about the ketogenic diet is, you eat until full and then because your diet is high in fat, more calorie dense, you'really generally not as hungry. And that has been my winning combination.

I hope this helps.
Unknown said…
i am taking remeron and love it! but i am gaining the weight... last time i went thru this i didnt know it was the drug but knew i was full of fluid! i started taking diurex over the counter and peed off 9 lbs in a day! plus eating healthier.. i couldnt stick to Adkins or sugar busters so i just didnt eat anything that really swells when wet. ex. bread white or brown, noodles, rice, taters, none of it. i still kept fruits with sugars and drank my coffee which raises your cortisol levels, and quit teas and sodas..drink water instead. i lost 40 pounds but it took about 3 months. before i knew it i just didnt like starches. i dont really know what happened after i had my babies i really started craving the extra junk... now i am going back on the diet and bout to get the diurex this weekend. hope you get your meds straight and hope i lose! lol
Stephanie said…
Thanks for the diurex tip! I wonder if people starting out took Metformin (or berberine -- a supplement shown to be as effective as Met) would prevent weight gain> There are a couple of studies showing that this works when people take an antipsychotic. Seems like it would work with Mirtazapine.

Have you had your vitamin levels checked? That might account for your junk food craving.
adi said…
Thanks for this post (apart from people selling diets, boo!
Mirtazapine (under various brand names here in Australia) has changed my life and helped me balance full-time work as a classroom teacher and co-parenting two rugrats without succumbing to the 'black dog'. I am a runner, recently did my first half marathon, and couldn't work out why my weight was going up and up, rather than down and down, same weight as when pregnant with #2 but okay with energy levels and stamina. Argh!.
Now super keen to chat with psych and also a nutritionist and *FINALLY* make a plan.

703 said…
Shame about the trolls who put adds on this site, but I am so glad I found it. I have had severe and chronic sleep disturbance since sustaining a relatively minor whiplash injury nearly 30 years ago. I have tried various sleep’remedies’ which have left me feeling worse than not sleeping. I have been sent to various psychologists and ‘sleep’ doctors (ear, nose and throat specialists), have had acupuncture and even tried hypnosis to relieve my sleep problem, all to no avail. Eighteen months ago my GP prescribed Mirtazipine. It has been magical. Although I still have problems maintaining sleep and have sleepless nights occasionally, the overall improvement is astounding. I started on a 7.5mg dose, but gradually increased it as my body became used to the drug and my sleeping gradually worsened. I now take 45mg per night and thankfully that dosage has sustained improved sleep for several months. I haven’t gained weight since starting on the medication,but recently, after a huge spike in my blood pressure levels, set out to loose weight as quickly as possible. I resumed the five-two intermittent fasting diet, which had been successful previously. With no weight loss after several weeks I extended the fasting time to two 44 hour periods each week, during which I have a meal replacement shake each day and a low calorie meal at night. Still I have no success. Worse still, on the main fast days (Monday and Thursday) I have extreme difficulty falling asleep at night, often going without any sleep, or doze lightly just before it’s time to get up the next day. I have now been prescribed Stillnox which I will take each Monday and Thursday, and continue with Mirtazipine on the other nights. I have also stated having small high protein snacks on diet days and for 48 hours after weight training. I hope overall my sleep will improve, and that I do lose some weight. My blood pressure, however, has returned to normal levels. Something has worked!
Stephanie said…
703, thanks for your comment. I'm fairly convinced that Mirtazapine lowers the metabolism, and is possible that it's causing the subclinical hypothyroidism I'm experiencing (though studies are saying otherwise). I've read it's the appetite, but that's under control. It's the leptin, but my levels were tested last week, and they're perfect. I was a competitive runner, so I've been thoroughly tested and my resting metabolic rate was under for someone my age, BMI, and activity level.

I want to offer suggestions that might help. I take L-theanine (with inositol) in the morning before eating. It seems to counter any anxiolytic effects from the coffee I drink. I've made sure my B and D3 levels are optimal, and I take ZMA at night. I'm down to 5mg of mirtazapine, and when needed, a small dose of ambien. I'm a big fan of Now Foods because they're high quality, if you want to use what I do. Would still like to lose that 10lbs that lingering and all the cardio, body weight, weight lifting, jumping isn't getting me there. =-(
Unknown said…
I have just come across this blog and can I just say- Thank you for everyone that has shared their experiences!
I have just been prescribed Mirtazapine so I am yet to fully experience side affects/ positives/ negatives. I have read a lot about weight gain- which I am very anxious about. I haven't exercised in a while- because of the anxiety and the whole 'get up and go' loss. But, I eat pretty well and if the meds work for depression- Im hoping it gives me the boost to want to work out.
Will definitely be checking back on this blog as its been super helpful and hopefully I can share my own positive experience over the next few weeks :)
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XXX said…
When I started this medication, I didn't even know about the weight gain side effect. I went into drug and alcohol rehab for a while and I gained a lot of weight, but I put this down to having to eat a normal diet, where as I always usually had a high protein and moderate to low carbohydrate diet. I didn't eat much and was surprised at how much weight I gained, so it was probably the Mirtazapine as well as quetiapine I was taking at crimes which is also well known known for causing weight gain.

I was quite disgusted with weight gain and when I left rehab, or more accurately got kicked out because I used drugs and ended up street homeless, I ended up using opiates. I was then prescribed buprenorphine to replace my opiate addiction and was housed in a hostel, and I lost a considerable amount of weight even though I was still on mirtazapine. This was definitely a side effect of the opioid medication I was on.

Soon I was getting too skinny so I then made a conscious effort to gain weight through weight training and a high protein diet, but to my surprise I put on quite a lot of fat as well as muscle, which shouldn't happen on this this kind of diet & exercise regime. For about a year I have been trying to trim down, and I go weight training 6 days a week and often cardio on top; while I haven't gained wait over the last year, I haven't lost a pound, which is really frustrating . I am not in bad shape, but I'm not comfortable even with being muscular + normal fat; if I'm going to have muscle I would like to be very lean with the low body fat percentage, because I don't like looking meaty.

I think I have useful tips. Eating a very high protein diet, at least 150g or one gram of protein for every pound of body weight per day, and if you crave something sweet or indulgent, there are some incredibly delicious gooey chocolate protein bars that use sugar alcohols and othersweeteners and have far more protein than carbohydrate.

To be quite honest this post talks of losing 4lb in a matter of days on a carbohydrate controlled diet. You would be very naive to think this was body fat loss. 4 pounds of body fat contains 14000 calories, or seven days worth of calories. It is very well known that low-carb or carb restricted diets, and also a high protein diets for different reasons, cause a lot of water loss in the first week or so. This is due to a loss of glycogen, and glycogen is stored carbohydrate; for every gram of stored carbohydrate there are two grams of water. The body on average contains 500 g of stored carbohydrates, which equates to 1.5 kg, or about 3.3lb, of glycogen. Protein also causes additional water loss because of the extra nitrogen excreted by the kidneys, so probably most if not all of the weight you have lost has been from water. You have not given an update on the weight loss has continued and I know that the truth will probably be that it stalled or perhaps even you gained.

I am of the view that a very high protein diet is superior to a low-carb high fat diet because high protein intake stimulates muscle protein synthesis independently of exercise, which means more lean body mass which has a much higher metabolic rate than fat mass full stop hi protein intake has been shown by countless studies to improve body composition by, i.e. to increase the ratio of lean body mass two fat mass, although it is unclear if this is the same when you are taking ramaron (mirtazapine).

I have never heard of Mirtazapine decreasing cortisol levels and actually cortisol is responsible for fat gain and a decrease of muscle mass. It is glucagon, not cortisol, that opposes the action of insulin. Cortisol can actually increase insulin levels because it frees up stored carbohydrates increasing blood sugar levels. I therefore find your science a bit spurious and I think you ought to cite credible research studies. Eplanations I have heard have tended to relate to the histamine/H1receptor activity.
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Essex said…
This comment has been removed by the author.
Essex said…
I've been taking remeron 15-30mg for sleep for 6 weeks. I've gained about 15lbs mostly in the middle - from 115, now 130 lbs and before that gained 10lb on restoril - my normal weight was 105-110lb.

I've never had this kind of weight problem. I feel very lethargic and craving carbs big time. Ive had to buy a whole new wardrobe after the rapid weight gain.

Needless to say I've thrown out those evil pills and back to square one.
Unknown said…
Hi I'm dealing with the same isseus. 8 years of remeron and gain 20 kilo's of weight.
I'm wondering whate these diëts are. Low carbin? So I don't eat it any more or do I need to eat les carbs? And how much vitimins and omega do i have to eat?
Terri McCann said…
I used Remeron low dose for insomnia after a bout of misfortunes. I have slept very well and have actually lost several pounds...here is what I did. I cut out added sugars. Exercised as usual but not too much....BY CUTTING THE SUGAR I KEEP THE INSULIN IN CONTROL. NO HYPO, NO WEIGHT GAIN. However, I can happily report I am weaning off with Drs. approval. Also: very important....I was incredibly thirsty...and I feel that perhaps this thirst could be mistaken for hunger...not sure, just throwing it out there.
Lori New York said…
Hey everyone. Omg yes the weight I have gained from being on mirtazipine is quite substantial. I'm 44 years old and am 5 ft 1 inch tall. I have struggled with severe depression, anxiety , OCD AND PTSD for many years. I've tired more antidepressants then I can recall. My weight fluctuates , depending on my mental state. When my depression and anxiety are at their worst I can't eat at all. At times going down to dangerously low weight levels. At one point hospitalized because my anxiety had become so severe I had no appetite and lost so much weight that I was down to about 85 pounds. I didn't want to be that skinny and unhealthy but I couldn't muster up the desire to eat. Eventually after being put back on Paxil and given Klonapin to take each day I was able to get better and gain some weight back .... at least enough to be healthy. My normal healthy weight is about 110 to 115. When a few years later my anxiety and depression became severe again I thought I was going to end up back in the hospital. I was having extreme anxiety every waking moment ..... it was and is a truly toterous feeling. A full nervous breakdown. I couldn't function. My doctor put me on mirtazipine and within days I was feeling amazingly so much better. It was a life saver ....... but now I have gained so much weight from it and it is very stressful and upsetting. In about 4 months since I been on it I have gained about 20 to 25 pounds. I don't recognize my own body. In 44 years I have never been overweight until now. My stomach is big and my clothing doesn't fit. I have tried to eat less which I have never had to do until now and nothing is working. Although my anxiety is better I feel pshyscally unhealthy and depressed about the weight gain. I'm not sure what to do or what the next step should be. I will be discussing it with my doctor during my next visit. I don't think I can continue with this medication if this is the side affect. Here's hoping for a solution. I certainly can't imagine handling another nervous breakdown but I also don't want to become diabetic or have heart and liver disease in a few years from too much fat. Ugh I'm exhausted and so tired of feeling like a defective person who can't just be mentally and physically healthy and content. Even if not happy for the love of god at least somewhat calm and functional. Sincelerly Lori in New York
Cyn said…
Happy to have found this thread.I have had severe insomnia for many years and took ambien for many until my Dr wanted me to be off it. It was difficult and we tried many other drugs and finally Remeron 7.5 mgs and 50 mgs of trazadone. Naturally like most of you I gained 12-15 lbs over the course of 5 months.I have now been on it for 11 months. I am 5ft 3 inches and went from 130 to 145. I tried to get off Remeron but but couldn't deal with the lack of sleep and tension headaches so relented and went back on it but started a low carb diet. I have been on low carbs for 5 months maybe 50 grams a day and have lost 15 lb. I am back to 130 lbs and I plan on staying low carb forever and to continue Remeron with trazadone. It has been a godsend for me. I am healthier now and my cholesterol and blood sugar are normal as well. I am 69 years old and try to walk several miles a day but don't always get to. After reading this thread I am here to report low carb does seem to work at overcoming weight gain from Remeron
Cyn said…
I didn't post my name above but I am Cynthia
said…
Glad this post is still getting replies!

A little background: I've previously been diagnosed with Bipolar II and have successfully been on Lamotrigine for a bit now. It's been fantastic in so many ways, especially with major depressive episodes. However, Lamotrigine doesn't help with anxiety nor the insomnia I've dealt with most of my life.

After talking to my head doc we decided to try adding Mirtazapine (7.5mg). We discussed the potential for weight gain, but I'm happy to have found a blog with suggestions to mitigate it. We also discussed that if this side effect is severe, the weight gain could create a body image problem that negates the positive impact of the drug. Self esteem is a particularly big factor in my struggle with Bipolar.

With that said, thank you for all the replies! I'm hopeful that starting Mirtazapine with a game plan for weight gain might make all the difference. As always, looking for silver linings in this fog. Cheers!
Unknown said…
Hello! I have been taking Remeron since August 2018 and ha e put on about 18 pounds that I can not get off!!! I am a vegetarian, so I already eat an low carb, high fiber and plant protein diet. Nothing I do seems to budge the flubber!!! I have tried everything. I’m convinced the Remeron has shut off my metabolism and that everything that goes into my mouth goes directly to my midsection and won’t budge. I’m planning on going off it tomorrow. I’m just too uncomfortable and non of my clothes fit!!! :-(
Lori New York said…
I have been on the Remeron for about 6 months now. I have gained about 20 pounds. Although it saved me from having another nervous breakdown it has caused me to have a body that I hardly recognize. As others have said I am trying to eat less and especially less carbs but my body seems to still be holding onto the weight. I’m only 5 feet 1 inch ..... 105 pounds before the Remeron. I now weigh about 125 pounds. Which wouldn’t be a problem maybe if I wasn’t so short and it didn’t all go to my stomach. Yuck. Clothing doesn’t fit but I don’t want to come off of it for fear of the extreme anxiety coming back which lead to my nervous breakdown a few years ago. It really does feel like my metabolism has slowed down SO MUCH. It’s crazy. I don’t have answers but I wanted to share since my experience is similar to so many others. You’re not alone and it is very frustrating.
Cyn said…
Cynthia Here.... hang in there with the low carb /keto. I think that Remeron or mirtazapine really increases your hunger all the time but if you eat low carb to satisfy the hunger you will lose weight and fat. I keep pecans and almonds and a few slices of cheese in my bag to eat when I feel starving I really like a big salad with cucumbers, almonds and chicken with bleu cheese dressing too. Just like someone said before I really do not miss starches or sugars and now I am staying at 128 lbs. Hope it works for you all.
Unknown said…

It says here that Remeron has no influence on blood sugar regulation?

https://www.ncbi.nlm.nih.gov/pubmed/16649829
"CONCLUSION:
The antidepressant therapy with mirtazapine was associated with a significant increase in body weight, body fat mass, and leptin concentration. In contrast to other psychotropic medications inducing weight gain, such as some second-generation antipsychotics, mirtazapine treatment did not influence the glucose homeostasis."

I was prescribed it today but I am so hesitant because of the weight gain, I am on a keto diet so that gives me hope but then the snippet I just posted has confused me, don't know what to do!
Trish Hill said…
Trish
Hi there, I just had to come back to this blog to thank everyone for posting about eating a low carb diet, while taking Mirtazapine.
I have GAD and PTSD. I successfully came off Citalopram over a 14 month taper. It was horrible. I managed three months off medication before having a massive relapse, which ended up putting me on a psych ward for a few days. The doctors wanted me on Mirtazapine and I was in no state to argue. It really helped me. Within three days I started to feel so much better. As soon as I came home I started to research Mirtazapine, and I came across this blog almost immediately, as I was looking for solutions to the weight gain side effects. I had gained four stone in weight when I was on Citalopram, and couldn't afford to gain a single pound more! When I was on Citalopram, I tried a low carb diet but it didn't work. However, I found this post and thought as I was on a different class of medication, perhaps I should at least try it. So I sent my husband off to the butcher's and hit low-carb HARD. I've been taking Mirtazapine now for three months. Started on 15mg, up to 30mg (that made me mean)so now back on 15mg. I am happy to replace that not only have I not gained any weight, I've lost two stone!!!!!
Over Christmas I didn't want to miss out on all the goodies, so on Xmas Eve, Xmas day and boxing Day I ate carbs. OMG, I ate and ate. I gained half a stone in three days. I was mortified. So, started back on the low carb and it's taken three weeks to loose that half a stone, and I've had to be ruthlessly strict. I supliment with quality minerals and vitamins. Drink loads of water, and take laxatives and/or enemas. It's very hard, and you have to be very strict. It seems that ANY carbs my body gets it clings onto and converts to fat while I'm on Mirtazapine. But if I don't eat any.......then it can't do that. I don't go to the gym, I don't have an eating disorder, I'm half way through the menopause, taking Mirtazapine, yet I'm still loosing weight. I have no cravings and feel as fit as a fiddle. That test at Xmas told me everything I needed to know. I hope it helps someone else out there.
It's not easy, you really can't cheat and have to do a lot of research into how to do this safely. Make sure you balance your electrolytes and mineral supplements. Make sure they are good quality and bio available. Have regular bloody tests and seek advice from professionals if your new to low carb eating.
But after all is said and done, it works. Simple as. So thank God I found this blog before my journey with Mirtazapine began.
Unknown said…
Lisa here.

Gosh, I am really feeling all of these responses. I've been on Mirtazapine since June, and I've gained 20 lbs (9 kilograms) since then. I've been a healthy eater, and very active (cycling, weight training, walking, hot yoga), but nothing seems to make any difference. In November, I even switched to a whole-food plant-based diet, and I've gained weight. Forks over Knives purports that such a diet that avoids oils and highly processed foods will stimulate weight loss without counting calories. I still counted calories. Each day for over 2 months, I had at least a 300 calorie deficit and still held onto the fat.

After reading this thread, I've gone through my regular diet and found that it's incredibly carb-heavy (sweet potatoes, lentils, black beans, chick peas, bananas, farro)-- basically my whole diet is a carb frenzy. So, this is low-carb idea is making sense to me. A low-carb diet that is also entirely plant-based is pretty tricky, so I'm going to have to try to work in some greek yogurt and eggs here and there. In addition to that, I started taking Glucomannan supplements about a week ago. It's a root extract that expands in your stomach, promoting the feeling of fullness, so you eat less. It really does work (when I remember to take it 20 minutes before I eat).

I just saw my doctor who also wants me doing intense cardio every day... yuck. But I'm desperate to get the weight off. I'm suddenly so uncomfortable in my own body; I have only 2 pairs of pants that fit, I can barely cross my legs anymore, and bending over makes me feel like I'm going to choke on my own body fat. It's awful. I got so fed up with the weight about a month ago, that I asked my psychiatrist to start tapering down. With her blessing, I tapered down for about 4 days before I called back frantically, saying it was a mistake. My mental health took such a nose dive that I had to decide: Fat or Dead. I chose Fat.

My new plan of action is to try this low-carb thing, but I feel like I need to also watch the fat too. So I can't go full Keto. I'm going to increase weight training because building muscle is supposed to boost metabolism, do at least a little cardio each day, keep taking my supplements, and drink Matcha tea. Good God... so much work just to get comfortable in my own skin.

I'll be back to report on my progress. Thank you all for contributing to this thread!
Trish Hill said…
Hiya Lisa

Yes, plant based low carb is going to be very difficult for you. If it helps at all, I don't count fat, fats don't seem to make any difference to my weight loss. It's only carbs that contribute to my weight gain (over Xmas). I also take very dark chocolate every day, two or three chunks. 85% Lindt, the benefits are amazing. Flavonoids and magnesium.
What I try to bear in mind is this: I'm staying very low carb to loose the weight. But once it's stabilized, I don't have to be as strict. Then I can stay in Mirtazapine. I've recently had my bloods done and my doctor was very surprised by how low my cholesterol was, compared to before. So the low carb option is having other good effects on my system. I do eat some green and red veggies, but 80% if my diet is fat and protein. I don't have any cravings at all. But any white carbs, rice, potatoes,bread,pasta......you get the picture, they can effect my weight overnight. Good luck, I think it can be managed, but it's very very difficult. I suggest that this time, I just got this will power from out of nowhere, determined to tackle the weight gain. Like a switch was flicked in my head and reality hit. Probably because of that, and the experience at Xmas, I'm finding it easier every week. My body also seems to have adjusted to the diet and I no longer have to take laxitives. But that's taken over three months. Sometimes I think, just a slice of toast, what's the harm? But then my scientific brain kicks in and I know the harm, so I just eat dark chocolate instead. I have no real idea as to Mirtazapine reacts to carbohydrates,it's just personal experience.
Hope you find a way to do it on a plant based diet. If you struggle, maybe fish could be a temporary option for you.
Best of luck
Trish XXX
Unknown said…
Thanks for your response, Trish! The support is actually tremendously helpful.

It's only been 3 days, and I'm already down 4 pounds, and I FEEL soooo good-- so much less fluffy and bloated. I'm definitely bending the rules on being fully plant-based, and I'm 100% okay with it. Greek yogurt, eggs, cream, and cheese are my friends right now :) I missed them. Fish and shrimp, too!

I'm finding this diet surprisingly non-restrictive. I'm not really counting calories or fats, but I'm getting all the things I love. Dark Chocolate, hell yes. Red wine, absolutely. This has been the first time I've seen any progress at all in 7 months, so I'm feeling SUPER motivated to stick to this diet. Like you said, I know the harm of piece of bread or some pasta, so I think I can easily look at them as total enemies rather than seductresses.

Thank you, again, and I will report back soon with more progress, I hope!

Cheers,
Lisa
Trish Hill said…
Well done Lisa!!!! Yes, all carbohydrates are the enemy when on Mirtazapine. Crazy thing is that I tried keto when I was on Citalopram, didn't work, at all. I think it's horses for courses.
Going to a 50th Birthday party on Saturday and I'm taking a Tupperware container loaded with cheese. I don't care, I really don't. A girls gotta do what a girls gotta do.
The more fat you eat the better. They say 1-4 protein to fat, but that's just nasty. I recon I'm about 2/3.
Best wishes
Trish
Cyn said…
Cyn here posting again after almost a year and yay I am still on mirtazapine and still low carb and hanging in there happily at 128 lbs.Its been almost 2 years for me and it is the only way to maintain my weight. I do feel hunger from mirtazapine but combat it with low carb eating. I eat bacon and eggs for breakfast, meat and cheese celery and cream cheese and lots of salads. I snack on nuts and cheese and costco low carb protein bars and I drink a diet coke every afternoon. It's a lifestyle for me now. I have been baking some with almond flour and like the results and I also bread chicken thighs with parmesan cheese and fry them. Like Trish my numbers from bloodwork for A1C and glucose and cholesterol and kidney functions are all good now too. It's simple no sugar and no starch. AT this point I am not trying to lose but just maintain and it is working. My advice is to stay low carb and don't worry about fat at all . The enemy is carbohydrates.
Screwylouey said…
Great post, and I’m very glad that I happened across it. I was on and off Mirt over the years, and each time I had to give it up when the weight gain got too much. It was really perfect for me in all other respects, especially not causing sexual dysfunction. For various reasons this is about the only anti-anxiety med I could (sort of) tolerate. I’m at a point where I really should go back on if only for a few months. I’m absolutely dreading the prospect of gaining massive weight. I just got done losing weight. Without Mirt, I easily maintain 5’11” and 180 lbs. With the Mirt, I struggle to keep it at 215. I know Mirt is more sedating at lower doses. A question I had that was whether Mirt also causes greater appetite at lower doses. I haven’t been able find a straight answer to that. What I’ve read seems to indicate that it does, but i can’t tell. Do any of you know?

Thanks
Unknown said…
Hi Screwylouey,

During my little stint in hospital because of PTSD, I had the chance to talk with a pharmacist at length about Mirt; She said that—as you alluded to— Mirt is a drug in which the side effects decrease at higher doses. My psychiatrist doubled my dose about a month ago, and I absolutely notice a difference in my appetite. I’m not constantly hungry and craving carbs. Better yet, I’m able to drop weight (albeit very slowly), I’m still sleeping well, and my mood is stable. No change in my mood at all from the lower dose. I had a metabolic test done, and I’m right where I should be, so keep in mind that while Mirt may affect your metabolism and cortisol-insulin relationship, the weight gain is primarily from eating too much :/

Hope this helps, and best of luck!

Lisa
Screwylouey said…
Thanks, Lisa. Would you mind me asking which dose you are on?
Unknown said…
Sure. Keeping in mind I'm a 5'5" female, I started at 15mg when I was 140 lbs, gained 25 lbs, then I've been on 30mg for a month or so.
Unknown said…
Thanks to all for your input. I'm about to start 15mg for PTSD anger / irritability.

Can anyone else comment on appetite decreasing when your dose was increased?

Thanks again - Buck
Has anyone else found that the side effects decrease with higher doses? I have been trying to cut back (from 15 mg to 7.5 and now half of a 7.5 tab.)

I’m also not sure if anyone has mentioned the fact that insomnia in of itself can be linked to weight and other health issues. So for me, there is that added stressor of going off of the mIrt.

J
Unknown said…
Jodie, I just recently cut back from 30mg to 15mg before stopping completely. I didn’t find that the side effects (mostly hunger and weight gain) changed at all with a lower dose.

As for your anxiety over the insomnia, I get it. My psychiatrist advised me to replace my usual dose of mirt with Benadryl. It helped a bit, but I still had trouble falling asleep and staying asleep, so I put 5mg of melatonin on top of that. I’m not sure if that’s advisable, but it helped a lot. I’m also very sensitive to melatonin.

In all, I was still able to sleep; it was just restless sleep for about a week, and it got better as the week went on. Then I was back to normal with the occasional brief wake-up.

I’d also like to add that I lost 15lbs in a month and a half after getting off. Hell yeah.

Hope this helps!!
Unknown said…
Oops, and my hunger also was MINIMALLY decreased for a short period of time when I went from 15mg to 30mg. I was anticipating a change in appetite, so it could’ve been placebo at work. As discussed earlier in this thread, it was the cutting carbs and watching caloric intake that helps while taking mirt. I will add that I did the Whole30 which REALLY helped with my sugar cravings and weight gain. It’s a tough diet— not for the faint of heart. But it’s pretty amazing. -Lisa
Cyn said…
Cyn here
I am still low carb and keeping my weight at 128. FYI I am 5 ft 3 and take 7.5 mgs of mirtazapine for insomnia. I have not seen the side effects decrease with time. I am 71 years old. I take it with a trazadone and still wake up frequently but it works for me and don't intend to ever stop. I still think mirt increases hunger but I have figured it out with low carb eating . I am pretty active trying to walk 2 miles a day and hiking whenever I can but not in pouring rain
I haven't changed my dosage for 3 years.
Trish Hill said…
Hi Again
Trish here with an update a year on. Since posting last year I can reliably report the following:
Exercise is healthy but doesn't help weightloss on Mirtazapine.....at all.
ANY carbohydrates go straight onto your belly, and they take weeks to get rid of again, so not worth it!
Fat, protein, kefir,yoghurt,dark chocolate,nuts,eggs,mayo,cheese, fish and decaf....CAN keep a human alive and healthy (me).
Watch your sodium, potassium and magnesium as you won't be getting any from veg anymore. I have two Epson salt baths a week (magnesium sulfate X3 cups 30-40 mins), potassium in the dark chocolate and use a quality salt for sodium. Happy to report that still managed to maintain healthy weight and still on Mirtazapine.
But!!!! Every single time I give in to carbs, I PILE it on and it's more trouble than its worth to get rid of it again.
How does low carb work fighting weight gain on Mirtazapine?? I have zero effing clue, ziltch, nada,niente. But it just does 😃.
Is it easy existing without carbs? No, it's bloody awfully hard. But is it worth it? Depends on you. For me, it's given me my life back. So on a sliding scale, no carbs is doable. Mind me though, no carbs means exactly that. This is some strange wierdness going down, it's chemistry, you can't cheat. Good luck everyone. Keep strong. It CAN be done.
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