Mirtazepine

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BeccaColliesBurton
BeccaColliesBurton Posts: 79 Member
in Health and Weight Loss
Is anyone else on this anti depressant? Would maybe be helpful to swap notes, have some support. I just started four days ago. Thanks x

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  • Keto_Vampire
    Keto_Vampire Posts: 1,670 Member
    edited October 2018
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    Mechanism of action is dose dependent...generally sedating dosed 7.5mg-30mg/night. Higher doses can cause paradoxical insomnia due to norepinephrine release (from alpha-2 antagonism) outweighing histamine-1 antagonism & 5-serotonin-2C antagonism due to receptor affinity changes with higher doses (90+% of time dosed in 7.5-30mg range from prescribers). Higher doses generally used in PTSD (45-60mg/day)

    Lower dose range can have some weight gain but this drug does not have significant anticholinergic effects (dry mouth, mydriasis, drying of secretions/sweat, urinary retention, cognitive deficit, etc.) unlike tricyclic antidepressants used adjunctively for insomnia. 5-serotonin-2 antagonism generally gives a sense of well being & better mood (indirectly boosts dopamine & serotonin). Generally not considered to significantly affect libido unlike typical SSRIs.

    Give it some time (weeks) before making any judgments & follow up with MD of course. Mirtazapine is generally a good add on for those with melancholy & parkinson's disease and various other comorbidities associated with malnourishment/undereating & insomnia as symptoms

    Has quite a bit of overlap with trazodone (of course they are not the same though due to different binding affinities & dose range responses)
  • singingflutelady
    singingflutelady Posts: 8,736 Member
    edited October 2018
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    I was on it for a few months because of gastroparesis (no appetite and nausea in particular) and it made me super hungry. I am a recovered anorexic binge/purge subtype so have a history of binging and the extreme hunger it caused resulted in a lot of binging so I had to go off of it. I did gain some weight (I was underweight and barely ate) when on it but I lost it quickly after I stopped it but I blame the (needed) weight gain on the binging.
  • Anya_000
    Anya_000 Posts: 725 Member
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    Always consult with your MD before making changes. We use this drug in frequently in the elderly to increase appetite, help with mild depression, and insomnia.
  • kshama2001
    kshama2001 Posts: 27,950 Member
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    Anya_000 wrote: »
    Always consult with your MD before making changes. We use this drug in frequently in the elderly to increase appetite, help with mild depression, and insomnia.

    Huh, sounds perfect for my 80 yo mom, who struggles with insomnia and to stay above Underweight.
  • mbaker566
    mbaker566 Posts: 11,233 Member
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    i don't think super hungry covers how hungry it made me. eater of worlds covers it about right
  • singingflutelady
    singingflutelady Posts: 8,736 Member
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    mbaker566 wrote: »
    i don't think super hungry covers how hungry it made me. eater of worlds covers it about right

    Oh I could not get enough bread and butter. Binging is very bad with delayed gastric emptying.
  • MissDevin
    MissDevin Posts: 608 Member
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    my pain management doctor put me on this for abdominal nerve entrapment. i also suffer from gastroparesis and other gastro issues. i also take topamax...so i have the feelings of hunger, then the feelings of not wanting to eat anything.
  • BeccaColliesBurton
    BeccaColliesBurton Posts: 79 Member
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    Wow, thank you everyone for your replies. I amgoing to have to be so super controlled. I think they will be leaving me on15mg as its and adjunct with Venlofaxine 75mg. Iwas having terrible insomnia.
    Now unpleasant dreams but I can cope better with that than no sleep. I feel rather like a big blob at the moment as it is as for some stupid reason i seemed to need to hit the worst weight before i could give myself a kickup *kitten*. Silly but hey.

    Interesting range of uses it has.

    Thanks again to you all. Much appreciated
  • Keto_Vampire
    Keto_Vampire Posts: 1,670 Member
    edited October 2018
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    Venlafaxine is pretty notorious for GI upset, nausea, cramping (supurlatives amongst the SSRI's from STAR*D trials)...pretty smart thinking on the prescriber's part for using mirtazapine as a complement because many do lose appetite on venlafaxine (at least initially until tolerance develops).

    Now, venlafaxine also has a dose dependent mechanism of action...(I'll keep my chemist/drug dealer thoughts to myself unless you ask...)

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