mynameiswatson Posted February 27, 2014 Share Posted February 27, 2014 I recently started taking Remeron on January 3rd, as an add-on with Effexor XR. I have taken this combination in the past with great success, but ended up going off both of them for unrelated reasons. As I started up Remeron again, I started with 7.5 MG (my previous dose) and went up to 15 MG after about a week, then 22.5 MG about a week after that. At that point, I felt that it was really helping my depression and anxiety and was very happy with it- except for the fact that I gained 30 lbs in 4 weeks. I am loathe to go off of it because its the only add-on medication I've found helpful, and I've already tried so many I'm running out of options. At the same time, the weight gain is significant and I'm quite uncomfortable physically from the added weight, not to mention whatever health impacts the additional weight has. I have dealt with Remeron-induced weight gain before through very strict calorie counting, but I just don't know if I have it in me to do that again. Maybe its the depression talking, but I just feel like setting such strict parameters around my eating is going to set me up to fail and then I'll get in a cycle of diet failure and self loathing. Regardless, the other idea I brought to my psychiatrist was that maybe at a higher dose of Remeron weight gain would not be such a huge problem. I have had trouble finding any solid evidence of this, though, and was basing my theory on having read that at higher doses the noradrenergic action predominates and thus people experience less sedation. My hope is that this extends to weight gain as well (that its less at higher doses) but like I said, I haven't found any evidence of it. My pdoc doesn't know the answer, although she confirmed that people experience less sedation at higher doses, so we decided to give it a try. I'm at 30 MG now and will be going up to 45 MG tonight. I have to say, since I increased from 22.5 MG to 30 MG i have been feeling worse. I have had headaches, which is already a problem as I get chronic migraines. I haven't been sleeping as well and my mood has been lower. I'm hoping some of this is transient, but regardless, I'm not sure if its even worth it to keep going up. Has anyone had the experience where they found that weight gain wasn't a problem at a higher dose of Remeron? Specifically, are there any of you that started taking it, gained weight, increased your doze to 30 mg or 45 mg and found that weight gain was no longer a problem? And a question for those who have weight gain from any antidepressant- just generally, how did you deal with it? Strict dieting? Accept the weight gain as a trade off for not being depressed? A part of me just wants to say to hell with it, buy some pants with elastic waistbands and be fat and happy. But mostly I just want to not be depressed without gaining a crap ton of weight. Link to comment Share on other sites More sharing options...
jt07 Posted February 28, 2014 Share Posted February 28, 2014 I take 45 mg of Remeron every day. Honestly, I have not found that the Remeron hunger goes away or even eases up with increasing dose. It's still the same struggle at 45 mg as it was at 15. As far as how I deal with the weight gain, I do accept it to a certain extent as part of my depression or as part of my treatment. The only way I know to get rid of it is diet and exercise. Link to comment Share on other sites More sharing options...
shesellsseashells Posted February 28, 2014 Share Posted February 28, 2014 I can relate to what you described about the med weight gain. I experience a fair amount of weight fluctuation. I completely understand where you're coming from as far as not wanting to subject yourself to strict calorie counting. I'm not in a great place weight-wise, but I have recently decided rather than going on another restrictive rampage I would try to accept myself for how I am right now. This doesn't have to be me forever, it is just how I am right now. I'm working on mindful eating and bought a pedometer to increase my activity level because I tend towards the very sedentary when I'm depressed. It seems like you have a lot going on with your med adjustments: perhaps it would be kind to give yourself a break on the weight gain front, let your body get used to the meds, and see if your weight returns to its set point once things are on a more even keel? I know that can be really hard. Just a thought though, and I wish you well. Link to comment Share on other sites More sharing options...
taurmaurils Posted March 13, 2014 Share Posted March 13, 2014 I agree - I haven't seen any decrease in craving or gain with increased dosage. Probably more. That and the RLS that make it impossible to get to sleep every night are two of the reasons I badly want off Remeron. Link to comment Share on other sites More sharing options...
AugmentedReality Posted March 22, 2014 Share Posted March 22, 2014 (edited) My best advice as an athlete and fitness coach is to start controlling your diet and exercising if you are in a state to do so. I started my Mirtazapine over a year before to improve my sleep with mild dosages around 7.5mg/d following a three month break when I realized that I need to jump on the antidepressant train to control my depression which has lasted for over a decade. I started increasing the mirt gradually from 15 to even 45mg/d but did`nt find any remission so I "negotiated" Effexor augmentation and it was started around 37.5mg/d. I have had to increase my dose to 225 over the last three months and finally find myself being the most stable, confident and relaxed I`ve ever been in my life, I`m also ADD but have steered clear from stimulants a year ago. Currently I`m taking 225mg/d effexor and 45mg/d mirt which is the highest I could go with mirt. I enjoy the most relaxed and best quality sleep in my lifetime due to the mirt increasing my REM sleep and everything seems to work fine, I have experienced RLS a few times and tried lowering my mirt dose to 30mg/d resulting in waking in to a panic attack so I`m gonna keep things like this in the future. I did experience some additional water retention and increased my weight for about 5kg starting from the lowest dose of mirt. Effexor itself suppresses my appetite a bit but I`m constantly on a controlled diet and currently have been cutting fat for the last two or three months and I`ve lost all the waterweight and the moonface I gained on eating more and consuming mirt. It`s apparent that Mirt does cause binge eating for some people and I`ve heard people eating cake in the middle of the night but it can all be avoided by will power and a scheduled diet. Decrease your sodium intake, drink a LOT of water, 3-5 liters a day (which goes for every person in the world) and avoid processed foods, especially fast carbs and fats are harmful for your weight gain, all the french fries and chips go straight to your face and belly especially while on mirt. Consume mainly lean meat, chicken and fish with whole wheat pasta or rice accompanied by green veggies, broccoli, cauliflower.etc and take more calories from protein sources. Good luck, it can all be avoided or minimized, a good medication can also give you a boost on your will power and motivation to take care of yourself in all the possible ways Edited March 22, 2014 by AugmentedReality Link to comment Share on other sites More sharing options...
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