# Best ways to counteract Remeron bloating weight gain



## Iwillovercomeanxiety1 (Aug 23, 2010)

What are some options to prevent weight gain/bloating from Remeron? I diet and exercise very strictly but still get bloated. Are there weight loss drugs that are good and can reduce this?


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## SFC01 (Feb 10, 2016)

why dont you count every calorie ? Its very easy to assume you are on a diet but can forget the type and amounts of snacks you have when you are on a med that causes weight gain and hunger. 

Do you eat after 6PM ?


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## Iwillovercomeanxiety1 (Aug 23, 2010)

SFC01 said:


> why dont you count every calorie ? Its very easy to assume you are on a diet but can forget the type and amounts of snacks you have when you are on a med that causes weight gain and hunger.
> 
> Do you eat after 6PM ?


. I have been greatly limiting calories. I still get bloated like I'm pregnant. I'm trying to figure out if there is any 5HT2a antagonist like Remeron that I can substitute it for? Maybe they won't have as much weight gain


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## SFC01 (Feb 10, 2016)

Plenty of 5HT2 anatgonists out there, maybe @Gillman fan or @watertouch can step in with some examples ?

From my experience though, I would say most wont have the same intensity of hunger / weight gain as you get from mirtazapine.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

SFC01 said:


> Plenty of 5HT2 anatgonists out there, maybe @Gillman fan or @watertouch can step in with some examples ?
> 
> From my experience though, I would say most wont have the same intensity of hunger / weight gain as you get from mirtazapine.


 Yeah I'd really like to know better options that can substitute for Remeron. I know Seroquel could be an option but I'm wondering how safe it is and if it's less likely to cause weight gain. Remeron causes weight gain instantly at lowest dose.


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## SFC01 (Feb 10, 2016)

Quetipiane is safe - I used to take 25/50mg - and although the appetite does increase it does fade away as you get used to it after a few days and its nowhere near as bad as remeron, from my experience.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

SFC01 said:


> Quetipiane is safe - I used to take 25/50mg - and although the appetite does increase it does fade away as you get used to it after a few days and its nowhere near as bad as remeron, from my experience.


Yeah I can handle increased appetite, as long as it doesn't screw with your metabolism. With Remeron I'm not eating more, it just screws with my metabolism and makes me gain weight. How was Seroquel for your anxiety?


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## kageri (Oct 2, 2014)

Seroquel is just as likely to cause weight gain with an equal or higher side effect risk and some potential for worse side effects. However, everyone responds differently to each med so if one doesn't work try another. Having been on all those meds and some of them all at once there isn't really a way to stop weight gain if they are going to cause it. I'd have to cut calories to under 1000 a day with exercise and be starving all the time to cause weight loss. Put yourself on a bunch of sedating antidepressants and unless you get lucky and don't respond strongly to the weight gain side effects you could be anorexic and still at least maintain weight. Sometimes if you wait it out things will stabilize when your body gets used to the med, of course that may then mean the good effects reduce too and you just end up raising it, or you might respond differently to another med despite it equally having odds of weight gain overall in people but if it does happen there isn't really a solution. You can run yourself into the ground and those meds can just end up making your body wear itself out and tear itself up rather than burn fat. Eventually I'd reach the point my muscles were not recovering, my blood sugar was plummeting (I got an ambulance ride to the ER one day), and I'd been so hungry for days that I couldn't force myself to go on and for all that I might manage to impact my weight by 10lbs out of the 130lbs I gained over a couple years. Don't end up there because often it's not a battle that can be won. If you have consistent weight gain symptoms and not just a temporary effect a little exercise and calorie counting isn't going to get you anywhere but miserably laying there too sore and hungry to move. You are better off finding something else to try taking.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

kageri said:


> Seroquel is just as likely to cause weight gain with an equal or higher side effect risk and some potential for worse side effects. However, everyone responds differently to each med so if one doesn't work try another. Having been on all those meds and some of them all at once there isn't really a way to stop weight gain if they are going to cause it. I'd have to cut calories to under 1000 a day with exercise and be starving all the time to cause weight loss. Put yourself on a bunch of sedating antidepressants and unless you get lucky and don't respond strongly to the weight gain side effects you could be anorexic and still at least maintain weight. Sometimes if you wait it out things will stabilize when your body gets used to the med, of course that may then mean the good effects reduce too and you just end up raising it, or you might respond differently to another med despite it equally having odds of weight gain overall in people but if it does happen there isn't really a solution. You can run yourself into the ground and those meds can just end up making your body wear itself out and tear itself up rather than burn fat. Eventually I'd reach the point my muscles were not recovering, my blood sugar was plummeting (I got an ambulance ride to the ER one day), and I'd been so hungry for days that I couldn't force myself to go on and for all that I might manage to impact my weight by 10lbs out of the 130lbs I gained over a couple years. Don't end up there because often it's not a battle that can be won. If you have consistent weight gain symptoms and not just a temporary effect a little exercise and calorie counting isn't going to get you anywhere but miserably laying there too sore and hungry to move. You are better off finding something else to try taking.


I mean what do you though if you need a calming med that'll help you sleep but not cause weight gain? Are there any med options or are you just ****ed?


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## watertouch (Nov 4, 2013)

From Stahl's prescribersguide on mirtazapine
http://stahlonline.cambridge.org/pr...rapeutics&name=Mirtazapine&title=Therapeutics
*
How Drug Causes Side Effects*
• Most side effects are immediate but often
go away with time
✽ Histamine 1 receptor antagonism may
explain sedative effects
✽ Histamine 1 receptor antagonism plus
5HT2C antagonism may explain some
aspects of weight gain

*Potential Disadvantages*
• Patients particularly concerned about
gaining weight
• Patients with low energy

*PEARLS*
• SSRIs, venlafaxine, bupropion,
phentermine, or stimulants may mitigate
mirtazapine-induced weight gain
• If weight gain has not occurred by week 6
of treatment, it is less likely for there to be
significant weight gain
¨• Weight gain as a result of mirtazapine
treatment is more likely in women than in
men, and before menopause rather than
after


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## watertouch (Nov 4, 2013)

Dr R. Mariano www.definitivemind.com on Mirtazapine:

REMERON (MIRTAZAPINE):

Mirtazapine does the following:

Blocks presynaptic alpha-2 adrenergic receptors, resulting in an increase in norepinephrine signaling. Presynaptic alpha-2 receptors on serotonin neurons also inhibit serotonin signaling. Blocking such alpha-2 receptors results in an increase in serotonin signaling.
Blocks serotonin 2 (a) receptors, which may result in increased dopamine signaling in the frontal cortex.
Blocks serotonin 3 receptors (helps reduce nausea).
Blocks histamine 1 receptors, which may cause sedation, increased appetite.
Blocks alpha-1 adrenergic receptors (mild - may reduce blood pressure).
Blocks acetylcholine muscarinic receptors (mild) - may cause dry mouth, blurred vision, constipation, forgetfulness. This may also increase dopamine signaling

.

The overall indirect increase in dopamine signaling helps support libido.

Weight gain can be significant. The lower the dose (down to 15 mg a day), the larger the weight gain and the more sedation one gets. Past 30 mg a day, weight gain is reduced since the increase in norepinephrine signaling that results helps outweigh the block in histamine, thus reducing the increase in appetite.

As an antidepressant, it tends to be milder than the serotonin-reuptake inhibitors or the serotonin-norepinephrine reuptake inhibitors. The overall effect on signaling systems is relatively mild except for its block of histamine receptors. It generally is not adequately effective for reducing anxiety.

Most psychiatric medications increase appetite. This is a problem in the long run, once people improve in function.

The antidepressants - by and large - increase appetite. Remeron is useful in this regard. I often use it when using stimulants to treat attention deficit/hyperactivity disorder since the stimulants reduce appetite and risk impaired growth. The tricyclics, such as Amitriptyline, stimulate appetite significantly. The serotonin-reuptake inhibitors gradually increase appetite and weight.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

watertouch said:


> Dr R. Mariano www.definitivemind.com on Mirtazapine:
> 
> REMERON (MIRTAZAPINE):
> 
> ...


Good information. Do you know what would be a good substitute for Remeron? I need something with similar action (5HT2A antagonist) that might not cause as much weight gain? Also Trazodone didn't work for me. It made me agitated maybe because of the Serotonin reuptake inhibition


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## Captainmycaptain (Sep 23, 2012)

Here's one way to stop the weight gain from Remeron: get off Remeron. There are much better sleep medicines that don't cause weight gain.


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## UltraShy (Nov 8, 2003)

DRUGSAREnotGOOD said:


> Here's one way to stop the weight gain from Remeron: get off Remeron.


That's exactly what I was thinking.

When my elderly mother was alive, her MD gave her Remeron to deal with complaints of insomnia & lack of appetite. He prescribed the drug to make her sleep & gain weight!


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## Gillman fan (Sep 24, 2016)

Try low-dose Risperdal.
Noritryptiline is also quite mild as far as the antihistamine action... I may have gone from 260 lbs to 270 as a result of Nort but it is hard to isolate the causal effect.


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## UKguy (Sep 30, 2013)

Gillman fan said:


> Try low-dose Risperdal.
> Noritryptiline is also quite mild as far as the antihistamine action... I may have gone from 260 lbs to 270 as a result of Nort but it is hard to isolate the causal effect.


I definitely gained weight on the two tricyclics I tried. Not much but enough to be noticeable.

Weight gain seems to be one of those issues that doctors dismiss, I guess because there is such a stigma around obesity anyway. It seems like their answer is always 'diet and exercise', but if they were really following evidence based medicine they would never prescribe that approach because it fails (in the long run) for the majority of people... And the chances of being able to drop weight whilst taking a drug that increases appetite and slows the metabolism is virtually zero.

So as others have said the OP should consider getting off Remeron.


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## SSRIManiac (Jun 14, 2014)

Wellbutrin with Topamax is a good combo strategy. Especially since they're not controlled. 

Or if you can get a stimulant get low dose Adderall or Vyvanse.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

SSRIManiac said:


> Wellbutrin with Topamax is a good combo strategy. Especially since they're not controlled.
> 
> Or if you can get a stimulant get low dose Adderall or Vyvanse.


This is something I may consider. Does Topomax treat anxiety/depression too?


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## Elad (Dec 6, 2009)

If I had those issues with a drug I would probably consider taking T3 tbh. Basically sending thyroid into overdrive to cut off water retention and increase caloric expenditure. 

But this is terrible advice unless you don't care about playing with your thyroid &#55357;&#56842;. So don't do this unless you already know what t3 is.


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## SSRIManiac (Jun 14, 2014)

Iwillovercomeanxiety1 said:


> This is something I may consider. Does Topomax treat anxiety/depression too?


I don't think so, it's just approved for headaches. There were some trials in psychiatry for mood stabilization in bipolar but nothing significant..

It's also approved for weight loss in conjunction with Phentermine.


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