Weight gain mirtazapine

Mirtazapine s most common adverse effects are somnolence, weight gain, dry mouth, and constipation. 

Antidepressants. There are numerous reasons to expect that antidepressants may be helpful in the treatment of AN. First, depressed mood and other symptoms of depression such as anhedonia, decreased energy, poor concentration, and psychomotor retardation are common in cases of starvation from any cause. Second, AN patients and their family members have high rates of comorbid MDD and OCD, illnesses best treated with antidepressant medications. Finally, weight gain is a well-documented side effect of many antidepressants including the tricyclic antidepressants (TCAs) and mirtazapine. 

Somnolence Somnolence was reported in 54% of patients treated with mirtazapine. Dizziness Dizziness was reported in 7% of patients treated with mirtazapine. Increased appetiteAA/eight gain Appetite increase was reported in 17% of patients treated with mirtazapine. In some trials, weight gain of 7% or more of body weight occurred in 7.5% of patients treated. 

Mirtazapine has been found to have synergistic depressant effects on motor and cognitive performance when used in conjunction with benzodiazepines or alcohol (Kuitunen, 1994). Somnolence and increased appetite accompanied by weight gain are common adverse effects. Lower doses are clearly associated with more sedative effects than those with higher doses. It is unclear if a similar pattern is noted for appetite and weight gain. 

Mirtazapine has been shown to reduce anxiety symptoms and sleep disturbances associated with depression, as early as 1 week after the start of treatment. Other advantages are minimal sexual dysfunction, minimal nausea, and once-daily dosing. In addition, mirtazapine is unlikely to be associated with cytochrome P450-mediated drug interactions. The disadvantages of mirtazapine are weight gain and prominent early sedation. 

As noted previously, sexual dysfunction and nausea are not commonly associated with mirtazapine treatment. The most common side effects are sedation, weight gain, and dizziness. 

The weight gain associated with mirtazapine use may be partially caused by increased appetite. A mean increase of 3.7 kg over the first 28 weeks of treatment has been reported in several controlled... 

Mirtazapine Somnolence, dry mouth, increased appetite, constipation, weight gain, dizziness... 

Maprotiline (bupropion) NET > SERT inhibition (amoxapine, maprotiline) t increased release of norepinephrine, 5-HT (mirtazapine) but no effect on 5-HT (bupropion) amoxapine and maprotiline resemble TCAs (mirtazapine) amoxapine and maprotiline rarely used bupropion) sedation and weight gain (mirtazepine) Interactions CYP2D6 inhibitor (bupropion)... 

FIGURE 7—12. When mirtazapine blocks histamine 1 receptors, it can cause anxiolytic actions, but also sedation and weight gain as side effects. 

Mirtazapine is an antidepressant that increases both serotonin and noradrenaline by blockade of central a2 auto- and heteroreceptors mirtazapine also blocks 5-HT2 and 5-HT3 serotonin receptor subtypes, and that former property may induce slow-wave sleep. Systemic administration of mirtazapine has been shown to increase genioglossus muscle activity in anesthetized rats in a dose-dependent manner [55]. In a randomized, double-blind, cross-over trial of ten patients with OSA, mirtazapine at a dose of 15 mg reduced the AHI by 50 %, and the arousal index by some 29 % [56], Side-effects with use of mirtazapine include somnolence and hyperphagia/weight gain. 

Both mianserin and mirtazapine are antidepressant drugs which possess central 0C2 adrenoceptor blocking properties (pA2 7.3). However, mirtazapine is much more potent at histamine Hi receptors (pA2 9.1) and at 5-HT2 and 5-HT3 receptors (pA2 8.2). Blocking of Hi receptors explains the main side effects of mirtazapine, which produces marked sedation and weight gain. Blockade of presynaptic inhibitory 0C2 autoreceptors increases the release of NA, while blockade of presynaptic 0C2 inhibitory heteroreceptors on serotonin nerve terminals (Table 2) is likely to increase the release of serotonin. 

Trimipramine is a sedating tricyclic antidepressant that has been used as a hypnotic (1) it shares this activity with other drugs of its class, notably amitriptyline, dosulepin, doxepin, and trazodone, and with the tetracyclics mianserin and mirtazapine. Trimipramine may be preferred for this purpose, since it has less effect on sleep architecture, including REM sleep (2), and has only a modest propensity to produce rebound insomnia in a subset of patients (3). Sedative antidepressants may be particularly appropriate for individuals at risk of benzodiazepine abuse and patients with chronic pain (4). The usual pattern of tricyclic adverse effects, especially antimuscarinic and hypotensive effects and weight gain, can be expected. Some authors, enthusiastic about GABA enhancers, contend that antidepressants are not useful hypnotic alternatives (5). 

In placebo-controlled trials the most common adverse effects of mirtazapine were dry mouth (25%), drowsiness (23%), increased appetite (11%), and weight gain (10%) (SEDA 21,13). 

Since some antidepressants such as mirtazapine can be associated with significant weight gain, before starting treatment, weigh all patients and determine If the patient Is already overweight (BMI>25.0-29.9) or obese (BMI>30)... 

SSRIs, venlafaxine, bupropion, phentermine, or stimulants may mitigate mirtazapine-induced weight gain... 

Weight gain as a result of mirtazapine treatment is more likely in women than in men, and before menopause rather than after... 

Allison, D. B. and D. E. Casey (2001). Antipsychotic-induced weight gain a review of the literature. J Clin Psychiatry 62(Suppl 7) 22-31. Anttila, S. A. and E. V. Leinonen (2001). A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev 7(3) 249-64. Baptista, T., N. M. Kin, S. Beaulieu and E. A. de Baptista (2002). Obesity and related metabolic abnormalities during antipsychotic drug administration mechanisms, management and research perspectives. Pharmacopsychiatry. 35(6) 205-19. 

Due to the blockade of 5HT3 receptors in the chemotrigger zone of the medulla, this drug does not produce the nausea associated with other serotonergic drugs. Mirtazapine does cause sedation and weight gain. 

Mirtazapine OL antagonist, associated with weight gain... 

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