PDA

View Full Version : zispin and weight gain



Rachel_123
01-06-09, 13:41
hi :)
i have been on zispin since february. the medication seems to work really well (the number of panic attacks i get has dramatically reduced since) but i have gained about a stone in weight. the thing is, its only around my stomach area, and im concerned that this will affect my heart. Ive started to eat more healthily, mainly cutting the excess carbs and chocolate that i love so much. I'm also starting yoga in 3 weeks after my exams. Has anyone else noticed this side affect and have it been positive or negative for you?

insecureme
14-09-09, 10:20
hello there

yes I've had the weight gain, again mostly around the waist, where I actually gained quite a lot. I got to a point where I was feeling better and could exercise and eat healthily and was able to lose quite a bit of it.

Thing is, I've had a relapse in my anxiety to the extent that I can't go out and exercise much any more..... but when I start to feel better again I will definitely be out there on my bike and walking.

good luck!

S.J.
17-10-09, 23:42
Hi,

Sadly I know exactly where your coming from. I was on Mirtazipine for about 18 months and I put on 4 stone!! I had no idea that it was a common side effect to gain weight with this med. I'm told that it contains an agent that stops you from feeling full therefore you end up eating more. It was a big deal for me as I was a size 18 in clothes already and so I changed my meds, which has been a disaster in itself... Hope that gives you a bit more insight... Take care, Sue

Mister
30-11-09, 22:26
It's hard to know for sure whether any drug can directly cause weight gain without increased consumption of food. But, like S.J. I know where you're coming from.

I try to eat my evening meal (tea :)) about 9 PM, roughly an hour after taking 30mg, as I know, no matter what has been eaten beforehand I'll still feel hungry. Maybe eating this late isn't good for the body but it redcuces the calorie intake and subsequent weight gain. In theory...?!

The weight still keeps piling on but I don't care too much. As long as I feel better mentally, the forthcoming challenge of shedding the excess poundage seems a lot easier.

ElizabethJane
01-12-09, 00:11
I am taking mirtazapine 30mg. I have been on it this time for about two months. Prior to that I was taking it for about a year and a half. In that time my depression improved and I ballooned to thirteen and a half stone. I slimmed down earlier this year and lost a stone and a half with the help of weight watchers.I had previously lost half a stone owing to illness. I didn't think that I was eating unhealthily but I was obviously eating too much. Unfortunately I had a relapse in September so I agreed to go back onto mirtazapine and come off dothiepin. My weight started to swing wildly even after staying on ww's and exercising. In one week I put on four and a half pounds what? The next week I lost it again. I am now just a pound above what I weighed in the summer and yet I still feel fat! I am two pounds below my goal weight and now within healthy range and BMI. Being on mirtazapine has made me obsessive about my weight. There are some foods that I don't eat or eat very occasionally. I weigh myself every night and morning. I want to proved to myself that I can stay on mirtazapine and lose/maintain a healthy weight. It is an experiment. I'm not sure what will happpen at Christmas? As I eat less food my a stomach accepts less food. Homemade soup is good which can be filling without putting on the weight. Goodness knows what will happen when I go out with my work for the Christmas Party. A half stone on in a week? This could be a reality. I'll let you know how I get on.

Danath
01-12-09, 11:27
Zispin/Mirtazipine does cause weight gain as its most common side effect (and also I assume, to get depressed people who are off their food eating again.) it does this as it gives you an increased appetite and often gets you craving carbs and all the high energy grub.

How do I know?

I've still got the stretch marks lol.

Dan

KK77
02-12-09, 15:57
Mirtazapine induces weight gain through various ways according to the research. Of course it increases appetite (I've been on it and know) but it also increases leptin and TNF-alpha which are involved in the regulation/distribution of fat (another factor for abdominal weight gain and increased cholesterol). It's unfortunate because it's said by many to be a very effective AD.

Anyway, here's the link if anyone's interested.

http://www.medscape.com/viewarticle/588676

KK77
02-12-09, 16:04
You may find the link requires log in so I'll paste it here.


Response from Joel Lamoure, RPh, BSP, FASCP
Assistant Professor, Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Mental Health Pharmacist, London Health Sciences Centre, London, Ontario, Canada Mirtazapine (Remeron®) is an atypical antidepressant with noradrenergic and specific serotonergic activity that blocks alpha-2 autoreceptors and heteroreceptors (enhancing serotonin release), selectively antagonizes the serotonin 5-HT2 and 5-HT3 receptors in the central and peripheral nervous system, enhances serotonin neurotransmission at the 5-HT1 receptor, and blocks the histaminergic (H1) and muscarinic receptors.[1-3] (javascript:newshowcontent('active','references'); ) Mirtazapine is not a serotonin or norepinephrine reuptake inhibitor.[1] (javascript:newshowcontent('active','references'); )
Mirtazapine is associated with weight gain both in the short- and long-term.[4] (javascript:newshowcontent('active','references'); ) Patients taking mirtazapine often report a voracious appetite, with intense cravings for carbohydrates.[1] (javascript:newshowcontent('active','references'); ) One meta-analysis examining 4 studies demonstrated that the majority of weight gain took place during the first 4 weeks of treatment.[4] (javascript:newshowcontent('active','references'); ) A study by Thase and colleagues[5] (javascript:newshowcontent('active','references'); ) found that the incidence of self-reported weight gain after 12 weeks of mirtazapine was 21%. This incidence increased to 30% in patients who remained on mirtazapine during the 40-week continuation phase of treatment. However, there was no statistically significant difference between mirtazapine vs placebo with respect to the incidence of new-onset weight gain during the continuation phase. Specifically, this study found that weight gain during the 40 weeks of the continuation phase was only about half the weight gain observed during the first 8 to 12 weeks of therapy.
The exact mechanism by which mirtazapine induces weight gain has not been clearly elucidated, but it appears to be multifactorial and pharmacodynamic in nature. Several hypotheses have been put forth in the literature. For example, some suggest that mirtazapine-induced weight gain may be secondary to its effects on the 5-HT2C and H1 receptors.[2] (javascript:newshowcontent('active','references'); )
A second hypothesis for mirtazapine-induced weight gain is a disturbance of the neurobiological controls that regulate food intake.[1] (javascript:newshowcontent('active','references'); ) A study by Fernstorm[3] (javascript:newshowcontent('active','references'); ) demonstrated a reduction of the basal metabolic rate in patients treated with antidepressants in general. Given this observation, it may be prudent for patients taking mirtazapine to be vigilant about caloric intake to minimize weight gain. However, there have been no published studies that examined whether being proactive in this manner reduces subsequent weight gain in those taking mirtazapine.
Certain antidepressants in general may induce weight gain, partially as a result of increase in fat mass, which is a major determinant of serum leptin levels. Leptin is a fat cell hormone that causes appetite-reducing feedback.[1] (javascript:newshowcontent('active','references'); ) Consequently, another hypothesis is that mirtazapine-induced weight gain may be secondary to changes in leptin and the tumor necrosis factor-alpha (TNF-alpha) cytokine system.
One open-labeled study involving 11 patients taking mirtazapine demonstrated that during the first week of therapy, a significant increase in weight (mean weight gain of 2.4 kg) was observed, and plasma levels of TNF-alpha increased. A slight and slow increase in leptin became significant by the end of the fourth week of treatment. Therefore, the findings suggested that the activation of the TNF-alpha cytokine system may be an early, sensitive, and specific marker of mirtazapine-induced weight gain. In addition, leptin may be a less sensitive and more variable marker with respect to weight gain.[6] (javascript:newshowcontent('active','references'); )
Although the details of the mechanism by which mirtazapine causes weight gain are unknown, future research is desirable because the implications of this side effect may be catastrophic in some individuals. Specifically, mirtazapine-induced weight gain may contribute to worsening of obesity-related preexisting comorbidities (eg, hyperlipidemia, coronary artery disease, hyperglycemia) or lead to the development of comorbidities that are linked to obesity, such as type 2 diabetes.[7] (javascript:newshowcontent('active','references'); )
Researchers evaluated whether Beck Depression Inventory scores suggesting depression or use of antidepressant medications led to the development of diabetes in a study population of patients with impaired glucose tolerance.[8] (javascript:newshowcontent('active','references'); ) Patients were randomized into one of 3 groups: standard lifestyle recommendations plus placebo; metformin plus standard lifestyle recommendations; and intensive lifestyle recommendations. Glucose, Beck Depression Inventory, weight, and fasting insulin levels were assessed at baseline and annually during the study. The researchers found that patients in the intensive lifestyle arm and placebo arm who took antidepressants at baseline or frequently during the study were 2 to 3 times more likely to have diabetes develop. Elevated depressive symptoms in and of themselves did not predict the development of type 2 diabetes.
In conclusion, it is essential that the patient as a whole be considered when initiating mirtazapine to treat moderate depression. Comorbidities, medications, and patient goals should all be central in the therapeutic decision. Our premise and promise to the patient should always be to get the right drug to the right patient at the right time for the right condition, with a minimum of side effects.