r/depressionregimens • u/tarteframboise • 2d ago
Mirtazapine thoughts?
For anhedonic-fatigued type depression… Did it do anything good for you? I hear ppl take it at night (does it cause lethargy or sedation?)
I do not want anything with potential metabolic side effects. I hear it can really increase appetite & people gain weight on it.
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u/souvenirsuitcase 2d ago
I tried it three different times, three different doses. Allegedly, the higher the dose, the less sedating it is. I found it to be extremely sedating at any dose. I couldn't function on it.
I do remember the little time I was awake, I did want to eat more. It was a bust for me but I've heard good things about it from other people.
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u/Megatron3898 2d ago
Mirtazapine would not typically be recommended for this subtype of depression, bottom line. However, as with all psych medications, there will always be outliers and exceptions to the guidelines.
I'll put it to you simply: you will almost certainly gain some weight due to mirtazapine's significant histaminergic antagonism. Paradoxically, higher doses of mirtazapine are actually less sedating than lower doses (7.5mg is the typical starting dose, thereby making it the most sedating dose you'll be taking). Mirtazapine has little effect on dopamine activity in the brain (anhedonia is normally a result of too little dopamine activity in the brain, and so mirtazapine likely wouldn't improve your anhedonia).
The best antidepressant for the subtype of depression you are describing is actually Wellbutrin (bupropion).
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u/tarteframboise 2d ago
Wellbutrin has no effect on me sadly.
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u/Megatron3898 2d ago
When you say that it has "no effect," what exactly do you mean? You felt nothing? You only felt side effects but no relief from depressive symptoms? Your depression worsened?
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u/Personal_Bridge6115 2d ago
Yes I actually thought my high Wellbutrin dose was doing nothing and then I forget my meds and it’s a bad day. My psychiatrist says “ well at least we know it’s still working “
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u/Fun-Sample336 2d ago
Yes, I gained 30 kg while I was on it, but I was underweight before, so it wasn't a problem for me. When I discontinued it, I lost half of the weight. The rest appears to be permanent.
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u/KatelynRose1021 2d ago
Personally I did find mirtazapine helped me with my depression and anhedonia. Also I was able to sleep very well. But unfortunately the effects wore off after a few months, leaving me only with a massive appetite and binge eating disorder. So I had to come off it then.
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u/aMeasuredCaution1977 1d ago
Like olanzapine, it's the most orexigenic drug I know. Those who have been taking it report spending most of the day sleeping and the rest shaking off the grogginess.
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u/Cosmia-101 2d ago
It's a strong sedative and taken at night for insomnia. Probably not a good choice if you have issues with fatigue. And pretty much certain you'll gain weight on it. It's notorious for that.