Mirtazapine Leads To Weight Gain And Systemic Inflammation

Discussion in 'Scientific Studies' started by DaveFoster, Apr 23, 2017.

  1. DaveFoster

    DaveFoster Member

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    It's well known that mirtazapine stimulates the appetite unlike typical antidepressants, and it tends to lead to weight gain. Dr. Peat has talked about the negative hormonal effects of leptin through its interaction with estrogen. Mirtazapine, it increases the levels of leptin and the inflammatory protein TNF-alpha.

    Besides its tendency to increase BMI and body fat percentage, mirtazapine also strongly antagonizes the 5-HT3 receptor, which results in an elimination of nausea and diarrhea, and it often causes constipation. The lack of intestinal motility and increased circulating levels of endotoxin (particularly without good thyroid function or co-administration of a laxative such as cascara sagrada) could result in the increased inflammatory biomarkers.

    Body weight, the tumor necrosis factor system, and leptin production during treatment with mirtazapine or venlafaxine. - PubMed - NCBI

    Weight gain is a frequent and important side effect of psychopharmacotherapy. Recent studies suggest that the fat-cell-derived hormone leptin and the tumor necrosis factor-alpha (TNF-alpha) cytokine system are pathophysiologically involved. No information is available concerning the influence of the antidepressants mirtazapine and venlafaxine on these immunoendocrine variables. An open-labeled study was performed in 20 patients suffering from major depression treated with either mirtazapine (N = 11) or venlafaxine (N = 9). During 4 weeks, the patients' weight, body mass index (BMI), and plasma levels of leptin, TNF-alpha, sTNF-R p55, and sTNF-R p75 were assessed. Mirtazapine induced a significant increase in weight (mean weight gain: 2.4 kg) that was evident after the first week of treatment. In parallel, the plasma levels of TNF-alpha and both soluble TNF receptors increased. In addition, a slight rise in leptin levels, which occurred slowly and was significant only at the end of the 4 th week of treatment, was observed. Weight decreased slightly but significantly in patients treated with venlafaxine (mean weight loss: 0.4 kg), whereas plasma levels of leptin, TNF-alpha, or soluble TNF receptors did not change significantly. The present results further support the notion that the activation of the TNF-alpha cytokine system is an early, sensitive, and specific marker of weight gain induced by psychotropic agents. In contrast, the effects of such drugs on leptin production seem to be less sensitive with respect to weight gain and more variable.
     
  2. Milena

    Milena Member

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    @DaveFoster Does cyproheptadine affect the weight gain factors mentioned here.? I'm taking low-ish doses - 1-2mg per day in 2 doses.
     
  3. OP
    DaveFoster

    DaveFoster Member

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    Cypro should further contribute to weight gain; keep in mind that cyproheptadine has other anti-inflammatory effects, and mirtazapine should as well. If one ate a very low-fat diet and kept their metabolic rate up, then the weight gain could be minimized.
     
  4. Milena

    Milena Member

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    Comparable or less then Mirtazapine, in your opinion. I'm not sure it is the main driver for me, although I have the odd craving.

    I did a test today with Red Bull. No discernable increase in temperature after consumption.
    Forget Insulin resistance, I've got thermometadiabolical resistance :wacky:
     
  5. OP
    DaveFoster

    DaveFoster Member

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    Mirtazapine has a stronger appetite-stimulating effect. Have you gotten a thyroid panel done? (bloodwork)
     
  6. Milena

    Milena Member

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    They only did TSH and T4. I pitched for T3 but no go. TSH is over 5 but not enormously high. As per the norm, Doc classed is as no problem. I'm working around it atm. Getting a high watt incandescent and doing peaty foods.
     
  7. Frankdee20

    Frankdee20 Member

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    Not many benign antidepressants exist then, how about bupropion. ? Completely different class I know.
     
  8. OP
    DaveFoster

    DaveFoster Member

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    With increasing TSH, the negative effects are non-linear. For example, the difference between a TSH of 1 and 2 is far greater than the difference between a TSH of 2 and 3. It's unlikely that you're healthy if you have a TSH of 5 and above. "Peating" will probably not drop your TSH from 5, and if it does, it will take a while.

    Bupropion does not have the negative effects of the SSRI's; it can cause some people anxiety and should probably not be used long-term because it's only been tested on the general population for a few decades, so no one knows its long-term effects.

    It tends to favor norepinephrine uptake as well, and thyroid tends to do the same. Considering its use as a smoking cessation aid, it probably compensates for hypothyroidism in the same way as nicotine, so thyroid and aspirin can work on similar mechanisms.
     
  9. Elron

    Elron Member

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    You seem to like mirtazapine...why's that?
     
  10. dilantinoid

    dilantinoid Member

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    bump

    gained 15lbs on Mirtazepine
    no appetite increase
    15mg
    reluctanct to come off this medication due to reliable sleep and increased productivity

    add TocoVit + Progesterone? @DaveFoster @haidut
     
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