Amitriptyline vs mirtazapine weight gain

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Amitriptyline vs mirtazapine weight gain – which one is right for you?

Both amitriptyline and mirtazapine are commonly prescribed antidepressants that can lead to weight gain as a side effect.

If you are concerned about weight gain, it’s essential to talk to your doctor about alternative options and strategies for managing your weight while on medication.

Consider discussing the potential benefits and risks of each medication with your healthcare provider to determine the best course of action for your mental health and overall well-being.

Key Differences

When comparing Amitriptyline and Mirtazapine, there are key differences in their mechanisms of action and side effects:

Medication Amitriptyline Mirtazapine
Class Tricyclic antidepressant NaSSA (Noradrenergic and specific serotoninergic antidepressant)
Mechanism of Action Primarily inhibits the reuptake of serotonin and norepinephrine Blocks histamine H1 receptors and enhances central noradrenergic and serotonergic neurotransmission
Side Effects Drowsiness, dry mouth, constipation, weight gain Sedation, increased appetite, weight gain
Weight Gain Common side effect with long-term use Notable weight gain reported in some patients

Overall, Amitriptyline and Mirtazapine exhibit differences in their pharmacology and side effect profiles, including their impact on weight gain.

Impact on Weight Gain

Impact on Weight Gain

Both Amitriptyline and Mirtazapine are commonly used antidepressants that may contribute to weight gain as a side effect. However, the mechanisms by which they affect weight gain differ.


Amitriptyline is known to cause weight gain through various mechanisms, including increased appetite, slowed metabolism, and changes in carbohydrate metabolism. It can lead to significant weight gain over time.

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Unlike Amitriptyline, Mirtazapine is more strongly associated with weight gain due to its potent histamine receptor-blocking properties. This can lead to increased appetite and cravings, making it easier to gain weight while taking Mirtazapine.

Impact on Weight Gain

When considering the impact of amitriptyline and mirtazapine on weight gain, it is important to note that both medications are associated with weight gain as a common side effect.

Factors Amitriptyline Mirtazapine
Effect on Appetite May increase appetite and lead to weight gain Known for increasing appetite and causing weight gain
Metabolic Changes May affect metabolism and contribute to weight gain Can alter metabolic rate, potentially leading toweight gain
Water Retention Can cause water retention, adding to weight gain May lead to water retention and weight gain
Overall Impact Overall, amitriptyline has been associated with more significant weight gain compared to mirtazapine in some studies While both medications can contribute to weight gain, mirtazapine may have a milder impact in some cases

It is essential for patients to discuss the potential for weight gain with their healthcare provider when considering these medications for treatment.

Amitriptyline: Pros and Cons

When considering amitriptyline as a medication, it is important to weigh the pros and cons carefully:

  • Pros:
    • Effective in managing depression and certain types of chronic pain.
    • Can be used to treat insomnia and anxiety.
    • Available in generic form, making it more affordable for patients.
    • Long history of use and well-studied for various conditions.
  • Cons:
    • May cause significant weight gain and increase appetite in some individuals.
    • Can lead to drowsiness, dizziness, and other side effects, especially at the beginning of treatment.
    • Requires close monitoring by healthcare providers due to potential interactions with other medications.
    • Not recommended for use in elderly patients or those with certain heart conditions.
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1. Weight Gain: Amitriptyline is associated with a higher risk of weight gain compared to mirtazapine. This can be a significant drawback for individuals who are already struggling with weight management.

2. Side Effects: Amitriptyline may cause a range of side effects, including dizziness, drowsiness, dry mouth, constipation, and blurred vision. These side effects can be bothersome and impact the quality of life of the individual taking the medication.

3. Drug Interactions: Amitriptyline has a higher potential for drug interactions compared to mirtazapine. This can complicate the treatment regimen for individuals who are taking multiple medications for various health conditions.

4. Withdrawal Symptoms: Abruptly stopping amitriptyline can lead to withdrawal symptoms such as nausea, headache, and fatigue. This can make it difficult for individuals to discontinue the medication if needed.

5. Overdose Risk: There is a higher risk of overdose with amitriptyline compared to mirtazapine, especially in cases of intentional or accidental overdose. This risk should be carefully considered, particularly in individuals with a history of substance abuse or suicidal ideation.


While mirtazapine is generally well-tolerated, there are some potential drawbacks to consider:

  • Weight Gain: Mirtazapine is known for causing more significant weight gain compared to other antidepressants. This can be a concern for individuals already struggling with their weight or those who are prone to obesity.
  • Sedation: Mirtazapine has a sedating effect, which can be beneficial for individuals experiencing insomnia or anxiety but may also lead to daytime drowsiness or fatigue.
  • Increased Appetite: Some individuals may experience an increase in appetite while taking mirtazapine, leading to potential overeating and further contributing to weight gain.
  • Sexual Side Effects: Like many antidepressants, mirtazapine can cause sexual dysfunction, including decreased libido, erectile dysfunction, and difficulty reaching orgasm.
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Mirtazapine: Pros and Cons

Mirtazapine: Pros and Cons

When it comes to mirtazapine, there are several pros and cons to consider before starting this medication.


1. Effective for depression
2. Can help with anxiety and sleep disturbances
3. Less likely to cause sexual side effects compared to other antidepressants
4. Generally well-tolerated
5. May improve appetite and weight gain in those who are underweight


1. Sedating effects, which can be pronounced
2. Increased appetite leading to weight gain
3. Possible risk of developing metabolic syndrome
4. Discontinuation symptoms if stopped abruptly
5. Potential for interactions with other medications


1. Effective for Depression: Mirtazapine is known for its effectiveness in treating depression, especially in cases where other medications have not been successful.

2. Sedative Effects: Mirtazapine has sedative effects, which can be beneficial for individuals experiencing insomnia or anxiety.

3. Appetite Stimulation: Unlike some antidepressants that can suppress appetite, mirtazapine is associated with increased appetite, which can be helpful for those struggling with poor eating habits.

4. Fast Acting: Mirtazapine is relatively fast-acting compared to some other antidepressants, providing quicker relief for symptoms.

5. Lower Risk of Sexual Side Effects: Mirtazapine is less likely to cause sexual side effects compared to some other antidepressants, making it a preferred choice for individuals concerned about this issue.