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Q. As I am gaining weight with Paroxetine and Mirtazapine, shall I opt Zoloft?

Answered by
Dr. Seikhoo Bishnoi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 16, 2016 and last reviewed on: Aug 21, 2020

Hi doctor,

I have OCD and bipolar depression. I am taking Paroxetine and Mirtazapine for OCD and sleep respectively. I am gaining too much weight. Can I switch to Zoloft?

#

Hi,

Welcome to icliniq.com.

I can understand your concern.

  • Both Mirtazapine and Paroxetine are known to cause weight gain. Sertraline (Zoloft) also causes some weight gain. So, in my opinion shifting to Sertraline will not be a good idea.
  • Other SSRIs (selective serotonin reuptake inhibitor) like Fluoxetine or Escitalopram can be tried instead of Paroxetine.
  • Fluoxetine does not cause much weight gain and is considered as safe. The drug has great efficacy in controlling OCD (obsessive compulsive disorder) symptoms too.
  • For sleep, I suggest low dose Benzodiazepines instead of Mirtazapine. The benzodiazepines will relieve anxiety and help in sleep. Discuss with your doctor for these drugs.

For further information consult a psychiatrist online -->https://www.icliniq.com/ask-a-doctor-online/psychiatrist

Thank you doctor,

I would like to know whether taking Fluoxetine will not affect my bipolar (irritability) or my sleep (worsen insomnia). I am currently taking Paroxetine 60 mg and Mirtazapine 30 mg. I am not using any mood stabilizer. How should I switch to SSRIs?

#

Hi,

Welcome back to icliniq.com.

  • Fluoxetine is relatively safe in bipolar disorder as compared to other SSRIs like Paroxetine you are taking. The drug should reduce irritability.
  • Fluoxetine causes insomnia and should be taken preferably in the morning after breakfast. Evening doses should not be given and so, the drug will not result in disruption of your sleep.
  • Taking a low dose Benzodiazepine like Clonazepam will help with good sleep.
  • Cross tapering is the best option to stop using the drug. Reduce the dose of Paroxetine slowly over four weeks and increase the dose of Fluoxetine over four weeks. This will not cause any withdrawal symptoms.

For further information consult a psychiatrist online -->https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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