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How to manage Mirtazapine weight gain and Ventab effects?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I have been taking the following antidepressants for 14 years with doses as below. Tablet Lametec 25 mg in the morning, 50 mg in the night, tablet Ventab 25 mg in the morning and 50 mg at night, and tablet Mirtazapine 15 mg at night. I am gaining weight due to Mirtazapine and having erection issues due to Ventab.

I want to stop these two pills completely, but I read that it has to be tapered slowly. How shall I taper the dosage of Ventab and Mirtazapine? And how much time will it take? My height is 162 cm, and my weight is 74 kg.

Kindly help.

Thank you.

Hi,

Welcome to icliniq.com.

Thank you for seeking help from a psychiatrist.

I can understand your situation.

You may have a major depressive disorder. There is non-pharmacological management for your depression. It will help if you follow the guidelines to deal with it. It will help you.

  1. You should do exercises daily for 30 to 45 minutes, like going for a walk.
  2. You should do meditation for 20 minutes daily, sit in one place in a comfortable position, and try to concentrate on your normal breathing; do not stop or force yourself to control your thoughts.
  3. You should eat healthy home-cooked foods and avoid junk foods.
  4. You must drink enough water.
  5. You should spend quality time with friends and family daily, or do video calls if you are away from your family.
  6. You should spend time on creative hobbies like reading good books, writing journals, painting, drawing, learning new skills, or playing musical instruments.
  7. You should sleep for seven to eight hours daily.
  8. You must avoid tobacco, alcohol, or any substance abuse.

I suggest you stop tablet Ventab 25 mg (Desvenlafaxine) and continue the rest of the medications for eight weeks. Then taper and take tablet Ventab 25 mg at night instead of 50 mg for another eight weeks, so you are off from tablet Ventab. After that, take tablet Mirtazapine 7.5 mg for another eight weeks and continue your tablet Lametec (Lamotrigine).

I hope this helps.

Thank you.

Patient's Query

Hello doctor,

Thanks for the reply.

In case, if I stop tablet Mirtazapine, will I get problem with sleep? Should I add any sleep medication for it?

Kindly help.

Hi,

Welcome back to icliniq.com.

If you have a sleep disturbance, you can take the tablet Clonazepam 0.25 mg. You have to be patient during tapering your medications, as you have been on those medications for more than 14 years, you may have some mild withdrawal symptoms.

I hope this helps.

Thank you.

Medically reviewed byDr. Chithranjali Ravichandran

Published At August 23, 2021
Reviewed AtFebruary 12, 2026

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