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Indian J Psychiatry. 2020 Jan;62(Suppl 1):S74–S122.

Background: During the course of treatment with Antidepressants the issue of weight gain & metabolic changes have emerged as an important concern and specifically in long-term therapy. Though it's an ongoing debate whether weight gain and metabolic perturbations with antidepressants use are the consequences of increased appetite and weight gain, respectively, or represents direct pharmacological effects of the drug in metabolism.

Methods : We therefore conducted a proof-of-concept, open-label clinical trial, hypothesizing that in exceptionally healthy men no change if metabolic parameters would occur under Mirtazapine , when environmental factors --- nutrition, sleep and physical exercise etc were controlled and kept constant. Over a 4 week preparation phase , 15 healthy young men were attuned to a Standardized diet adjusted to their individual calorie need, to a regular sleep/ wake cycle and moderate exercise. Continuing this protocol , we administered 15 mg of mirtazapine daily for 10 days.

Results: While no significant weight gain or changes in resting energy expenditure were observed under these conditions, hunger and appetite for sweets increased with Mirtazapine