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I can imagine how frustrating this situation must be for you. Many, if not most, of the antidepressants cause weight gain in a significant percentage of people taking them. This is a big problem and needs to be part of the risk/benefit ratio that you and your doctor use to determine whether to use a particular drug or not. Sometimes the benefit of relief of depressive symptoms is greater than the problems caused by the weight gains. But there are also certain antidepressants that have a better track record of not causing weight gain.
First, though, Remeron is a tetracyclic antidepressant. This class of antidepressants as a whole tends to cause weight gain in significant percentages of people taking them. Tricyclics and tetracyclics work with the muscarinic acetylcholine receptor and the histamine receptors in your brain. These receptors also work with your weight regulation systems in the brain. Therein lies the problem is our current understanding. So, again, if tetracyclics and your system work particularly well in relieving your depressive symptoms, you may need to consider this benefit as more important and take preventive measures against the associated weight loss.
However, Wellbutrin and Viibryd are two antidepressants that are considered (from the reports of patients) to be the least weight gain prone drugs. Wellbutrin has been around for a long time and has been the go to antidepressant if there was a problem with weight gain or reduced sexual desire as side effects. Viibryd is an SSRI, and while that class is rather prone to these side effects, the clinical trials were remarkable in that patients hardly complained at all about either problem. Since it's been on the market, this has been the reports from patients. So you may want to talk with your doctor about these two alternatives.
You might also consider adding a behavioral component to your treatment for your depression and/or anxiety. While behavioral treatment requires more effort from the patient than medications and is not as quick acting, it doesn't have the side effects nor withdrawal symptoms of the medications. If you would like to introduce a behavioral treatment, feel free to ask me another question about it. Just write “For Dr. Mark” at the beginning and everyone will know it’s for me.
Okay, I wish you the very best!
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