<s>[INST] Hi, my name is Camilla, I would like to know of any alternative to mirtazapine, as I am gaining too much weight from it. It has to be something that works as good as mirtazapine in order to get a good night sleep, since my depression symptoms really triggers this. Bst rgds Camilla [/INST] Hi Camilla, Mirtazapine is an effective anti-depressant with sedation and increase in weight as its significant side effects. As an antidepressant, there are many alternatives to mirtazapine. Selective serotonin reuptake inhibitors like Escitalopram, sertraline, etc. are effective and safe. It causes lesser weight gain than mirtazapine but is not as effective sedative. Bupropion has the least association with weight gain. However, is also not sedating. As you have mentioned that your sleep problems are triggered by depression, I think starting these anti-depressants with short term sedatives will solve your problem. Sedating anti-depressants include agomelatine and tricyclic antidepressants like amitriptyline. Tricyclics also cause weight gain and also have much more side effects. I do hope this information was useful. You can discuss these Chat Doctor. Best wishes. </s>