Apparently she was put on
Mirtazapine, also known as Remeron. Side effects cause
weight GAIN.
Er, I have a hard time believing a doctor put her on that. I wonder if she just randomly Googled for AD names and that's the first she saw and she just went with it. If she actually is taking it, it makes me wonder what could be up that they'd go with an atypical tetracyclic antidepressant over first-line drugs like sertraline and bupropion. It would be very irresponsible for a doctor to put a super-massively morbidly obese person on a drug known for knocking people out and then waking them up ready to hork down 10lbs of food if better options exist. This drug is literally given to anorexics to get them to eat.
Mirtazapine (an NaSSA) is not even a trendy AD anymore, it was new back in the 1990s but fell out of favor over newer SSRIs and Wellbutrin. The only reason I could think of for prescribing it is if she's tried all the better, safer options and they all failed, which is
very unlikely.
If she needs help sleeping (which I don't doubt based on her size and sleep apnea), it would have been more responsible to start her a script for hydroxyzine to take at night, which is very common. Technically you're not supposed to take hydroxyzine for more than four months because it can expedite dementia in some people, but mirtazapine is also a histamine 1 antagonist and can have the same outcome. Plus what does Chantal need her brain for? She's already ruining her cognition with weed and fat.
I see no evidence that Chantal is so severely crippled with treatment-resistant MDD that a doctor would risk putting her on mirtazapine (it does take effect a bit faster than SSRIs) given how fat she is. It's not even really effective for anything but depression, so I'm thinking she didn't disclose things like her involuntary tics and rapid mood cycling. She triggers warning bells for cyclothymia and so she'd be carefully watched for signs of bipolar disorder. I don't think she's bipolar (especially if she is taking mirtazapine because it would have made her manic by now), just that she has a personality disorder paired with a lifestyle-related mood issue and gluttony exasperated by the endocrine dysfunction caused by extreme obesity.
Either:
A) Chantal is lying and doesn't know enough about ADs to know why mirtazapine would be the wrong choice and she's not actually taking anything but likes the idea of being able to say that she's on antidepressants.
B) Chantal has burned through all the better options and her doctor is just throwing whatever at her at this point to see if anything works (
extremely unlikely).
C) She complained of depression and sleep troubles, and her doctor decided against the common SSRI + hydroxyzine combo for some dumb reason.
D) Chantal complained about an inability to orgasm (gross) on SSRIs and wanted a med change. But even then, they'd have first tried stacking the SSRI with mild anti-anxiety med Buspar, which increases sex drive, and if that didn't work, they'd have moved her to Wellbutrin.
E) Her doctor has a wicked sense of humor and decided to give her a drug that he knew would make her eat even more than she already does.
Hey Chantal, if you're reading this and not lying about taking mirtazapine, you need to go back to your doctor for reevaluation or find a different one. Tell them these two things: that you experience rapid mood cycling resulting in destructive impulsive behaviors, and that you experience involuntary verbal tics exclusively triggered by intrusive thoughts. I get that you don't understand why, but I gotta stress, these are two VERY important key points that will likely completely change your diagnosis, get you screened for bipolar disorder, and get you on the proper medication for whatever the hell is wrong with you.