Mirtazapine

Definition
Mirtazapine is most commonly used to treat depression. Mirtazapine is available in the United States under the trade names of Remeron and Remeron SolTab.
Mirtazapine, sold under the trade name Remeron, is taken by mouth and swallowed whole. Remeron SolTabs should be allowed to dissolve in the mouth. No water is needed when taking the SolTabs, since these tablets disintegrate in saliva and are not swallowed whole.
Purpose
Mirtazapine is best known for treating depression. However, it may also be used for treating anxiety or to make people drowsy just before surgery.
Description
Mirtazapine is usually thought of as an antidepressant, or a drug that alleviates symptoms of depression. Approved by the Federal Drug Administration (FDA) in 1996, it is believed to alter the activities of some chemicals in the brain and, in this way, reduce chemical imbalances responsible for causing depression and anxiety. As with all antidepressants, it may take several weeks of treatment before full beneficial effects are seen. Mirtazapine is broken down by the liver and eliminated from the body mostly by the kidneys. It is supplied in 15-, 30-, and 45-mg tablets.
Recommended dosage
The recommended initial dose of mirtazapine in 15 mg taken at bedtime. The dose may be increased in 15-mg increments every one or two weeks as needed until symptoms of depression or anxiety resolve. Typical doses range between 15 and 45 mg. Dosages above 45 mg per day are not recommended. Elderly people or those with liver or kidney disease should use mirtazapine carefully, since they may be more sensitive to some of the drug's side effects.
Precautions
Mirtazapine may cause weight gain and may increase cholesterol levels and should be used carefully in overweight individuals and those with high cholesterol levels. If symptoms of fever, sore throat, or irritation in the mouth occur, a health care provider should be notified. Rarely, mirtazapine may lower blood counts, causing people to be at an increased risk of serious complications, including infections. Mirtazapine may increase the tendency for seizures . As a result, it should be used carefully in people with epilepsy or other seizure disorders. Mirtazapine may alter moods or cause mania. It should be used carefully in people with a history of mania. Mirtazapine may alter liver function and should be used cautiously by those with a history of liver disease. If abdominal pain, yellowing of the skin or eyes, darkening of urine, or itching occurs, a health care provider should be notified immediately.
More than 50% of individuals using mirtazapine report feeling sleepier than normal and 7% feel dizzy. As a result, people taking mirtazapine should not participate in activities that require mental alertness—like driving— until they know how the drug will affect them. Because there is an increased likelihood of suicide in depressed individuals, close supervision of those at high risk for suicide attempts using this drug is recommended. Mirtazapine is not recommended in pregnant or breast-feeding women.
Side effects
The most common side effects that cause people to stop taking mirtazapine are sleepiness and nausea. Other common side effects are dizziness, increased appetite and weight gain. Less common adverse effects include weakness and muscle aches, flu-like symptoms, low blood-cell counts, high cholesterol, back pain, chest pain, rapid heartbeats, dry mouth, constipation, water retention, difficulty sleeping, nightmares, abnormal thoughts, vision disturbances, ringing in the ears, abnormal taste in the mouth, tremor, confusion, upset stomach, and increased urination.
Interactions
Use of mirtazapine with antidepressants referred to as monoamine oxidase inhibitors (MAOIs) such as Parnate ( tranylcypromine ) and Nardil ( phenelzine ), is strongly prohibited due to the potential for high fever, muscle stiffness, sudden muscle spasms, rapid changes in heart rate and blood pressure, and the possibility of death. In fact, there should be a lapse of at least 14 days between taking an MAOI and mirtazapine.
Because mirtazapine may cause drowsiness, it should be used carefully with other medications that also make people prone to sleepiness, such as antidepressants, antipsychotics, antihistamines, anti-anxiety agents, and alcohol. Increased sleepiness has been reported when mirtazapine was used with both alcohol and the anti-anxiety drug diazepam .
See also Depression and depressive disorders
Resources
BOOKS
Ellsworth, Allan J., and others. Mosby's Medical Drug Reference. St. Louis, MO: Mosby, Inc, 1999.
Facts and Comparisons Staff. Drug Facts and Comparisons. 6th Edition. St. Louis, MO: Facts and Comparisons; Philadelphia: Lippincott Williams and Wilkins, 2002.
Organon Staff. Remeron Package Insert. West Orange, NJ: Organon Inc, 2001.
Kelly Karpa, RPh, Ph.D.
My psychiatrist put me on 7.5 mg of Mirtazapine which obviously is less than what you are taking but it took a few days to over come the side effects which involved me feeling very dizzy and sleepy. It is worth waiting a few days and being patient to let your body get used to the drug. I was lucky enough to be in hospital when I first was taking the drug so I could just go to bed but felt so much better and started sleeping really well and the side effects disappeared after a few days.
I hope that helps.
I have been taking Mirtazapine for about 2 wks now. I have gained 9 lbs. in the 2 wks. since taking this drug! I am 35 yrs old and have NEVER struggled with my weight or had a weight issue. Besides the weight gain, Mirtazapine does seem to help with my depression. Will the side effect of the weight gain eventually go away or should I stop taking it? Thank you.
cheers and good luck all.
My mother (patient of PD) took mirtazep 15 mg on Monday night at 10 pm approximately and in tuesday morning she took PK merz 100mg and jumex 5mg since then she is sleeping for almost 18 hrs per day that is on tuesday and wednesday, Can any one advise is it something associated with the side effects of the medicines. She has discontinued the medicine till we get in touch with her doctor again.
Advise PLEASE
thank you for your message, that does sound very reassuring. i have been on like 8 different pills since i was 14, im 20 now... its rubbish and i want to find something that works. if this doesnt then i will prob have to go back into hospital... which sucks!
i am a keen runner and i go for like an hour every day... yet this weight wont shift. really not helping my Bullemia unfortunatly. I just feel like a Zombie, not happy, not sad... but just existing... its horrible!
Alice x
just read your comments on here. it is very sad that you have been on so many anti depressants and you are so young!
I would say stop taking them if they are making you feel like this. either that or you will end up topping yourself by the sounds of things. is there even anyone in your life who cares anyway? only you dont mention of any one. So why don't you just do it anyway? Caroline is talking a load of rubbish. egnore her, she is making out as if she cares but she doesnt so just bloody well do it and be dont with it.
kind regards,
Natasha
I'm not depressed all the time. I have some good days where I feel good and have plenty of energy. But on a bad day, I will sleep on the sofa all day, wearing my pyjamas, not eat nor even brush my teeth. Then I will feel very lonely and unloved. Then I cry and cry and feel so bad that I think the world would be a better place without me. It's really horrible. My bad dreams are usually fear based. I can't find my car or I get lost and it is exhausting trying to find my way. Or I have pets that I love and I haven't fed them or they run away and get lost and I can't find them. The dreams have changed over the years but they have the same effect on me.
My anxieties have been a part of my life since I was about 9 years old. I have been through a myriad of compulsions and social 'butterflies'. The most prominent is avoiding being around other people. My friends would call me and I wouldn't answer the phone. They would come over to take me out with them for the night and I would pretend I wasn't home. I wouldn't go to the store or out to eat. Not even for fast food. Now I am single again, I chat to potential dates online or on the phone, but I nearly always cancel dates to meet in person. I joined a social club and at the very first meeting, became very sweaty and ill. I had to leave before I fainted.
I order my food, clothes and everything online. Occasionally, I have to go out but I return home as quick as I can. My compulsions have included everything from spelling words in my head, counting, pulling my hair, chewing my lips and fingernails and picking the skin on my feet. I will not stop until I am bleeding and in pain. It's very weird and most of the time I'm not aware that I'm doing it. But walking on sore feet is a constant reminder.
Re-reading this, I think I sound pretty messed up! I am trying to feel better. Fingers crossed, the Mirtazapine will work!
Ive been taking Sertraline for past month due to increased anxiety, But due to lack of libido my doctor took me off of them and put me on 15mg of Mirtazapine, forgot to take at night and took as per usual yesterday morning - within half hour I felt drunk and couldnt keep my eyes open, had to lay on settee where I spent most of the day asleep - woke up to fill my face (am already overweight) went to bed at 11pm and slept til 8am this morning making a total of 18hrs sleep I have a 9yo son (on hols with his dad til tonight) and cant afford to feel like this, do you think it will pass or shall I go back on the previous medication ?
Keep it simple and take 1mg of Xanax. Stay away from this crap drugs like Zoloft(school shooting drug), Paxil, and Prozac(another school shooting drug.
Why do people put this shit into their bodies.
I am playing it safe with Ambien and Xanax, and staying away from the garbage.
I have only taken 15 mg a single dose of Mirtazapine about 19.00 pm last night. I have been sleeping til 7.00 a.m this morning but I can not wake up completely and is almost 12.00. I had urine retension this morning and a fever of 37.5 C and some problems vith my vision. I don't think I'll take a second dose.
He is almost 40, hasnt had the best of upbringings, been in prison for minor offences, hady a family, chkdreb and lost them to a lesbian ..
He is a nice person a lot of the time.. his main problems ..he causes arguments in the midst of us being happy all the time .. no matter how I react we fall out . I’ve found out he lies and cheats online and now I’ve learned in person .. with another women, but yet is paranoid about me .. when I’m loyal..
He loves being a very sexual being with me, walking with me and getting out, he is struggling with his weight a bit as I am ..
He’s sought mental health support over this year and tbh not been given hardly any support at all, still awaiting appointments to attend CBT and has been advised to go on Mirtazapine from Friday ..
The Dr he saw told him he would be on the tablets for a minimum of 2 yrs and that they will cause erectile dysfunction & won’t be able to perform in the bedroom.. he is that desperate to be a better person he’s agreed to anything they have said .. coz he wants to find and see his children .. I love him so much even though he has broken my heart more times than I want to admit .. I want him to get better, to lose the paranoid feelings he gets, to resist the urges to cause arguments with me, to just chill m be happy .. I know sex isn’t the be all and end all but it is an important part of our relationship which I feel he relies upon more than I do tbh .. I don’t know how this drug is going to affect him, his self esteem if he gains more weight and his moods ..,
We don’t live together, coz he has mental heath problems it’s been advised he doesn’t interact with my little one .. although he has never been violent towards me in almost 3 yrs and I deff do not back down verbally in an argument ..
Can anyone plz advise me re the effects the Dr says he will experience please..
Thank you in advance xx
I've been (zonked) out of it all day. Just lay under the covers and enjoy the warmth and escape. I've never seen a medication that makes you crave warmth the way this stuff does. I'm amazed at how much this stuff (the drugs) changes the person you are. Dad called earlier. I was (zonked out) on the couch with the tv on. Thought the call coming in (that the ringtone) was part of the tv commercial. Finally got up about 45 minutes later and was going to call him back. It was 7:50. I'm looking at emails. (need to wait till 8pm for his tv show to end) Closed my heavy eyes and when I opened them it was 8:07pm. Lost 18 minutes just sitting in the chair! Seemed like 10 seconds went by. I called him back. We talked. I cant remember what about, but I just mainly sat there with my eyes closed half the time and listened. Occasionally he'd say, "are you there?" I'd say yes. Earlier about 9pm I got the slight but noticeable nausea again. I thought, with only half the pill, this stuff is still nearly as strong. It's building up. It also gives you a "just sit and stare into space and think nothing and be brain dead" feeling. As much as it helps make me drowsy for sleep, I think the negative side effects are outweighing any helpfulness of the product.