Mirtazapine
About
Mirtazapine belongs to a group of medicines called anti-depressants used to treat the major depressive disorder. Additionally, Mirtazapine is sometimes used to treat obsessive-compulsive disorder (OCD), and anxiety disorders. Depression is a mood disorder characterised by sadness, unhappiness, anger, hopelessness or loss that interferes with a person’s daily activities.
Mirtazapine contains ‘Mirtazapine’, which increases the activity of mood-enhancing chemical messengers such as serotonin and norepinephrine in the brain, which communicate between brain cells, thereby regulating mood and treats depression.
You are advised to take Mirtazapine for as long as your doctor has prescribed it for you, depending on your medical condition and response to the treatment. In some cases, you may experience certain common side-effects such as sleepiness, drowsiness, weight gain, dry mouth, headache, nausea, vomiting, and tiredness. Talk to your doctor if you experience these side-effects persistently.
Please do not stop taking Mirtazapine without consulting your doctor, as it could lead to recurring symptoms. Consult your doctor if you are pregnant or breastfeeding. Mirtazapine is not recommended for children below 18 years as the safety and effectiveness have not been established. Avoid consuming alcohol along with Mirtazapine as it could lead to increased drowsiness and dizziness. Keep your doctor informed about your health condition and medicines to rule out any side-effects.
Uses of Mirtazapine
Medicinal Benefits
Mirtazapine belongs to a group of medicines called tetracyclic anti-depressants. Mirtazapine is used to treat major depressive disorder. Additionally, Mirtazapine is sometimes used to treat obsessive-compulsive disorder (OCD) and anxiety disorders. Mirtazapine works by increasing mood-enhancing chemical messengers such as serotonin and norepinephrine in the brain, which communicate between brain cells, thereby regulating mood and treating depression.
Directions for Use
Storage
Side Effects of Mirtazapine
- Sleepiness
- Drowsiness
- Weight gain
- Dry mouth
- Headache
- Nausea
- Vomiting
- Tiredness
In-Depth Precautions and Warning
Drug Warnings
Do not take Mirtazapine if you are allergic to any of its contents; if you are taking monoamine oxidase inhibitors (MAOI) such as moclobemide, tranylcypromine, selegiline or have taken them in the last 14 days. Inform your doctor if you have/had epilepsy, low blood pressure, urination problems or enlarged prostate, glaucoma, diabetes, schizophrenia, mania, dementia (memory loss), heart, kidney or liver problems. Consult your doctor immediately if you have suicidal thoughts, such as killing or harming yourself. Consult your doctor if you are pregnant or breastfeeding. Mirtazapine is not recommended for children below 18 years as safety and effectiveness have not been established. Avoid consuming alcohol along with Mirtazapine as it could lead to increased drowsiness and dizziness. Rise slowly from sitting or lying position as Mirtazapine may cause dizziness on standing suddenly.
Drug Interactions
Drug-Drug Interactions: Mirtazapine may interact with anti-depressants (moclobemide, tranylcypromine, selegiline, nefazodone, duloxetine, sertraline, escitalopram), antibiotics (erythromycin, linezolid), anti-fungal (ketoconazole), anti-TB (rifampicin), antipsychotic (olanzapine, aripiprazole, quetiapine), anti-convulsant (carbamazepine, phenytoin, pregabalin), pain killer (tramadol, morphine, acetaminophen, hydrocodone), antihistamine (cetirizine), antacid (cimetidine), blood thinner (warfarin), anti-anxiety (alprazolam), and anti-hypertensive (metoprolol).
Drug-Food Interactions: Do not take St. John’s wort (herbal supplement to treat depression) along with Mirtazapine. Avoid consuming alcohol along with Mirtazapine as it may increase the sedative effects.
Drug-Disease Interactions: Inform your doctor if you have epilepsy, low blood pressure, urination problems or enlarged prostate, glaucoma, diabetes, schizophrenia, mania, dementia (memory loss), pheochromocytoma (tumour of the adrenal gland), heart, kidney or liver problems.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid consumption of alcohol while taking Mirtazapine as it may cause an increased sedative effect.
Pregnancy
cautionMirtazapine belongs to pregnancy category C. Please consult your doctor if you have any concerns regarding this, your doctor will prescribe only if the benefits outweigh the risks.
Breast Feeding
cautionMirtazapine may pass into breastmilk. Consult your doctor before taking Mirtazapine, your doctor will decide whether Mirtazapine can be taken by breastfeeding mothers or not.
Driving
unsafeMirtazapine may cause sleepiness, dizziness and drowsiness. Do not drive or operate machinery if you experience these symptoms.
Liver
cautionDose adjustment may be needed in patients with liver impairment. Please consult your doctor if you have a liver impairment or any concerns regarding this.
Kidney
cautionDose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeMirtazapine is not recommended for children below 18years as the safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
- Maintain a healthy diet and exercise regularly as it helps in improving overall health and boosts self-esteem.
- Regularly attend therapy sessions.
- Perform meditation and yoga. This helps in relieving stress and provides relaxation.
- Follow a regular sleep pattern to improve the amount and quality of sleep you get.
- Include foods rich in omega-fatty acids such as fish, nuts, fresh fruits, vegetables and olive oils.
- Neurotransmitters are made up of amino acids. Amino acid-rich foods such as meat, dairy products, and certain fruits and vegetables help in the proper maintenance of neurotransmitters.
- Complex carbohydrates help in stimulating serotonin (a feel-good neurotransmitter). These include whole grains, legumes, spinach, broccoli, oranges and pears.
- Exercising helps in the production of the body’s natural anti-depressants. It also helps in relieving stress, improving mood, boosting self-esteem, and providing restful sleep.
- Avoid smoking and alcohol consumption.
- Learn about your condition, understand the risk factors and follow the doctor’s treatment plan.
Special Advise
- Your doctor may suggest regular cardiac check up as Mirtazapine may cause a condition that affects the heart rhythm (QT prolongation).
- Regularly monitor blood sugar levels as Mirtazapine may cause fluctuation in blood glucose level.
- You should not discontinue Mirtazapine abruptly; your doctor will reduce the dose slowly over a few weeks.
Patients Concern
Disease/Condition Glossary
Major depressive disorder: Major depressive disorder, also known as clinical depression, is a mental health disorder characterised by a persistent and intense feeling of sadness for an extended duration of time. It mainly impacts mood, behaviour, and other physical functions, such as sleep and appetite. Symptoms include sadness, loss of interest, appetite changes, sleep problems, restlessness, lack of energy, feeling worthless or guilty, thoughts of harming oneself, difficulty concentrating, making decisions, and thinking. The exact cause of depression is unknown. However, factors such as stress, changes in hormone levels, alcohol or drug abuse, abuse during childhood, certain medical conditions and medications might increase the risk of developing depression.
FAQs
Mirtazapine works by increasing mood-enhancing chemical messengers such as serotonin and norepinephrine in the brain, which communicate between brain cells, thereby regulating mood and treating depression.
Mirtazapine may cause weight gain due to increased appetite. Eat a healthy diet and exercise regularly to maintain a healthy weight.
Do not discontinue Mirtazapine without consulting your doctor, as it could lead to recurring symptoms. To treat your condition effectually, continue taking Mirtazapine for as long as prescribed. Do not be reluctant to speak with your doctor if you feel any difficulty while taking Mirtazapine.
Dry mouth could be a side-effect of Mirtazapine. Limiting caffeine intake, avoiding smoking and mouthwashes containing alcohol, drinking water regularly, and chewing sugar-free gum/candy might stimulate saliva and prevent drying of the mouth.
Orthostatic hypotension could be a side-effect of Mirtazapine. Orthostatic hypotension is a sudden lowering in blood pressure leading to dizziness on standing. If you experience this, do not try to stand up suddenly or start walking; instead, lie down and get up slowly only when you feel better.
Please consult your doctor before taking Mirtazapine if you have glaucoma as it might cause increased pressure in the eye.
Consult your doctor before taking Mirtazapine if you have diabetes, as it might fluctuate blood glucose levels. Regular monitoring of blood sugar levels is advised if you are taking Mirtazapine. Talk to your doctor if you experience fluctuations in blood sugar levels.
Constipation could be a side-effect of Mirtazapine. Drink plenty of fluids and eat high-fibre foods such as vegetables, fruits, and cereals. Talk to your doctor if the condition persists or worsens.
