Mirtazapine

Mirtazapine 15mg, 30mg, 45mg

Mirtazapine is an antidepressant primarily used to treat major depressive disorder. It works by enhancing the activity of certain neurotransmitters in the brain, specifically norepinephrine and serotonin, which can improve mood and relieve symptoms of depression. Mirtazapine is often prescribed when other antidepressants have not been effective, and it may also help with sleep disturbances associated with depression, as it can have a sedating effect. Additionally, it is sometimes used off-label to manage anxiety disorders and post-traumatic stress disorder (PTSD).

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Description

Mirtazapine is an antidepressant medication primarily used to treat major depressive disorder. It belongs to a class of medications known as noradrenergic and specific serotonergic antidepressants (NaSSAs), which help improve mood and alleviate symptoms of depression by affecting the balance of neurotransmitters in the brain.

Uses / Indications

Major depressive disorder (MDD)
Anxiety disorders (off-label use)
Sleep disturbances related to depression
Loss of appetite in certain conditions
Post-traumatic stress disorder (PTSD) (off-label use)

Dosage and Administration

Adults:
Initial dose typically starts at 15 mg once daily, preferably taken at bedtime. Doses may be adjusted based on therapeutic response, often ranging from 15 mg to 45 mg per day.

Geriatric patients:
The dosage should be initiated at a lower dose, often 15 mg once daily, and adjusted cautiously.

Note: Dosage may vary based on individual medical conditions and doctor’s advice.

How It Works (Mechanism of Action)

Mirtazapine increases the release of neurotransmitters serotonin and norepinephrine by blocking certain receptors in the brain. This unique mechanism not only helps relieve depressive symptoms but also enhances sleep quality in patients. Its sedative effects make it particularly useful for patients who have insomnia as a symptom of their depression.

Side Effects

Common side effects:

Drowsiness or sedation
Increased appetite and weight gain
Dry mouth
Fatigue

Rare/serious side effects:

Severe allergic reactions (rash, swelling, difficulty breathing)
Thoughts of self-harm or suicide
Serotonin syndrome (symptoms may include agitation, hallucinations, rapid heart rate)

Seek medical attention if serious side effects occur.

Precautions / Warnings

Inform your healthcare provider if you have a history of liver disease, kidney issues, or are pregnant/breastfeeding.
May cause sedation; use caution when operating vehicles or machinery.
Gradual discontinuation may be necessary to avoid withdrawal symptoms.

Drug Interactions

May interact with:

Alcohol (may enhance sedative effects)
Other antidepressants (risk of serotonin syndrome)
Benzodiazepines and other central nervous system depressants
Medications that affect liver enzymes

Always inform your healthcare provider about any other medications or supplements you’re taking.

Storage Instructions

Store at room temperature (20°C–25°C / 68°F–77°F).
Keep away from moisture, heat, and direct light.
Keep out of reach of children.

Missed Dose / Overdose

Missed a dose?
Take it as soon as you remember. If it’s almost time for your next dose, skip the missed one. Do not double up.

Overdose symptoms:

Excessive sedation or drowsiness
Confusion
Rapid heart rate
Low blood pressure

Contact a poison control center or seek emergency medical help immediately.

Contraindications

Known hypersensitivity to Mirtazapine
Concomitant use with monoamine oxidase inhibitors (MAOIs)

Brand Names / Alternatives

Remeron
Remeron SolTab (orally disintegrating tablet)
Generic name: Mirtazapine