What is MIRTAZAPINE And What Are Withdrawal Effects?
Mirtazapine is an atypical antidepressant that is sold under the brand name Remeron, among others.
It also works well as an antihistamine
In the United States, it was the 104th most-prescribed drug in 2020, with over 6 million prescriptions.
Brand Names for MIRTAZAPINE
Remeron, Zispin
The History of MIRTAZAPINE?
Mirtazapine is a tetracyclic antidepressant that was first approved for treating major depressive disorder (MDD) in the Netherlands in 1994.
This drug was first made by Organon Inc. and got FDA approval in 1997 for treating MDD.
You may see the effects of this drug as soon as one week after you start taking it.
Mirtazapine was first used as a medicine in the US in 1996. The patent ran out in 2004, and there are now generic versions of the product.
What Kind of Drug is MIRTAZAPINE?
Mirtazapine is a tetracyclic antidepressant that works in a way that is different from other antidepressants.
Even though we don’t know exactly how it works, mirtazapine improves transmission of serotonin and adrenaline.
What Is MIRTAZAPINE Licensed To Treat?
It is often used to treat depression that is made worse by anxiety or insomnia. This is because mirtazapine makes you sleepy.
There were 1,841 ratings of Mirtazapine by users on On Drugs.com
https://www.drugs.com/comments/mirtazapine/
They gave it
- 6.6/10 for effectiveness against depression.
- 6.6 for anxiety
- 6.9 for PTSD
- 6.4 for OCD
- 5/10 for Hot Flashes (Hot Flushes)
- And 7/10 for Insomnia.
Most of my patients value it most for its effect on their sleep, and dislike it most for putting weight on them by stimulating appetite. As I say, there are zero or very few calories in the tablet itself. They say it makes them crave sugary food.
In the USA:
Major Depressive Disorder (MDD)
In the UK:
Major depression
Doses:
Initially 15–30 mg daily for 2–4 weeks, dose to be taken at bedtime, then adjusted according to response to up to 45 mg once daily, alternatively up to 45 mg daily in 2 divided doses.
It has off-label uses in preventing nausea after surgery. Some clinicians use it in fibromyalgia.
How Long Does Mirtazapine Take To Work?
Its effects can take up to four weeks, but they can also start as early as one to two weeks.
How Long Does Mirtazapine Stay in Your System?
The half-life of Mirtazapine is between 20 and 40 hours, depending on the individual. Therefore, it will linger in your body for up to 80 hours. People with reduced kidney function will get rid of mirtazapine at a slower rate and so doses should be reduced or it should be avoided.
Risks and Cautions for MIRTAZAPINE
You should be cautious of taking mirtazapine if any of the following conditions apply
- Heart problems
- diabetes
- Over 65
- a history of mania (stop taking it if you feel hyper)
- history of seizures
- urinary retention
- low blood pressure,
- psychosis (could make psychotic symptoms worse)
- a family tendency to get angle-closure glaucoma.
Side Effects of MIRTAZAPINE
Common side effects include sleepiness, dizziness, increased appetite, and weight gain. More serious side effects include mania, low white blood cell count, and more children committing suicide.
The good news is that in comparison with anti-depressants, it causes fewer sexual side effects and doesn’t have such a bad effect on sexual interest and performance. But it still has some.
Overdose
Based on what we know about overdoses with just mirtazapine, the symptoms are usually mild. There have been reports of depression of the central nervous system, disorientation, and long-term sedation, as well as tachycardia and mild high or low blood pressure.
But at doses much higher than the therapeutic dose, especially mixed overdoses, there is a chance of more serious effects, including death. In these cases, people have also reported QT prolongation and Torsade de Pointes. This is dangerous and can be fatal.
If you have overdosed on mirtazapine, seek immediate medical help.
In Pregnancy
Use with care because there isn’t much experience with it, and watch for withdrawal symptoms in the newborn infant.
How Long Does Mirtazapine Withdrawal Last?
Mirtazapine withdrawal Can Last for Up To 16 days, but the withdrawal will get easier during that period. You may not notice symptoms after 10 days.
When you stop taking mirtazapine or another antidepressant, you may experience withdrawal symptoms.
To keep withdrawal symptoms to a minimum, doctors recommend lowering the dose slowly and gradually.
When mirtazapine treatment is stopped suddenly, it can cause depression, anxiety, tinnitus, panic attacks, vertigo, restlessness, irritability, decreased appetite, insomnia, diarrhoea, nausea, vomiting, flu-like symptoms, allergy-like symptoms like pruritus, headaches.
Because mirtazapine has a long-half life, it stays in your body for 10-16 days. Though the withdrawal effects will get better over that time, you may still have symptoms until the end of that time.
Depending on your individual biology, you may excrete the mirtazapine quicker than that, but if you have any reduced kidney function, it will take longer.
Conclusion: Should You Take mirtazapine for Your Depression?
This study sets it out:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907331/
Mirtazapine is an effective antidepressant with unique mechanisms of action. It is characterized by a relatively rapid onset of action, high response and remission rates, a favorable side-effect profile, and several unique therapeutic benefits over other antidepressants.
Another stud: Lancet Study from 2018 showed that Mirtazapine was both effective and well-tolerated.
If you are suffering from lack of sleep and are underweight, it is probably the perfect antidepressant for you.
If you are overweight or have diabetes, you may wish to avoid it and try another one.
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