MIRTAZAPINE
Drugs in Pregnancy and Lactation.
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Name: MIRTAZAPINE
Class: Antidepressant
Risk Factor: CM
Fetal Risk Summary
Mirtazapine is a tetracyclic antidepressant that is chemically unrelated to selective serotonin reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors. Although the exact mechanism of action is unknown, the antidepressant effect is thought to result from an increase in central noradrenergic and serotonergic activity (1). Mirtazapine is also a potent inhibitor of histamine (H1) inhibitors, a property that probably explains the marked sedation often seen with this agent.
No teratogenic effects were observed in rats given doses up to 100 mg/kg or in rabbits given doses up to 40 mg/kg, 20 and 17 times the maximum recommended human dose on a mg/m2 basis, respectively (1). Toxicity observed in rats at the maximum dose (but not at 15 mg/kg) included an increase in postimplantation losses, increased pup deaths during the first 3 days of lactation, and lower pup birth weights.
It is not known whether mirtazapine crosses the placenta to the fetus. Because of its low molecular weight (about 265), however, transfer to the fetus in measurable amounts should be anticipated.
Mirtazapine was approved by the FDA for use in the United States in June 1996. No published reports describing the use of this drug in human pregnancy have been located. Moreover, no reports of adverse pregnancy outcomes related to mirtazapine have been reported to the FDA (F. Rosa, personal communication, FDA, 1996).
Breast Feeding Summary
It is not known whether mirtazapine is excreted into human milk. No reports describing the use of the drug during lactation have been located. Because other antidepressants are excreted into milk (see Maprotiline, another tetracyclic antidepressant) and because of its relatively low molecular weight (about 265), the passage of mirtazapine into milk should be expected. Moreover, the long-term effects on neurobehavior and development from exposure to this class of agents during a period of rapid central nervous system development have not been studied. The American Academy of Pediatrics considers the effects of other antidepressants to be unknown, although they may be of concern (2).
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References
- Product information. Remeron. Organon, 1997.
- Committee of Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.
Q&A about Mirtazapine
I have started mirtazapine 3 days ago and feel really dizzy and lightheaded, how long does it take for initial symptoms to wear off? I have searched the net but can't seem to find out how long symptoms should persist before you know you should stop taking this medication...any input is appreciated, thanx!
Prozac helps my mood during the day but when I use it I have difficulty sleeping at night. Could I use Mirtazapine at night to help me sleep and Prozac during the day for my mood? My doctor prescribed me some but I am waiting for the week end to try it.
http://en.wikipedia.org/wiki/Serotonin_s...
I'm on Mirtazapine and indeed, it does help you to sleep, but i'm almost certain if you speak to your doctor that he/she would recommend either switching the Prozac to another similar alternative to help with the insomnia side-effect of it, or just keep you on Mirtazapine on its own. Failing that, I s'pose if you were happy with the Prozac apart from the sleep problem. they may keep you on that and prescribe a sedative or sleeping tablet like Zopiclone to help you get off to sleep, but that's so addictive. I'm sure it's the Prozac that's preventing you from sleeping so, personally, I would say your best option is to get off the Prozac and move over to something else. SSRI's as you probably know generally cause insomnia, and other dreadful things like Nausea/Vomiting/Diarrhea etc.
I have been given Mirtazapine 15 mg for mild depressions linked to Insomnia. I have been taking them for just over 3 weeks. I have experienced drowsiness the first couple of weeks which has worn off but feel lower than when I started. However I am also (as a result of six months of insomnia and depression) five weeks out of a nine year relationship with my partner. So it is difficult to tell if what I am feeling is just a broken heart. The patient information leaflet, various websites and fourms say that it can take up to four weeks before you start to feel better but I wondered if anyone has experience feeling worse before feeling better with these tablets, or if this means they just dont agree with me. I have arranged to see my GP this week to discuss it but wondered if I am being impatient.I am also seeing a councellor once a week.
Hi I was given Mirtazapine for a medication because my cat has been having a low appetite recently and the container came with a few crushed-looking tablets inside. I tried forcing my cat to eat the tiny tablets, but she would not allow me to and she would later throw the piece that was given to her. I tried again, this time crushed and with some of her food, and that time hopefully will be a success and she would be more hungry and eat and be healthy again.
Any suggestions on how I should feed my cat this Mirtazapine for her appetite loss? Thank you.
My doctor wants me to take sertraline and mirtazapine. I am deathly afraid of taking these drugs because of the chances of addiction and overdosing.
What are the chances of adiction and the specific symptoms if overdose occures with sertraline and mirtazapine?
I'm not a medical expert - but it looks like both of these drugs do much the same thing for much the same symptoms - your medical practitioner should have told you if you are supposed to take both.
"specific symptoms of overdose"
Some of that information is in the references, but I am not sure I understand it properly - if you don't either, then a real doctor, talk with, you should!
http://en.wikipedia.org/wiki/Sertraline
http://en.wikipedia.org/wiki/Mirtazapine
Is it safe to take Mirtazapine together with Wellbutrin? My doctor said, that he cannot confirm nor reject the safety, so he does not reccommend it.
I have just come back from my psychiatrist appointment, where I have been prescribed this to take alongside my other antidepressant medication.
It was suggested to me that it would be a good idea for me because it can have sedative effects on some people who take it. He said I would notice immediately if this was going to happen in my case, and said that this would be an ongoing thing with this medication and not something that would wear off after a while.
I've been asked to try it for 6 weeks to see if I get any benefit from adding this to my usual medication.
Hope this helps.
it says that the half life of mirtazapine is 20-40 hours would that mean that the whole life is 40-80 or is it different?
and are there really bad side affects? I'm also taking bupropion sr 100mg. Is that a good deression pill and how long does it take to feel it working. Is it also good to take both of these pills together?
Keep in mind that all anti-depressants have the potential to give a person the energy to commit suicide, so if you have suicidal thoughts make sure you speak to your provider immediatly.
