Mirtazapine
Risk Factor: CM
Class: CENTRAL NERVOUS SYSTEM DRUGS
/ Antidepressants
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
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).
References
- Product information. Remeron. Organon, 1997.
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Committee of Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
Questions and Answers
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!
You need to call the doc that prescribed this medication and let him know you are having side effects. The doc will call you back and tell you what to do. Without calling the doc he has no way of knowing you are having problems with this medication.
Could I take Prozac during the day and Mirtazapine at night to sleep?, 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.
I really wouldn't advise it as it may cause what's known as "Serotonin Syndrome" due to the combination of two anti-depressant drugs that both work on Serotonin.
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.
Why does mirtazapine make you gain weight? Is it just because it increases appetite?, I was prescribed mirtazapine 15 mgs to help me sleep. Is it going to make me gain weight? I know with a lot of meds, the only reason you gain weight is because they increase hunger/appetite...is this the same case for this one, or does the medication itself directly cause weight gain?
Thanks!
It does cause weight gain directly. Be careful
How long does Mirtazapine take to work?, 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.
It takes between 2 and 4 weeks for most anti-depressants to kick in. It can depend on your weight. If you are smaller it will kick in sooner. I have major issues with insomnia and depression. I also get an anti-histamine from my doctor which has a slight sedative to help me sleep. They arent addictive and can help a bit.
How do give Mirtazapine to my cat?, 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.
Our previous cat needed various medications for the last couple of years. I really didn't want to stress her out by trying to force pills down her throat. So we always kept a jar of baby food (Gerbers chicken or turkey - plain, with nothing else added to it) and hid the pill in the food.
What are the specific symptoms if overdose occures with sertraline and mirtazapine?, 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?
All I can suggest is that these references below may help you somewhat
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 Wellbutrine?, 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.
Yes it is perfectly safe to do so if you have consulted a doctor who is familiar with these meds. They both offer considerable advantages for me. I am able to sleep well with the Mitazapine and the Wellbutrin helps with the weight gain normally associated with this drug and helps to heighten my alertness. These are anti-depressents and are used only in my case for these reasons. I found that alone they are not as good as in combination.
Can take mirtazapine lead to cramp and tiredness when swimming?,
I have had mirtazapine in the past, obviously all anti-deps' work differently with all people, but never ever before (or since) have I had such a bad experience with these kinds of drugs.
Side effects can cause tiredness, and if your tired this will lead to cramps and other effects when excersizing.
Are these the "soltabs" the ones that dissolve on your tongue?
The best option would always be to ask your doctor or any pharmacist in any chemist for advice, they are all fully qualified to advise you.
If you dont want to do this look up the product literature online from the company who manufactured the drug (the box should indicate the manufacturer, then go look on their website).
As said though, everyone has different reactions to different drugs, especially anti deps', one persons experience with them may be totally different to somone elses.
But my experience with them was awfull.
Can I take herbal diet pills with Mirtazapine?, I've been taking Mirtazapine for depression for the past few months, and been on the full 45mg for the past month. I went through the normal appetite increase and weight gain. Now things seem to be back to normal, and my diet is fine, and I'm taking up jogging everyday. I want to take the diet pills to help me loose the weight I gained. They are made from dandelion root, kelp and boldo. I'll be grateful for any opinions, thank you!
I have been through it all and know what's it about. The main thing is to stick in there. You can't be an addict to food and never exercise if you want to live a healthy life and keep the weight off. I've worked out, done every diet, and all types of classes.
Nothing works, besides dedication and intelligence towards the subject of losing weight.
First, depending on how much weight you need to lose, your diet is the first concern. You can't eat 10,000 calories a day and expect the weight to come off, even if you are exercising a lot. Which brings us to the next thing. Duh, Exercising...
This is a must especially if you need to a lot of weight. Get at least 30 mins of some good hardcore exercising. Do some cardio, in the long run, it's good for the heart.
However, I find the most hardest part of losing weight/keeping it off, in my diet. It's so hard to keep your fingers out of the cookie jar or those chocolate goodies. I've found a great addition to help any one out, it's a natural weight loss supplement called Proactol. Now don't get all crazy on me and say diet pills don't work. That is true, but not in this case. This one isn't meant to burn pounds while you sit on the couch. It's an appetite suppressant, along with being a fat binder. I saved money on the pills at theweightlossplace.com along with getting some good info. It basically makes those fingers not go towards the cookie jar. For me it's the best pill I've tried and I've tried cupboards full. Now this doesn't mean you have to follow my foot steps but I've successfully lost roughly 70 pounds and keeping it off til this day.
Well good luck and remember what I said, Dedicate.
