Mirtazapine  is a medication prescribed by your healthcare provider, selected based on current evidence-based guidelines to best address specific mental health conditions. While effective, it's important to understand that all medications come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Equally essential is knowing how to monitor for side effects, and understanding the strategies to reduce their occurrence or manage them effectively. This guide aims to empower you with this knowledge, ensuring a well-informed approach to your or your child's treatment.

What is Mirtazapine?

Mirtazapine is an antidepressant by classification and works increasing levels of norepinephrine and serotonin in the brain.

When is Mirtazapine prescribed to Children & Adolescents? 

Your doctor may prescribe Mirtazapine for

• Depression
• Anxiety (Generalized Anxiety Disorder & Social Anxiety Disorder)
• Panic Disorder
• Post-traumatic Stress Disorder (PTSD)
• Eating Disorder
• Post Menstrual Dysphoric Disorder (PMDD)
• Insomnia

What is the Dose of Mirtazapine?

• The dose typically ranges from 7.5 to 45mg.
• Started at a low dose, gradually increasing to effectiveness.

Medication Guidelines: What You need to know

• Take your medication consistently every day as directed by your healthcare provider, rather than using it only when you feel you need it.
• While some patients may notice improvement within the first two weeks of starting treatment, it may take up to eight weeks to experience the medication's full benefits.
• Abruptly stopping this medication can lead to a discontinuation syndrome, which may cause symptoms like dizziness, chills, lightheadedness, fatigue, headache, muscle aches, nausea, diarrhea, restlessness, irritability and tingling.

• After the first episode of depression is resolved, staying on the effective dosage for at least one year is needed to minimize the risk of symptom recurrence. Following this period, your healthcare provider will guide you through a gradual tapering-off process and stop the medication entirely. This approach ensures a smoother transition and reduces the likelihood of relapse. For second and subsequent episodes of depression and for other mental health disorders, treatment may need to be indefinite.

• Combining Mirtazapine with certain medications can lead to a dangerous condition called Serotonin Syndrome, caused by excessive serotonin levels in the body. Symptoms include anxiety, agitation, confusion, sweating, rapid heartbeat, high blood pressure, fever, stomach problems, tremors, muscle stiffness, spasms, and heightened reflexes. Over-the-counter agents and supplements such as Dextromethorphan (DXM), St. John's Wort, certain cough and cold medications, over-the-counter migraine medications, 5-HTP, and L-tryptophan can also interact with Mirtazapine to induce serotonin syndrome. It's vital to consult your primary care provider or psychiatrist before starting any new prescription or over-the-counter medication

What can be the possible

side-effects from the medication?

Serious but Rare Side-Effects

Risk Of increased suicidal Thoughts with antidepressants

 

Antidepressant medications can sometimes lead to increased suicidal thoughts or actions, particularly in children, teenagers, and young adults during the early stages of treatment. Research indicates a small but notable elevation in the risk of suicidal thoughts and behaviors among these groups, although these do not typically extend to actual suicide deaths. The current evidence is not definitive in establishing a clear link between antidepressants and these increased risks.

Risk-benefit analysis:

Despite these concerns, the advantages of treating depression significantly outweigh the potential risks. It's crucial, however, to vigilantly monitor for this side effect.

Monitoring guidelines:

Pay careful attention to any shifts in mood, behavior, thoughts, or feelings. This is particularly critical when starting a new antidepressant or adjusting the dosage. Watch for any sudden changes, as these can be indicative of increased risks and may require immediate action.

By closely observing and reporting these changes, the effectiveness and safety of the treatment can be maximized, ensuring the best possible outcome for the patient.

• Switching into Mania (An extreme increase in activity and talking): Antidepressants, when used independently, can induce manic episodes in individuals with bipolar disorder. Furthermore, some instances of bipolar disorder manifest initially as major depressive episodes. It's crucial to communicate your child's psychiatric history and any family history of bipolar disorder to your provider. This information ensures that the provider is vigilant about the potential risk of this side effect.
  
  
• Hematological Effects: In rare cases, Mirtazapine may affect blood cell counts, leading to a decrease in certain types of white blood cells or platelets. If you develop unusual bruising or bleeding, fever, or signs of infection while taking Mirtazapine, it's crucial to seek medical attention immediately.

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE