Mirtazapine

Why have I been prescribed mirtazapine?

Mirtazapine is licensed to treat moderate to severe major depressive disorder. You may wish to discuss this with your prescriber who will be able to give you more information.

Tablets are just one way to treat depression. Other therapies are also effective in managing depression. You may wish to discuss these with your prescriber.

What exactly is mirtazapine?

Mirtazapine is an antidepressant. It is not a tranquilliser or sleeping tablet. It comes both as an ordinary tablet and one that dissolves on your tongue, normally taken at night.

Is mirtazapine safe to take?

It is usually safe to take as prescribed by your prescriber, but like many medicines will not suit everyone. Let your prescriber know beforehand if any of the following apply to you:

  • Have kidney disease, diabetes, epilepsy, liver problems or glaucoma
  • Have a history of heart disease such as angina, low blood pressure or recent heart attack
  • Problems passing water
  • If you are taking other medication; this includes any prescribed medication or any medicines bought over the counter from your pharmacy, including herbal remedies
  • If you are pregnant, breast feeding, or wishing to become pregnant

What is the usual dose of mirtazapine?

The normal dose range for mirtazapine is between 15 and 45mg given at night.

How should I take my mirtazapine?

Follow the directions on the label. If you have any questions ask your pharmacist, nurse or prescriber. You should also read the information leaflet supplied with the medication.

What should I do if I miss a dose?

If you miss a dose and it is within a few hours of the normal time, continue to take it as normal. If it is longer, miss the dose and continue as normal when the next dose is due. Never double up on the dose.

When I feel better, can I stop taking mirtazapine?

No, if you stop your mirtazapine too early, your symptoms may return. To reduce the chances of this happening, it is advised you should continue to take it for at least 6 months after you become well and sometimes longer. You should discuss this with your prescriber.
You should not stop taking mirtazapine suddenly as it may cause some unpleasant ‘withdrawal’ effects. – see next section

Is mirtazapine addictive?

Mirtazapine is not addictive but it can cause ‘withdrawal’ or discontinuation effects if stopped suddenly, or rarely if a few doses are missed. These effects can include anxiety, dizziness, feeling sick and problems sleeping. Other people describe feeling confused or ‘out of sorts’. To help reduce the chance of this happening, the mirtazapine should be slowly stopped over a period of weeks. You may wish to speak to your prescriber, pharmacist or nurse about this.

What will happen to me when I start taking mirtazapine?

All antidepressants work slowly. Although some people notice a change in the first week, normally it will take several weeks for the antidepressant to have its full effect. It is important to continue to take the antidepressant, as long as you are able to tolerate it, for long enough so that its full effects can be seen, generally 6 weeks for depression. As with all antidepressants careful observations need to be made in the first few weeks of treatment, to look for any increase in suicidal thoughts which may occur.

As with all medication mirtazapine does have side effects. You may well experience these before you start feeling the benefits. Most side effects are short lived and will pass with time. The following table contains some of the more common and more important side effects of mirtazapine and what to do about them. It is not a complete list and not everyone will get all of those listed. Ask your pharmacist, nurse or prescriber if you are worried about anything else you notice that you think might be a side effect.

For details of the side effects table, please follow this link: Mirtazapine

Mirtazapine can also occasionally cause changes in your liver enzymes and sodium levels, and changes in your blood (agranulocytosis). These will be checked periodically by your prescriber and will be discussed with you if there are any problems. It may also cause fits (convulsions), but the frequency of this is not known.

What about alcohol?

Ideally do not drink alcohol when taking this medication. This is because taking them together can make you more drowsy, sometimes severely. There is no safe drink and drive limit when taking this medication. Once people have been taking this medication for some time, they may be able to take small amounts of alcohol. Try a small amount in a safe environment and see how you feel. Ideally get someone else to tell you.

Mirtazapine stays in the body a long time, so there is no point missing a tablet to have a drink.

Useful information

talking-shop-leafletPlease click on the image to the left or follow this link to download a copy of our Mirtazapine leaflet.