What side effects can mirtazapine have?
Below you will find the most important information about possible known side effects of mirtazapine.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Very common side effects:
Increased appetite, weight gain, drowsiness, dulling, headache, dry mouth.
Common side effects:
Unnormal dreams, confusion, anxiety, insomnia, listlessness, dizziness, tremor, drop in blood pressure on body position, nausea and vomiting, diarrhea, rash, joint pain, muscle aches, back pain, water retention in arms and legs, fatigue.
Uncommon side effects:
nightmares, exaggeration, excitement, delusions, restlessness (including restlessness or even anxiety and unwanted twitching), nervous discomfort, “restless legs”, fainting, low blood pressure, sensation in the mouth. !!!
Rare side effects:
aggression, muscle twitching, increase in transaminases in the blood.
unknown side effects:
abnormalities in blood formation (lack and absence of granulocytes, aplastic anemia, platelet deficiency, excess of immature blood cells), malfunction of the adrenal gland (excessive secretion of hormones impeding water secretion), sodium deficiency in the blood, Suicidal thoughts, suicide attempts, cramps (attacks), serotonin syndrome (sweating, chills, tremors, restlessness, anxiety), sensory abnormalities in the mouth, speech disorders, swelling in the mouth, increased salivation, severe skin reactions (Stevens-Johnson syndrome, bladder dermatitis, Erythema multiforme, toxic epidermal necrolysis), sleepwalking, general water retention in the tissue (edema), local swelling.
Patients with depressive illness show a range of disease-related signs and symptoms. Therefore, it can sometimes be difficult to assess which symptoms are due to the disease and which treatment of mirtazapine.
If mirtazapine is discontinued too quickly, it can temporarily lead to nausea, anxiety and arousal. Therefore, the dose must be gradually reduced (wiped out) at the end of the treatment.
The widespread use of the drug has shown that ingestion may increase the risk of fractures.
What interactions does mirtazapine show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Mirtazapine should not be used concomitantly with antidepressants from the MAO inhibitor group or for up to two weeks after the end of MAO inhibitor therapy. Conversely, about two weeks should pass before MAOIs are used in patients treated with mirtazapine.
Mirtazapine, like antidepressants from the drug class of selective serotonin reuptake inhibitors, affects the metabolism of the neurotransmitter serotonin. Therefore, with the simultaneous use with similar active ingredients (for example L-Tryptophan, Triptane, Tramadol, Linezolid, Venlafaxin, Lithium and preparations with St. John’s Wort) medical attention is required. There may be a serotonin syndrome. Signs include: fever, muscle stiffness and restlessness.
Mirtazapine may potentiate the dulling properties of benzodiazepines or other tranquilizers (especially most neuroleptics, H1-receptor blockers, opioid analgesics). Concomitant use with mirtazapine should only be carried out with medical care.
Mirtazapine can increase the effect of alcohol on the brain. Patients should therefore take no alcoholic beverages while taking mirtazapine.
In people treated with the blood thinner warfarin, mirtazapine at doses of 30 milligrams per day leads to some enhancement of anticoagulation. At higher doses of mirtazapine a stronger expression of this effect can not be excluded. Therefore, the blood clotting in such cases should be monitored very carefully by a doctor.
The concomitant use of mirtazapine with HIV-1 protease inhibitors (for AIDS), the macrolide antibiotic erythromycin, the antidepressant nefazodone, or fungicides from the group of imidazoles and triazoles (eg ketoconazole) must be carefully monitored by the physician Active ingredients inhibit the degradation of mirtazapine and thus increase its action. Cimetidine, a gastric acid binder in the H2 receptor blocker group, also potentiates the effects of mirtazapine.
In contrast, mirtazapine is broken down more quickly by the tuberculosis drug rifampicin and the antiepileptic drugs phenytoin and carbamazepine, thereby weakening its effects. The doctor will increase the mirtazapine dose if necessary. If concomitant treatment with such an agent is stopped, the dose of mirtazapine may need to be reduced.