DESCRIPTION
Mirtazapine is a mood elevator used to treat depression. Your doctor may prescribe an antidepressant drug, such as mirtazapine, to treat insomnia. Clinical trials with antidepressants have shown a wide range of effects on one's ability in addition to effects on daytime sleepiness. Some side effects associated with this drug include drowsiness, dizziness, anxiousness, confusion, weight gain, dry mouth, and upset stomach.
ORIGINAL USES (ON-LABEL)
The treatment of depression.
NEWLY DISCOVERED USES (OFF-LABEL)
Charles Bonnet syndrome, fibromyalgia, insomnia, migraine prevention, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder (PTSD).
POTENTIAL SIDE EFFECTS
Dry mouth, constipation, increased appetite, weight gain, flu-syndrome, muscle aches, abnormal dreams, agitation, anxiety, somnolence, abnormal thinking, increases in blood pressure.
CAUTIONS
- Do not use within 14 days of MAO inhibitors.
- Notify your doctor if you have a seizure disorder.
- May cause sedation, and impair tasks requiring alertness.
- May worsen psychosis in some patients with bipolar disease.
- The possibility of suicide is always present in patients with severe depression.
- Notify your doctor if you have kidney or liver impairment.
- SolTab formulation contains phenylalanine.
DRUG INTERACTIONS
Diazepam.
Avoid combination: MAOIs: Possible serotonin syndrome (hyperthermia, autonomic instability, seizures, death).
FOOD INTERACTIONS
Avoid alcohol.
HERBAL INTERACTIONS
St. John's wort, valerian, SAMe, kava kava.
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excretion in breast milk unknown. Do not breast-feed during therapy.
SPECIAL INFORMATION
This drug has a warning regarding that both adult and children with major depression may experience worsening of their depression and/or the emergence of suicidal thinking and behavior (suicidality), whether or not they are taking antidepressant medications.
The warning recommends patients being treated with antidepressants be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose changes.
Mirtazapine improved sleep in patients with depression. Alternatively, 8% to 48% of patients with depression who were treated with it reported daytime sleepiness compared with 18% of patients who received placebo.
In a small study of six patients with major depression and insomnia, this drug decreased in sleep latency significantly and significantly increased total sleep time and sleep efficiency during the first two weeks of treatment.
Researchers at the University of Connecticut Health Center in Farmington compared mirtazapine with another antidepressant, fluoxetine, in patients with major depression and insomnia.
Nineteen patients in this study received mirtazapine or fluoxetine for eight weeks. The mirtazapine group significantly improved in sleep latency and sleep efficiency after only two weeks of treatment.
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