|Type of medicine||Antidepressant|
|Used for||Depression in adults|
|Also called||Zispin SolTab®|
|Available as||Tablets, orodispersible (melt-in-the-mouth) tablets, oral solution|
Noradrenaline and serotonin are chemicals in the brain which, when released, act to improve mood. Depression is thought to involve a decrease in the amount of these chemicals. Mirtazapine works in the brain to increase the amount of noradrenaline and serotonin in order to lift mood and help relieve depression.
Before taking mirtazapine
Before taking mirtazapine make sure your doctor or pharmacist knows:
- If you have liver, heart or kidney problems.
- If you have hypotension (low blood pressure), glaucoma or diabetes.
- If you have ever had epilepsy.
- If you have been experiencing difficulty passing urine.
- If you have a history of psychiatric disorders such as schizophrenia or bipolar depression.
- If you have an intolerance to sucrose or have a condition called phenylketonuria.
- If you are pregnant, trying for a baby or breast-feeding.
- If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
- If you have ever had an allergic reaction to this or any other medicine.
How to take mirtazapine
- Before beginning treatment, read the manufacturer's printed information leaflet.
- Take mirtazapine exactly as directed by your doctor.
- Tablets should be swallowed whole with a glass of water. Do not not chew or crush the tablets.
- Orodispersible (melt-in-the-mouth) tablets should be removed carefully from the packaging by peeling off the foil then placed on the tongue where they will dissolve. They can then be swallowed without water.
- Try to take mirtazapine at the same times each day to avoid missing any doses. It is usually taken at bedtime.
- If you forget to take a dose, do not worry, just remember to take the next dose when it is due. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- It may take up to four weeks before you feel the full benefit of this treatment although some improvement is often felt earlier than this. Do not stop taking mirtazapine thinking that it is not working.
- Suicidal thoughts may be associated with depression and the medicines used to treat it. You may be at risk of such thoughts early in your treatment, or soon after stopping if you have previously thought about harming yourself, or if you are a young adult. Tell your doctor straight away if you are having any thoughts of harming yourself.
- You must keep your regular appointments with your doctor who will want to check on your progress. If you do not feel any better after taking mirtazapine for 4 weeks, let your doctor know.
- Mirtazapine should usually be stopped gradually over a few weeks to avoid withdrawal symptoms which may include dizziness, anxiety, headache, feeling sick and agitation. For this reason, do not stop taking mirtazapine without speaking to your doctor first.
Can mirtazapine cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Mirtazapine side-effects||What can I do if I experience this|
|Drowsiness||Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert. Try to avoid alcohol as it will increase drowsiness|
|Light-headedness or dizziness when getting up from a sitting or lying position||Getting up slowly should help. If you begin to feel dizzy, lie down until the feeling passes, then sit for a few minutes before standing. If this becomes a problem speak with your doctor|
|Increased appetite and weight, dry mouth, swollen feet and ankles, tiredness, shakiness, vivid dreams or difficulty sleeping, agitation, pain in the joints or muscles, and feelings of hostility such as anger||If any of these become troublesome, speak with your doctor|
Important: if you develop any of the following, contact your doctor straight away:
- Jaundice (yellowing of the skin and whites of the eyes).
- Fever, sore throat, or a swollen and sore mouth.
- Swelling of the lips, face or tongue.
If you experience these or any other worrying symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store mirtazapine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 59th Edition (March 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
- Manufacturer's PIL, Mirtazapine 15 mg and 45 mg Tablets, Actavis UK Ltd, electronic Medicines Compendium. Dated October 2010.
- Manufacturer's PIL, Zispin SolTab®; Manufacturer's PIL, Zispin SolTab®, Organon Laboratories Limited, electronic Medicines Compendium. Dated October 2010.
|Original Author: Helen Allen||Current Version: Helen Allen||Peer Reviewer: Prof Cathy Jackson|
|Last Checked: 15/12/2011||Document ID: 1081 Version: 24||© EMIS|
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.