Discussing the medication Mirtazapine specifically the topics we're going to cover include what is Mirtazapine the common dosage's fir Mirtazapine and uses cover the common side effects we'll talk about weight gain other side effects and warnings and cautions, and then we'll touch a little, but on withdrawal symptoms that can occur.
If you abruptly stop the medication it's very important information on purposes only, and it's not intended to serve as a substitute for the consultation diagnosis and/or medical treatment of a qualified physician or healthcare provider so what is Mirtazapine it's an interesting antidepressant that has it's also an alpha-2 agonist the interesting thing is the effect it affects the Alpha receptors related to norepinephrine in serotonin and that gives it a unique antidepressant effect different from other antidepressants on the market, and it can sometimes treat the depression symptoms with fewer side effects for a lot of folks so that's really interesting US, sold under the brand name REM Ron.
It is available in seven and a half fifteen thirty and forty-five milligram tablets there is also an oral disintegrating tablet we don't see those used as often common dosage typically we're going to course see it taken at bedtime with or without food, and we usually start at fifteen milligrams at bedtime and then increased fifteen milligrams every one to two weeks if we're not having the efficacy we're wanting max dose usually 45 there's been a few studies 60 milligrams a day I'm you know that's that would be extremely rare to you that much for somebody so what are the uses well of course is an antidepressant, so we see it use for that a lot we see especially for folks with sleeping problems really helpful there's nothing worse than you’re not feeling well you're depressed, and then you can't sleep that only escalates the situation.
And this medicine really does help a lot of people get some sleep, so they can really improve their mood off-label meaning it was not originally studied for this but over time we find it helps with these chronic headache prevention so folks that have repeated headaches sometimes it can help with that panic disorder sometimes can be related to depression and also some people with panic disorder have extreme difficulty sleeping so that does make sense for this most common side effects drowsiness over half the people experience drowsiness most of them probably welcome it as this is dosed at bedtime, and it can help them get a good night's sleep weight gain, so weight gain can occur and up to 12% of people so that is something to keep in mind that for some people that is difficult an increased appetite can contribute to that weight gain so dry mouth the 25% one in for constipation 13% increased cholesterol 15%.
So you know with the weight gain and the increase in appetite we could be it's a little tricky, but you know it would be mindful of our appetite make some good food choices maybe increase exercise can sometimes offset those, but that is a potential side effect and sometimes people do switch the medication because of that other side effects we can get some swelling or edema dizziness some people report a change in their dreams rash itchiness cough difficulty breathing you know these are all less than 10% or even in the 1% category, so these don't happen very often change in liver functions sometimes some mental confusion agitation change in blood pressure muscle weakness or back pain tremor and other side effects can occur what are some of the warnings that we worry about with this as with any antidepressant we watch for suicidal thinking extremely rare but if you find yourself in that category please seek help right away we need to be caution and folks with bipolar disorder.
As I can cause mania or hypomania serotonin syndrome extremely rare syndrome associated with antidepressants vision changes can occur withdrawal we'll talk about that just a little, but more restlessness it can affect sodium levels in the body we need to be cautious if people taking this has that have a history of seizures and there is a potential for drug interactions remember it is always best to go get all your medicines from the same pharmacy, so your pharmacist can screen for drug interactions and that your health care providers are aware of all the medications you take, so they can watch for them as well withdrawal symptoms typically to avoid withdrawal symptoms we're going to taper this over two to four weeks especially if you've been using meet a subpoena for longer than three weeks you probably want to slowly decrease the dose it can take some people require taper up to six months.
It depends let's say you've been on Mirtazapine for years you're going to want to slowly taper that as abruptly discontinuation symptoms include nausea vomiting diarrhea sweating chills tremor fatigue change in appetite sleep changes just it can be really uncomfortable, so some people want to slowly walk that dose down just for just so they don't have to go through all this withdrawal.
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