Author: Charles Frank
Common questions about mirtazapine
We hypothesized that mirtazapine would demonstrate long-term within-group efficacy for decreasing both the depressive symptoms and level of alcohol use of our subjects. Participants were required to be outpatients between 18 and 55 years of age at baseline to be included in the study. At the baseline assessment, participants were evaluated for the DSM-IV diagnoses of alcohol dependence and major depressive disorder, using an instrument called the MINI International Neuropsychiatric Interview (Sheehan et al., 1997). The MINI has demonstrated good reliability, validity, and clinical utility (Sheehan et al., 2008).
- During pregnancy, this medication should be used only when clearly needed.
- In a recent review (Watanabe et al., 2008), mirtazapine demonstrated a faster onset of therapeutic action compared to other antidepressant medications.
- Mirtazapine may significantly elevate serum triglyceride and total cholesterol levels.
If you are struggling with mirtazapine and alcohol addiction, Primrose Lodge offers effective treatment which can help you break free from this cycle. Mirtazapine, commonly sold under the brand name Remeron, is an antidepressant prescribed to treat depression, anxiety and insomnia. While mirtazapine can be an effective medication for these conditions, mixing mirtazapine and alcohol can be a dangerous combination. The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Check with your doctor right away if you think you are getting an infection or if you have a fever or chills, sore throat, sores in the mouth, lower back or side pain, or painful or difficult urination. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Take this medicine exactly as directed by your doctor in order to improve your condition as much as possible.
How does alcohol and mirtazapine addiction develop?
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Thus, to date, no medications have consistently demonstrated efficacy for treating the large population of persons with comorbid major depressive disorder and alcohol dependence. Thus, comorbid major depression and alcohol dependence currently represent a considerable unmet treatment need. Yoon and colleagues (2006) completed an 8 week open-label, naturalistic multicenter study using mirtazapine in a trial involving 184 subjects with comorbid alcohol dependence and depressive disorder. Subjects were prescribed a flexible dose schedule of mg/day of mirtazapine based on the clinician’s judgment.
Previous studies involving mirtazapine had not assessed level of drinking as an outcome variable. Results from our recent open label study [5] suggest robust acute phase efficacy for mirtazapine for decreasing both the depression and the drinking of that population. However, to date, no studies have evaluated the longer-term efficacy of mirtazapine in that population. We now report findings from a first long-term (two-year) naturalistic follow-up evaluation involving subjects from the acute phase trial.
Antidepressants and alcohol: What’s the concern?
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Level of drinking (number of drinks/week on the Timeline Follow-Back) and self-reported level of depressive symptoms (Beck Depression Inventory, BDI). Detox is the process of removing all traces of mirtazapine and alcohol from your body. This will help you to overcome physical dependence on the substances so you can focus on the psychological aspects of your condition.
However, mixing the two substances can also cause a range of physical side effects such as nausea, vomiting, dizziness, insomnia and sexual dysfunction. In some cases, mirtazapine and alcohol blackouts and memory loss can also occur, both of which can put you at risk of accidents, potential crimes and other dangers. Others may take alcohol and mirtazapine because the latter hasn’t started taking effect yet. Mirtazapine can take several weeks to start working so some people turn to alcohol in the meantime to help manage their symptoms.
If you are planning pregnancy, become pregnant, or think you may be pregnant, discuss with your doctor right away the benefits and risks of using this medication during pregnancy. Brief (about 10 to 15 minutes) Motivation Enhancement Therapy was also provided at each assessment, which focused on medication compliance and compliance with study procedures [8]. Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. If you or someone you know is struggling with mirtazapine and alcohol addiction, please contact Primrose Lodge to get the help you need. Our qualified team of professionals will be able to assess your condition and provide a treatment plan that will help you achieve long-term recovery.
Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.. Do not take mirtazapine with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking mirtazapine during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping mirtazapine before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe seizures.
Common questions about mirtazapine
No subjects reported serious adverse events; all adverse events related to mirtazapine were reported to be minimal to moderate. No subjects in the study dropped out due to side effects of mirtazapine. The findings of that study indicated that both medications resulted in a reduction of depression and alcohol craving. Mirtazapine demonstrated a large effect size for treating depression and a moderate effect size for treating alcohol craving. Efficacy for decreasing level of alcohol use could not be assessed, because neither of those two studies assessed level of drinking. Lovieno et al., 2011 [4] also noted the complete lack of study data on a number of newer antidepressants such as mirtazapine for treating comorbid populations.
Generic Name(S): mirtazapine
Alcohol can increase the nervous system side effects of mirtazapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with mirtazapine. Do not use more than the recommended dose of mirtazapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns. According to the NHS, some people can take mirtazapine and alcohol together but it is advised that you stop drinking the first few days you begin taking mirtazapine to see how it affects you.
Other Interactions
Participant-rated depressive symptoms were assessed with the Beck Depression Inventory (BDI) [10]. Drinking behavior was evaluated using the timeline follow-back method (TLFB) [11]. An eight-week open label study of mirtazapine and motivation therapy was conducted involving persons 18 to 55 years of age with DSM-IV diagnoses of comorbid MDD/AD.