MIRTAZAPINE (‘Zispin’)
Mur – taz – a – peen
Why have I been prescribed mirtazapine?
Mirtazapine is used to treat depression. It is an antidepressant. Depression is a common condition. It is different from the
normal “ups and downs” of everyday life. People with depression may feel sad most of the time and cannot see an end to
their sadness. Tiredness and poor sleep are very common, and so are changes in appetite. Many people also find that they
simply cannot enjoy any of life’s pleasures.
Depression is treated in many ways. Certain “talking” therapies are also effective for some people. Antidepressants can
generally be relied upon to relieve the symptoms of depression in most people.
What exactly is mirtazapine?
Mirtazapine is an antidepressant. It is not a tranquilliser or sleeping tablet. It is a relatively new kind of antidepressant. The
brand or trade name for mirtazapine is ‘Zispin’.
Is mirtazapine safe to take?
It is usually safe to have mirtazapine regularly as prescribed by your doctor, but it doesn’t suit everyone. Let your doctor
know if any of the following apply to you, as extra care may be needed:
a) if you have epilepsy, diabetes, or glaucoma, or suffer from heart, liver, kidney, or prostate trouble;
b) if you are taking any other medication. This includes medicine bought from your pharmacist without a prescription, such
as St. John’s wort.
c) if you are pregnant, breast feeding, or wish to become pregnant.
What is the usual dose of mirtazapine?
The starting dose of mirtazapine is usually 15mg or 30mg a day. The usual dose is 30mg a day. The maximum dose of
mirtazapine is 45mg a day.
How should I take mirtazapine?
Mirtazapine is best taken at night, especially at first, when you may feel a little drowsy. Look at the label on your medicine; it
should have all the necessary instructions on it. Follow this advice carefully. If you have any questions, speak to your doctor
or pharmacist. Most medicines are now dispensed with an information leaflet for you to read.
What should I do if I miss a dose?
Never change your dose without checking with your doctor. If you forget a dose, take it as soon as you remember, as long
as it is within a few hours of the usual time.
Is mirtazapine addictive?
Mirtazapine is not addictive, although some people do get some “discontinuation” effects if they stop some other
antidepressants suddenly. These effects can include anxiety, dizziness, feeling sick and not being able to sleep. Some
people feel confused and “out of sorts”. These symptoms are very rare indeed with mirtazapine. It is best to discuss this
with your pharmacist, doctor or nurse.
What will happen to me when I start taking mirtazapine?
All antidepressants work slowly. People tend to feel better over a period of weeks rather than days. Different symptoms
may get better at different times. Most people find that they feel noticeably better after about two or three weeks. However,
the full effect of antidepressants is usually felt only after about four to six weeks. It is very important to continue to take
antidepressants so that the full effects can be felt. Speak to your doctor or pharmacist if you have any questions about this.
Unfortunately, you might get some side effects before you start to feel any better. Most side effects should go away after a
few weeks. Look at the table over the page. It tells you what to do if you get any side effects. Not everyone will get the side
effects shown. There are many other possible side effects. Ask your pharmacist, doctor or nurse if you are worried about
anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
DROWSINESS Feeling sleepy or sluggish. It can last for a
few hours after taking your dose
Don’t drive or use machinery. This may wear off with time. If it is
still a problem after a few weeks, see your doctor.
INCREASED
APPETITE
Eating more and putting on weight,
especially just after you start taking
mirtazapine
Avoid fatty foods like chocolate, crisps and fizzy drinks. A diet
full of vegetables and fibre will usually help, as will physical
activities such as walking. If it becomes a problem or you are
worried, ask to see a dietician.
UNCOMMON
ALTERED LIVER
FUNCTION
Your liver is not working as normal. You
should not feel any symptoms. This is only
discovered if your doctor does a blood test.
Your doctor will probably want to do regular blood tests to make
sure your liver is OK.
RARE
DRY MOUTH Not much saliva or spit. Sugar-free boiled sweets, chewing gum or eating citrus fruits
usually helps. If not, your doctor can give you a mouth spray. A
change in medicine or dose may be possible.
HYPOTENSION A low blood pressure. You may feel faint
when you stand up.
Try not to stand up too quickly. If you feel dizzy, don’t drive. This
dizziness is not dangerous
TREMOR Feeling shaky Contact your doctor now.
VERY RARE
BLOOD
DYSCRASIAS
Loss of white blood cells, and may show
as fever or sore throat.
Contact your doctor now.
SEXUAL
DYSFUNCTION
Lack of libido or no interest in sex. Inability
to maintain an erection
Mention it to your doctor on your next visit.
What about alcohol?
It is officially recommended that people taking mirtazapine should not drink alcohol. This is because both mirtazapine and
alcohol can cause drowsiness. If the two are taken at the same time, severe drowsiness can result. This can lead to falls or
accidents. As well as this, drinking alcohol often makes depression worse. Excessive drinking is especially likely to do this.
Once people are used to taking mirtazapine, they can sometimes drink alcohol in small amounts without any harm. Avoid
alcohol altogether for the first one or two months. After this, if you want a drink, try a glass of your normal drink and see
how you feel. If this doesn’t make you feel drowsy, then it is probably OK to drink small amounts. It pays to be very cautious
because alcohol affects people in different ways, especially when they are taking medication.
Don’t stop taking your medication because you fancy a drink at the weekend. If you do drink alcohol, drink only small
amounts. Never drink any alcohol and drive while on mirtazapine. Discuss any concerns you may have with your doctor or
pharmacist.
When I feel better, can I stop taking mirtazapine?
No. If you stop taking mirtazapine, your original symptoms may return. To reduce your chances of becoming depressed
again, you may need to take your antidepressant for at least 6 months after you feel better, and sometimes longer. This is
not thought to be harmful. You should decide with your doctor when you can come off it.
Remember, leaflets like this can only describe some of the effects of medication. You may find other
books or leaflets also useful. If you have access to the internet you may find a lot of information
there as well, but be careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information Leaflet.
For more information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday on 020 7919 2999 or
visit www.nmhct.nhs.uk/pharmacy
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