Other important side effects that could potentially be serious include
- abnormal heart beats,
- low blood pressure upon standing
- (orthostatic hypotension),
- manic episodes, and
- decreased blood cells.
WARNING: If antidepressants are discontinued abruptly, withdrawal symptoms such as dizziness, headache, nausea, and changes in mood may occur. Such symptoms may occur when even a few doses of antidepressant are missed. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.
Antidepressants may increase the risk of suicide in children and adolescents. There are concerns that antidepressants may also induce suicide in adults. Patients with major depression may experience worsening of depression or suicidal thoughts regardless of whether or not they are treated. Therefore, patients started on antidepressants should be closely observed for signs of worsening depression, suicidal thinking or changes in behavior.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablet (Orally disintergrating): 15, 30, and 45 mg
STORAGE: Tablets should be stored at room temperature, 15-30 C (59-86 F).
DOSING: The usual starting dose for mirtazapine is 15 mg once daily, usually at bedtime. Doses may be increased every 1-2 weeks up to a maximum dose of 45 mg daily. It may be taken with or without food.
- the benzodiazepine class of anti-anxiety drugs (for example, diazepam [Valium], lorazepam [Ativan], clonazepam [Klonopin], alprazolam [Xanax, Xanax XR, Niravam]),
- the narcotic class of pain medications and its derivatives (for example, oxycodone and acetaminophen [Percocet, Roxicet, Tylox, Endocet], hydrocodone/acetaminophen [Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus, Norco], hydromorphone [Dilaudid], codeine, propoxyphene [Darvon]),
- the tricyclic class of antidepressants (for example, amitriptyline [Elavil, Endep], imipramine [Tofranil], desipramine [Norpramin]),
- certain antihypertensive medications (for example, clonidine [Catapres], propranolol [Inderal, Inderal LA, Innopran XL), and
- some antihistamines (for example, diphenhydramine [Benadryl], hydroxyzine [Atarax, Vistaril]).
Quick GuideDepression Hurts: Physical Symptoms of Depression
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