Mirtazapine Teva Uk (Mirtazapine)

Mirtazapine is a noradrenergic and specific serotonergic antidepressant indicated for depressive disorders.

• Major depressive disorder: alleviates depressive symptoms and improves mood in adults.
• Depressive episodes associated with major depressive disorder: reduces severity and frequency of episodes.
• Treatment‑resistant depression (as adjunct): may enhance response when other agents are insufficient.

• Mirtazapine antagonizes central presynaptic α2‑adrenergic receptors, increasing norepinephrine release, and blocks serotonin 5‑HT2 and 5‑HT3 receptors, enhancing serotonergic transmission while reducing associated side effects. This combined action raises synaptic concentrations of norepinephrine and serotonin, contributing to its antidepressant effect.

Mirtazapine may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Sedation or drowsiness: feeling unusually sleepy.
• Increased appetite and weight gain: heightened hunger leading to weight increase.
• Dry mouth: reduced salivation.
• Constipation: infrequent or difficult bowel movements.
• Dizziness: sensation of light‑headedness.
• Peripheral edema: mild swelling of the lower limbs.

Serious or Rare Side Effects

• Agranulocytosis: severe reduction in white blood cells.
• Seizures: occurrence of convulsive episodes.
• Severe hypersensitivity: rash, swelling, or breathing difficulty.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Suicidal thoughts: emergence or worsening of suicidal ideation.
• Hyponatremia: low blood sodium levels.

Before initiating therapy, consider patient‑specific factors and monitor for safety concerns.

• Pregnancy: safety not established; weigh potential benefits against risks.
• Breastfeeding: excreted in milk; assess infant risk before use.
• Elderly patients: start at low dose and monitor for excessive sedation.
• Hepatic impairment: dose adjustment may be required.
• Concomitant CNS depressants: increased risk of sedation and respiratory depression.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and light.

Mirtazapine can interact with several drug classes, requiring careful management.

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of serotonin syndrome.
• Central nervous system depressants (e.g., benzodiazepines, opioids): profound sedation.
• Potent CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): increased mirtazapine plasma levels.

Moderate Interactions (Monitor Closely)

• Other serotonergic agents (e.g., SSRIs, SNRIs): potential additive serotonergic effects.
• Anticholinergic drugs: heightened anticholinergic burden.
• Alcohol: may exacerbate CNS depression.
• Warfarin: possible alteration of INR, monitor coagulation parameters.