Side Effects of mirtazapine: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Main research findings

Mirtazapine is an antidepressant medication used to treat depression and other mental health conditions. This article reviews several studies that have investigated the potential side effects associated with mirtazapine use.

The research suggests that while mirtazapine can be effective for treating depression, it can also cause a range of side effects. Some of the most common side effects include drowsiness, weight gain, and dry mouth, as reported in several studies 5 . Mirtazapine has also been linked to more serious side effects like secondary angle closure glaucoma, as reported in one case study 16 , and potential drug interactions, such as increased fatigue and sleepiness when combined with paroxetine 4 .

Reasons for side effects

The side effects of mirtazapine are likely due to its mechanism of action. Mirtazapine works by blocking the reuptake of serotonin and norepinephrine, neurotransmitters that play a role in regulating mood, sleep, and appetite. By interfering with these neurotransmitters, mirtazapine can cause various side effects that affect these functions.

Common side effects

Drowsiness

Drowsiness is one of the most common side effects of mirtazapine. This side effect is mentioned in several studies 5 , 4 , 23 , and may be exacerbated if mirtazapine is taken with other medications that cause drowsiness.

Weight gain

Mirtazapine can also lead to weight gain due to its effects on appetite. Weight gain is listed as a potential side effect in various studies 5 .

Dry mouth

Dry mouth is another common side effect associated with mirtazapine. This side effect is mentioned in various studies 5 .

Nausea

Nausea can occur as a side effect of mirtazapine use, as indicated in several studies 5 .

Constipation

Constipation is another side effect that can be associated with mirtazapine use. This side effect is mentioned in several studies 5 .

Dizziness

Dizziness has been reported as a side effect of mirtazapine use, particularly when combined with adaptogens 17 .

Rash

Mirtazapine may cause rash, potentially due to an allergic reaction. This potential side effect is mentioned in one study 16 .

Secondary angle closure glaucoma

One case study has linked mirtazapine to secondary angle closure glaucoma 16 .

Sexual dysfunction

Mirtazapine may cause sexual dysfunction. This potential side effect is mentioned in one study 25 .

Countermeasures for side effects

Drowsiness

Drowsiness may be reduced by adjusting the dosage of mirtazapine. It's important to consult a doctor if using mirtazapine with other medications that cause drowsiness.

Weight gain

Weight gain may be managed through diet and exercise. Consult a doctor to discuss appropriate strategies for managing weight gain.

Dry mouth

Dry mouth can be relieved by staying well-hydrated. Consult a doctor if dry mouth is persistent or bothersome.

Nausea

Nausea may be alleviated through dietary changes or with medication. Consult a doctor to explore appropriate strategies for managing nausea.

Constipation

Constipation can be addressed by consuming a high-fiber diet and staying hydrated. Consult a doctor if constipation is persistent or severe.

Dizziness

Dizziness can be minimized by standing up slowly. Consult a doctor if dizziness is frequent or severe.

Rash

If you develop a rash, seek immediate medical attention. You may need to stop taking mirtazapine.

Secondary angle closure glaucoma

Secondary angle closure glaucoma is caused by increased intraocular pressure. If this condition is diagnosed, seek medical attention for appropriate treatment.

Sexual dysfunction

Sexual dysfunction may be addressed by adjusting the dosage of mirtazapine or switching to a different medication. Consult a doctor to discuss appropriate strategies for managing sexual dysfunction.

Comparison between studies

Common points of studies

Multiple studies have found that mirtazapine can cause side effects such as drowsiness, weight gain, and dry mouth.

Differences between studies

There are differences in the specific side effects reported in each study, as well as the severity of these side effects. The studies also vary in their findings regarding drug interactions with mirtazapine.

Precautions for application in real life

Mirtazapine can be an effective treatment for depression, but it is important to be aware of the potential side effects. Before starting mirtazapine, consult with a doctor to understand the risks and benefits of the medication. If you experience any side effects while taking mirtazapine, it's essential to contact your doctor immediately.

Current limitations of research

The available research on mirtazapine side effects has certain limitations. Some studies lack detailed information on the frequency and severity of side effects. Further research is also needed to understand how mirtazapine side effects interact with other factors, such as individual patient characteristics and medications.

Future research directions

Further research on mirtazapine side effects is necessary. This research should focus on providing more detailed information about the frequency and severity of side effects, as well as exploring the relationship between side effects and other factors.

Conclusion

Mirtazapine is a potentially effective treatment for depression, but it's crucial to be aware of its possible side effects. It's essential to discuss the risks and benefits of mirtazapine with your doctor before starting treatment and to report any suspected side effects to your healthcare provider promptly.

Literature analysis of 28 papers
Positive Content
19
Neutral Content
2
Negative Content
7
Article Type
2
0
2
10
27
1.

No benefit from mirtazapine for treating agitation in dementia.

Author:

Agitation reduction

This review focuses on the results of a randomized, double-blind, placebo-controlled trial investigating the effectiveness of mirtazapine for agitated behaviors in dementia, which found that mirtazapine significantly reduced the severity of agitated behaviors compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Pathophysiology and management of Akathisia 70 years after the introduction of the chlorpromazine, the first antipsychotic.

Author: ZareifopoulosN, KatsarakiM, StratosP, VilliotouV, SkaltsaM, DimitriouA, KarveliM, EfthimiouP, LagadinouM, VelissarisD

Akathisia

Akathisia, a distressing side effect of psychiatric drugs characterized by restlessness and an inability to sit still, is commonly associated with antipsychotic drugs that block dopamine D2 receptors. However, akathisia has also been reported with other drugs like SSRIs, SNRIs, stimulants, and mirtazapine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Antipsychotic Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD): Management of Extrapyramidal Side Effects.

Author: OhnoYukihiro, KunisawaNaofumi, ShimizuSaki

BPSD treatment
EPS
Parkinsonian symptoms

This review discusses the use of antipsychotic drugs for behavioral and psychological symptoms of dementia (BPSD), specifically focusing on managing extrapyramidal side effects (EPS). It highlights the synergistic effects of cholinesterase inhibitors and 5-HT reuptake inhibitors on EPS induction, while memantine and mirtazapine reduce EPS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Combination of mirtazapine and paroxetine: possible clinically demonstrated interaction?

Author: ČerveňováJaroslava

Depression treatment
Drug interactions
Side effects

This case report discusses the potential drug interaction between paroxetine and mirtazapine, two antidepressants, which may lead to fatigue and daytime sleepiness.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Lipoic acid prevents mirtazapine-induced weight gain in mice without impairs its antidepressant-like action in a neuroendocrine model of depression.

Author: OliveiraTatiana de Queiroz, Chaves FilhoAdriano José Maia, JucáPaloma Marinho, SoaresMichelle Verde Ramos, CunhaNatássia Lopes, VieiraCharliene Freire Xavier, Gadelha FilhoCarlos Venício Jataí, VianaGlautemberg de Almeida, De OliveiraGabriela Mariângela Farias, MacedoDanielle Silveira, VasconcelosSilvânia Maria Mendes

Cognitive enhancement
Depression treatment
Weight loss
Sedation
Weight gain

Mirtazapine (MIRT), an antidepressant, is associated with weight gain and metabolic changes. This study found that lipoic acid (ALA), an antioxidant, effectively prevented weight gain and metabolic changes induced by MIRT in a mouse model of depression without compromising its antidepressant and cognitive enhancing effects. The findings suggest that combining ALA with MIRT could offer a new treatment strategy for depression with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Serotonin Syndrome Following an Uncomplicated Orthopedic Surgery in a Patient With Post-Traumatic Stress Disorder.

Author: SchuchLuiz Gustavo, YipAnita, NouriKiana Farah, GregersenMaren, CasonBrian, KukrejaJasleen, WozniakCurtis, BrzezinskiMarek

Serotonin syndrome

This case report describes the first instance of serotonin syndrome (SS) in a young veteran with PTSD following surgery, highlighting the need for increased awareness of SS risk in this population.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Pharmacologic interventions for antidepressant-induced sexual dysfunction: a systematic review and network meta-analysis of trials using the Arizona sexual experience scale.

Author: LuftMarissa J, DobsonEric T, LevineAmir, CroarkinPaul E, StrawnJeffrey R

Improved sexual dysfunction

Sildenafil appears to be the most effective intervention for antidepressant-induced sexual dysfunction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Validating the effect of Ondansetron and Mirtazapine In Treating hyperemesis gravidarum (VOMIT): protocol for a randomised placebo-controlled trial.

Author: OstenfeldAnne, PetersenTonny Studsgaard, FuttrupTina Bergmann, AndersenJon Trærup, JensenAndreas Kryger, WestergaardHanne Brix, PedersenLars Henning, LøkkegaardEllen Christine Leth

Hyperemesis treatment

This study investigates the effect of mirtazapine, an antidepressant, on hyperemesis gravidarum, a condition characterized by severe nausea and vomiting during pregnancy. The study will also provide data on the effect of ondansetron, an antiemetic commonly used to treat hyperemesis gravidarum.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Drug-induced tics: An observational postmarketing study.

Author: TouafchiaDavy, MontastrucFrançois, Lapeyre-MestreMaryse, RousseauVanessa, ChebaneLeila, RevetAlexis

Drug-induced tic investigation
Drug-induced tics

This study investigated the association between drug use and tics. The study found that certain types of drugs, such as neuroleptics, psychostimulants, and anti-epileptics, were associated with an increased risk of tics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

13.

Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review.

Author: WangSheng-Min, HanChangsu, BahkWon-Myoung, LeeSoo-Jung, PatkarAshwin A, MasandPrakash S, PaeChi-Un

Improved safety profile
Lower overdose risk
Bleeding
Dry mouth
Gastrointestinal side effects
Hepatotoxicity
Hyponatremia
Seizure
Sexual dysfunction
Weight gain

This review compared the common side effects of tricyclic antidepressants (TCAs) with newer generation antidepressants, including SSRIs, SNRIs, mirtazapine, and bupropion. While newer antidepressants generally have fewer side effects after overdose and higher tolerability, evidence on other side effects was inconsistent, highlighting the need for further research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Gabapentin and oral antidepressants for chronic pruritus: a prospective cohort study evaluating efficacy and side effects in daily dermatological practice.

Author: KouwenhovenT A, van de KerkhofP C M, KamsteegM

Chronic pruritus relief
Gabapentin and antidepressant use

Gabapentin and antidepressants were effective and safe in treating chronic pruritus unresponsive to conventional treatment.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Are all antidepressants the same? The consumer has a point.

Author: CaminoSebastian, StrejilevichSergio A, GodoyAntonella, SmithJose, SzmulewiczAlejandro

High satisfaction
Emotional blunting

Patients using antidepressants reported different subjective experiences depending on the drug. Users preferred non-serotoninergic agents over serotonergic ones due to their lower propensity to produce emotional blunting.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Mirtazapine-induced bilateral secondary angle closure in a female.

Author: RajSrishti, KaurManpreet, SrinivasaraoKandragunta, ThattaruthodyFaisal, KaushikSushmita, PandavSurinder Singh

Angle closure
Ciliary body effusion

This case report describes a female patient who developed bilateral secondary angle closure, a condition characterized by blockage of the eye’s drainage system, after using mirtazapine for 6 months. This highlights a potential rare but serious side effect of mirtazapine, and underscores the importance of caution when prescribing antipsychotic drugs to patients at risk for angle closure.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

18.

Optimizing treatment for older adults with depression.

Author: SrifuengfungMaytinee, PenningtonBethany R Tellor, LenzeEric J

Depression treatment
Medication optimization

This review provides guidance on optimizing medication management for older adults with depression, including strategies for tailoring antidepressant regimens, addressing inappropriate medication use, and implementing measurement-based care.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Modified Xiaochaihu Decoction Combined with Mirtazapine in the Treatment of Persistent Depression: A Pilot Randomized Controlled Trial.

Author: LiXin, LiXiuyu, GongMan, LiChaoqun, LiJing, ZhouChao, HeTingting

Improved PDD treatment

The combination of modified Xiaochaihu Decoction and mirtazapine was more effective in treating PDD than modified Xiaochaihu Decoction alone. The total effective rate of the combined group (96.7%) was significantly higher than the control group (78.6%).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Determination of clozapine, and five antidepressants in human plasma, serum and whole blood by gas chromatography-mass spectrometry: A simple tool for clinical and postmortem toxicological analysis.

Author: BoumbaVassiliki A, RallisGeorge, PetrikisPetros, VougiouklakisTheodore, MavreasVenetsanos

Drug determination
None mentioned

This study developed a rapid and simple method for determining the concentrations of clozapine and five commonly co-administered antidepressants in serum, plasma, and whole blood using gas chromatography-mass spectrometry. The method was validated and found to be suitable for routine toxicological analyses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Validation StudyResearch to assess the validity and reliability of new measurement methods or diagnostic tests.

Language : English

22.

Pharmacological Treatments for Patients with Treatment-Resistant Depression.

Author: RubertoValerie L, JhaManish K, MurroughJames W

Symptom relief
TRD treatment
Metabolic side-effects

Ketamine, esketamine, and augmentation with certain second-generation antipsychotics like quetiapine or aripiprazole are effective treatments for treatment-resistant depression. Other effective strategies include augmentation with lithium, liothyronine (T3), lamotrigine, or combinations of antidepressants. A shared decision-making approach is recommended to guide treatment selection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Treatment of Antipsychotic-Induced Akathisia: Role of Serotonin 5-HT<sub>2a</sub> Receptor Antagonists.

Author: PoyurovskyMichael, WeizmanAbraham

Akathisia treatment
Side effects

Low-dose mirtazapine shows promising therapeutic efficacy in treating antipsychotic-induced akathisia, a common and distressing side effect of antipsychotic medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review.

Author: EconomosGuillaume, LovellNatasha, JohnstonAnna, HigginsonIrene J

Alleviation of multiple symptoms

This study assesses the effectiveness and safety of mirtazapine in alleviating multiple cancer-related symptoms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Pisa syndrome associated with mirtazapine: a case report.

Author: YamadaYuji, TakanoHarumasa, YamadaMaki, SatakeNaoko, HirabayashiNaotsugu, OkazakiMitsutoshi, NakagomeKazuyuki

Pisa syndrome

A case report suggests Pisa syndrome may be a possible side effect of mirtazapine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

28.

Focus on Depression in Parkinson's Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics.

Author: Agüera-OrtizLuis, García-RamosRocío, Grandas PérezFrancisco J, López-ÁlvarezJorge, Montes RodríguezJosé Manuel, Olazarán RodríguezF Javier, Olivera PueyoJavier, Pelegrín ValeroCarmelo, Porta-EtessamJesús

Improved depression symptoms
Side effects

This study used a modified Delphi survey to assess the knowledge and understanding of depression in Parkinson’s disease among experts in the field. The results provide guidance for the diagnosis and treatment of depression in patients with Parkinson’s disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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