Can you take Mirtazapine and Seroquel together?

In this article, we will discuss the concomitant use of Mirtazapine and Seroquel. We will discuss some research studies and shed light on the potential dangers of combining these two medications. 

Can you take Mirtazapine and Seroquel together?

You can take Mirtazapine and Seroquel together if your healthcare provider has prescribed this combination. 

Mirtazapine is an antidepressant, while Seroquel is an atypical antipsychotic medication (1,2). This combination is typically used when someone has depression along with symptoms of psychosis.

However, it’s crucial to note that the use of both an antidepressant and an antipsychotic medication together is carefully decided by a doctor. It may not be suitable for everyone, and some individuals may respond well to this combination with properly adjusted doses. 

People have different factors that can affect their health, so it’s the doctor’s responsibility to monitor your condition and recommend a safe treatment regimen according to your specific needs. Once a regimen is prescribed, you must properly follow it to achieve your desired therapeutic benefits.

What does research suggest?

Several research studies have discussed the combined use of Quetiapine – the active drug in Seroquel – with antidepressants like Mirtazapine. 

In a study involving twenty heavy drinkers with alcohol dependence, researchers tested an 8-week treatment using Quetiapine followed by an 8-week treatment combining quetiapine and Mirtazapine. They tracked alcohol use weekly and measured cravings (3).

Among the eleven participants who completed the study, the combination of Quetiapine and Mirtazapine showed better results compared to Quetiapine alone: fewer days of heavy drinking per week, fewer total drinks per week, and lower craving scores (3).

Another research study indicated that atypical antipsychotics like Quetiapine have shown promise as adjunctive agents in the treatment of treatment-resistant major depressive disorder (MDD), especially for patients with residual symptoms of anxiety and sleep problems (4).

The study concluded that Quetiapine should be considered for a broad range of psychiatric disorders. In terms of depression, it appears to work by blocking certain receptors (5-HT2A), which may enhance the effects of serotonin and provide greater relief from depression (4). 

Some research studies have discussed the side effects associated with the combination of these two medications. 

One case study included a 40-year-old military soldier with post-traumatic stress disorder who experienced severe rhabdomyolysis after starting treatment with Mirtazapine and increasing Quetiapine (5).

The doctors paused Mirtazapine and provided intravenous hydration, which helped lower creatine kinase levels. They were then able to reintroduce Mirtazapine without problems (5). 

This case suggests that the combination of Mirtazapine and Quetiapine, which affect serotonin receptors, along with muscle training, may have triggered rhabdomyolysis (5). This is important to consider when adjusting psychotropic medications.

What are the potential risks of taking Mirtazapine and Seroquel together? 

Taking Mirtazapine and Seroquel together is associated with some potential health risks, especially if the doses are not properly adjusted. The most concerning side effect of this combination is an increased risk of irregular heart rhythm (1,2). 

Although this is a rare side effect, it’s essential to be aware of it. This risk may be higher for individuals with certain heart conditions, such as congenital long QT syndrome, or those who have other cardiac diseases, conduction abnormalities, or electrolyte imbalances.

Beyond the mentioned risks, it’s crucial to consider that both medications can have side effects on their own. Mirtazapine is known for its sedative effects, which can cause drowsiness and impact your alertness. Seroquel, as an antipsychotic, can have side effects (1,2).

Moreover, combining medications always requires careful monitoring by a doctor. He/she will consider your unique medical history, current health status, and any other medications you might be taking to ensure that the combination is safe and suitable for your specific condition.


Combining Mirtazapine and Seroquel can be beneficial for some individuals but potentially risky for others. It’s essential to recognize that these combinations are not universally suitable; they are adjusted to each person’s unique medical history and needs.

Your doctor is the best person to determine if this combination is right for you, considering factors like your specific condition, other medications you may be taking, and your overall health. 

Your doctor will closely monitor your response to this treatment. If it works well for you and helps alleviate your symptoms, you’ll continue with it. However, if it doesn’t suit you or causes adverse effects, your doctor will explore alternative options.

The key takeaway here is always to follow your doctor’s guidance diligently. Healthcare professionals have the expertise to make the most appropriate treatment decisions for your well-being.

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Brunette MF, Akerman SC, Dawson R, O’Keefe CD, Green AI. An open-label pilot study of quetiapine plus mirtazapine for heavy drinkers with alcohol use disorder. Alcohol. 2016 Jun;53:45-50. doi: 10.1016/j.alcohol.2016.02.006. Epub 2016 Mar 17. PMID: 27256763.


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Saguin E, Keou S, Ratnam C, Mennessier C, Delacour H, Lahutte B. Severe rhabdomyolysis induced by quetiapine and mirtazapine in a French military soldier. J R Army Med Corps. 2018 May;164(2):127-129. doi: 10.1136/jramc-2018-000939. Epub 2018 Apr 9. PMID: 29632134.

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