Does Mirtazapine cause optic nerve damage?

In this article, we will discuss whether Mirtazapine causes optic nerve damage. We will also discuss some research studies on Mirtazapine-induced ocular side effects and what one should do if these side effects occur. 

Does Mirtazapine cause optic nerve damage?

Mirtazapine may cause optic nerve damage in some individuals. Although it is not listed as a common side effect and not many such cases have been reported, it is still a possibility (1,2). 

However, it’s important to understand that not everyone who takes Mirtazapine will experience this side effect. More commonly, people have reported side effects like dry eyes or blurred vision while using Mirtazapine. 

These side effects are generally less severe than optic nerve damage but should still be discussed with a healthcare provider if experienced. It’s crucial to remember that everyone’s response to medication can vary, and some individuals may be more sensitive to certain side effects than others.

What does research suggest?

There is limited research on the ocular side effects of Mirtazapine. However, some studies have discussed it. 

One case study discussed a unique case of a vision problem called acute angle closure (AAC) associated with the use of Mirtazapine as an add-on treatment. This condition can cause symptoms like blurred vision, eye pain, and more (3).

The case highlighted the importance of considering potential side effects when starting antidepressant medications, especially in individuals with predispositions to eye-related issues (3).

In this specific case, a person experienced AAC in their right eye after taking Mirtazapine. They had symptoms like increased intraocular pressure (IOP), eye discomfort, and a dilated pupil (3). 

An ophthalmologist diagnosed AAC and treated it with intravenous mannitol, which effectively reduced the IOP and resolved the eye symptoms. The Mirtazapine treatment was stopped, and the patient’s eye health improved after treatment (3).

Another study discussed a case where a patient developed papilledema, a condition involving optic nerve swelling while taking Mirtazapine for two years. The patient’s condition improved when they stopped taking Mirtazapine (4).

This case is important for healthcare providers to be aware of the potential side effects of Mirtazapine. Antidepressants can rarely cause papilledema (4).

The condition can be caused by increased cerebrospinal fluid pressure, which affects the optic nerve’s blood flow and can result in symptoms like blurred vision, double vision, visual loss, headaches, nausea, and vomiting. It’s more common in women and obese individuals (4).

It is important to know that other antidepressants, like Sertraline, Escitalopram, etc can also cause side effects like blurry vision, dry eyes, etc. It is important to monitor these side effects and report them to your doctor. 

What factors can contribute to Mirtazapine-induced optic nerve damage? 

Several factors can contribute to the risk of Mirtazapine-induced optic nerve damage. Age plays a role, as older individuals may be more vulnerable due to age-related changes in eye health. 

Underlying health conditions, especially those affecting the eyes or nervous system, can increase the risk. The dose of Mirtazapine can also be a factor; higher doses may pose a greater risk. 

Additionally, the use of other medications alongside Mirtazapine can interact and potentially heighten the risk of optic nerve damage. It’s important to remember that not everyone will experience these side effects, and their occurrence can vary widely from person to person.

What to do if you’re experiencing Mirtazapine-induced optic nerve damage?

If you’re experiencing optic nerve damage while taking Mirtazapine, it’s crucial to talk to your doctor about it. Even though these side effects are rare, they should not be ignored. Your eyes are vital, and addressing these side effects properly is essential.

These side effects, while infrequent, can sometimes lead to permanent eye damage if left untreated. That’s why it’s important to work closely with your healthcare provider to manage them. However, it’s essential not to stop taking Mirtazapine abruptly without your doctor’s guidance. 

Abruptly stopping medication can have its own set of potential issues, so your doctor can help you safely manage any side effects while considering your overall treatment plan. 

Your eye health matters, and discussing any concerns with your healthcare team is the best way to ensure it’s properly cared for.


In this article, we have discussed that Mirtazapine may cause optic nerve damage in some people. We have discussed some research studies and what one should do if this side effect occurs.

Was this helpful?

Thanks for your feedback!



The  Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. REMERON® (mirtazapine) tablets, for oral use. Available from:,%20021208s019lbl.pdf


Jilani TN, Gibbons JR, Faizy RM, Saadabadi A. Mirtazapine. 2022 Sep 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30085601. Available from:


Kahraman N, Durmaz O, Durna MM. Mirtazapine-induced acute angle closure. Indian J Ophthalmol. 2015 Jun;63(6):539-40. doi: 10.4103/0301-4738.162612. PMID: 26265648; PMCID: PMC4550991. Available from:


Ceylan ME, Evrensel A, Cömert G. Papilledema Due to Mirtazapine. Balkan Med J. 2016 May;33(3):363-5. doi: 10.5152/balkanmedj.2016.150151. Epub 2016 May 1. PMID: 27308085; PMCID: PMC4899000. Available from:

Find a supportive therapist who can help with Depression.

Discover the convenience of BetterHelp, an online therapy platform connecting you with licensed and accredited therapists specialized in addressing issues such as depression, anxiety, relationships, and more. Complete the assessment and find your ideal therapist within just 48 hours.


AskYourPharm is user-supported. We may earn a commission if you sign up for BetterHelp’s services after clicking through from this site