Does Mirtazapine cause unusual dreams?
By
Dr Natalia Marceli Stephanes (PhD)
Author bio
Dr Natália Marcéli Stephanes PhD is a Pharmacist with expertise in Drugs Administration and Toxicity; Discovery of New Drugs; Cancer Treatment; Biochemical Analyzes and Hematological Analyzes. She writes and reviews content on these topics.
Dr Natália Marcéli Stephanes’ Highlights:
- Pharmacist at the Department of Health of Santa Catarina State, Brazil
- PhD with a focus on oncology treatment
- Years of experience in commercial pharmacy
- Bachelor, Master and PhD degrees in Pharmacy at the Federal University of Santa Catarina
Professional Experience:
From her undergraduate studies to her Master’s and Doctorate degrees in Pharmacy, Dr Natália Marcéli Stephanes has participated in numerous scientific studies in the field of oncology and onco-hematology at the University Hospital of the Federal University of Santa Catarina, Brazil. Her research has focused on understanding the molecular and biochemical bases of malignant neoplasms and investigating safer and more effective therapeutic alternatives.
Dr Natália Marcéli Stephanes has also served as an assistant professor of haematology for undergraduate students at the Federal University of Santa Catarina. Additionally, she held the position of professor of Hospital Pharmacy at the Qualificar Technical School in Brazil, where she developed instructional materials for use in the Pharmacy Postgraduate Program at the Leonardo Da Vinci University Center.
In addition to her academic experiences, Dr Natália Marcéli Stephanes possesses a strong expertise in commercial pharmacy, with in-depth knowledge of medications, their routes of administration, desired effects, adverse effects, and toxicity.
Currently, Dr Natália Marcéli Stephanes works as a Pharmacist at the Health Department of Santa Catarina State, where her role entails providing pharmaceutical scientific consulting services to judges.
Education:
- 2016 Bachelor in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2018 Master in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2023 PhD in Pharmacy at the Federal University of Santa Catarina, Brazil
The main publications of Dr Natália Marcéli Stephanes are:
Falchetti M ; Delgobo M, Zancanaro H, Almeida K, Das Neves RN, Dos Santos B, Stefanes NM, et al. Bishop Omics-based identification of an NRF2-related auranofin resistance signature in cancer: Insights into drug repurposing. Comput. Biol. Med [Internet]. 2023; 152:106347.
Feuser PM, Matos dos Santos PC, Cordeiro AP, Stefanes NM, Walter LO, Maioral MF, Santos-Silva MC, et al. Antineoplastic activity of free 4-nitrochalcone and encapsulated in poly(thioether-ester) nanoparticles obtained by thiol-ene polymerization in two human leukemia cell lines (Jurkat and K562). J Drug Deliv Sci Technol [Internet]. 2022; 67:102924.
Jacques AV, Stefanes NM, Walter LO, Perondi DM, Efe FL, Souza LFS, Sens L, et al. Synthesis of chalcones derived from 1-naphthylacetophenone and evaluation of their cytotoxic and apoptotic effects in acute leukemia cell lines. Bioorg. Chem [Internet]. 2021; 116:105315.
Duarte BF, Vieira DSC, Lisboa ML, Stefanes NM, Grando LJ, Santos-Silva MC. Características clínico-epidemiológicas de pacientes portadores de carcinoma de células escamosas de boca. Arquivos Catarinenses de Medicina. 2021; 50(2): 232–245.
Machado V, Jacques AV, Stefanes NM, Santos-Silva MC, Biavatti MW. Anti-leukemic activity of semisynthetic derivatives of Lupeol. Nat. Prod. Res. 2021; 35(22):4494-4501.
Bigolin A, Maioral MF, Stefanes NM, Mascarello A, Chiaradia-Delatorre LD, Nunes RJ, Yunes RA, et al. A novel sulfonamide derivative as a strong and selective apoptotic agent against hematological malignancies. Chem. Pap. 2020; 74:2965–2976.
Bigolin A, Maioral MF, Stefanes NM, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Cytotoxic mechanisms of primin, a natural quinone isolated from Eugenia hiemalis, on hematological cancer cell lines. Anticancer Drugs. 2020; 31(7):709-717.
Maioral MF, Stefanes NM, Neufeldt PD, Chiaradia-Delatorre LD, Nunes RJ, Santos-Silva MC. Aldehyde biphenyl chalcones induce immunogenic apoptotic-like cell death and are promising new safe compounds against a wide range of hematologic cancers. Future Med. Chem. 2020; 12(8):673–688.
Perondi DM, Jacques AV, Stefanes NM, Maioral MF, Sens L, Pacheco LA, Cury NM, et al. A novel thiosemicarbazone as a promising effective and selective compound for acute leukemia. Anticancer Drugs. 2019; 30(8):p 828-837.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Argenta DF, Dotto MER, Santos-Silva MC, et al. PEO-chitosan nanofibers containing carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanoparticles loaded with pyrazoline for skin cancer treatment. Eur. Polym. J. 2019; 119:335-343.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Santos-Silva MC, Nunes RJ, Parize AL, et al. A new and efficient carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanocarrier for a pyrazoline with antileukemic activity. Mater. Sci. Eng. C [Internet]. 2019; 105:110051.
Maioral MF, Stefanes NM, Bigolin A, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Miconidine acetate, a new selective and cytotoxic compound with synergic potential, induces cell cycle arrest and apoptosis in leukemia cells. Invest. New Drugs. 2019; 37:912–922.
Srefanes NM, Toigo J, Maioral MF, Jacques AV, Chiaradia-Delatorre LD, Perondi DM, Ribeiro AAB, et al. Synthesis of novel pyrazoline derivatives and the evaluation of death mechanisms involved in their antileukemic activity. Bioorg. Med. Chem. 2019; 27(2):375-382.
Maioral MF, Bodack CN, Stefanes NM, Bigolin A, Mascarello A, Chiaradia-Delatorre LD, Yunes RA, et al. Cytotoxic effect of a novel naphthylchalcone against multiple cancer cells focusing on hematologic malignancies. Biochim. 2017; 140:48-57.
You can view some of Dr Natália’s work below and links to her professional profile below.
Research Gate: https://www.researchgate.net/profile/Natalia-Stephanes
Linkedin: https://www.linkedin.com/in/nataliamarceli/
In this article, we will discuss Mirtazapine-induced unusual dreams or nightmares. We will talk about the incidence of this side effect and what research indicates about this side effect. We will also discuss what one should do if Mirtazapine causes unusual dreams.
Does Mirtazapine cause unusual dreams?
Yes, Mirtazapine can cause unusual dreams or nightmares in some individuals. Some people have reported vivid or intense dreams that are often difficult to forget. Unusual dreams or nightmares are common with a number of antidepressants, and not just Mirtazapaine (1,2).
However, it’s important to understand that everyone’s response to medication can vary, and not everyone will have these specific dream-related effects. If you do notice unusual dreams or nightmares while taking Mirtazapine, it’s essential to communicate this to your doctor.
What does research suggest?
Research studies have found a potential link between Mirtazapine and nightmares in people of different age groups. The exact incidence of this side effect is not well-established, but it is considered common with antidepressants generally.
A 2006 case study included a 52-year-old man who experienced depressive symptoms like low mood, poor sleep, and more (3). He was prescribed Mirtazapine, but a day later, he began having vivid nightmares about being murdered, similar to a previous episode on Mirtazapine.
Researchers suggested that Mirtazapine’s effect on REM sleep might have induced these nightmares, as the drug is known to increase REM sleep, and other antidepressants that do the same, like Bupropion, have also been linked to vivid dreams and nightmares (3).
Another case has been reported of Mirtazapine-induced nightmares and vivid dreams at a low dose in a young adult female, which lead to the discontinuation of treatment with this antidepressant (4).
Another recent research study focused on sleep disturbances in depressed patients and the effects of antidepressants, particularly Mirtazapine (5). It’s known that mirtazapine, due to its sedative properties, can improve sleep quickly, despite the controversy over its mechanisms.
However, this research reports five cases of elderly patients (aged 69 to 79) with various conditions, where Mirtazapine led to intense nightmares, prompting treatment interruption (5).
This indicates that Mirtazapine, in some cases, can cause nightmares so intensely that drug discontinuation becomes the only choice to improve the patient’s quality of life.
What to do if Mirtazapine causes unusual dreams?
If you’re experiencing unusual dreams or nightmares while taking Mirtazapine, it’s crucial to communicate this with your doctor.
In some cases, if the dreams are tolerable and not causing significant distress, your doctor might suggest waiting it out, as this side effect might improve over time as your body adjusts to the medication.
However, if the dreams become more severe or bothersome, your doctor might recommend adjusting the dosage. Your provider might decrease the dose, as sometimes a lower dose can alleviate this side effect.
On the other hand, if the nightmares persist and are severely impacting your well-being, your doctor may consider discontinuing Mirtazapine and exploring alternative treatments. Mirtazapine stays in your system for about 4-9 days after the last dose, which means your body may take a week or two to recover.
Remember, it’s not safe to stop using Mirtazapine without your doctor’s approval.
Conclusion
In this article, we have discussed Mirtazapine-induced nightmares and how common they are. We have also discussed some published case studies which confirm that Mirtazapine may affect your sleep cycle or induce unusual dreams. We have also discussed what one should do if this side effect occurs.
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References
1.-
Jilani TN, Gibbons JR, Faizy RM, Saadabadi A. Mirtazapine. 2022 Sep 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30085601. https://pubmed.ncbi.nlm.nih.gov/30085601/
2.-
Tribl GG, Wetter TC, Schredl M. Dreaming under antidepressants: a systematic review on evidence in depressive patients and healthy volunteers. Sleep Med Rev. 2013 Apr;17(2):133-42. doi: 10.1016/j.smrv.2012.05.001. Epub 2012 Jul 15. PMID: 22800769. https://pubmed.ncbi.nlm.nih.gov/22800769/
3.-
Mathews M, Basil B, Evcimen H, Adetunji B, Joseph S. Mirtazapine-induced nightmares. Prim Care Companion J Clin Psychiatry. 2006;8(5):311. doi: 10.4088/pcc.v08n0510b. PMID: 17245439; PMCID: PMC1780138. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1780138/
4.-
Menon V, Madhavapuri P. Low-Dose Mirtazapine-Induced Nightmares Necessitating its Discontinuation in a Young Adult Female. J Pharmacol Pharmacother. 2017 Oct-Dec;8(4):182-184. doi: 10.4103/jpp.JPP_116_17. PMID: 29472752; PMCID: PMC5820750. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820750/
5.-
Liliana Dell’Osso, Primo Lorenzi, Benedetta Nardi, Barbara Carpita, Francesca Benedetti, Ivan Mirko Cremone, “Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients”, Case Reports in Psychiatry, vol. 2023, Article ID 8843206, 4 pages, 2023. https://doi.org/10.1155/2023/8843206
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