Is Mirtazapine a good antidepressant?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
This article will discuss the safety and efficacy of Mirtazapine – an antidepressant. We will discuss the conditions MIrtazapine treats, some common side effects, and discuss how one can ensure the safe and effective use of this medication.
Is Mirtazapine a good antidepressant?
Mirtazapine is a good antidepressant, which is generally well-tolerated in most cases. However, the effectiveness of Mirtazapine or any other antidepressant can vary from person to person.
What’s important to understand is that what works well for one person may not work as effectively for another. People have different physiological and genetic makeup and underlying health conditions, and they may be taking other medications that can interact with Mirtazapine.
For some individuals, these factors may make Mirtazapine not the best choice of medication. So, while Mirtazapine can be a good antidepressant for many and has a lot of success stories, it’s essential to work closely with a healthcare provider to determine if it’s the right medication for you.
What does research suggest?
Several research studies have investigated the clinical safety and efficacy of Mirtazapine and compared it with other antidepressants.
A clinical study indicated that Mirtazapine works in a unique way by affecting norepinephrine and serotonin receptors in the brain. This dual action might explain its fast-acting nature (1).
It’s metabolised in the liver, and steady levels are reached within about 4 days for adults and 6 days for the elderly. Commonly reported side effects are dry mouth, drowsiness, increased appetite, and weight gain, but it doesn’t have sexual side effects like some other antidepressants (1).
Studies have shown it’s as effective as various other antidepressants. It’s also helpful for depression with anxiety and sleep problems and is generally safe for long-term use (1).
Another research study compared the effects of Mirtazapine and Fluoxetine for depression, with both groups having similar starting depression scores (2).
However, the group taking Mirtazapine saw more significant improvements in their depression symptoms, especially after 3 and 4 weeks of treatment. The doses of Mirtazapine were higher than Fluoxetine during the study (2).
Side effects and drop-out rates were similar between the two groups, except Mirtazapine caused more weight gain. The study concluded that Mirtazapine was well-tolerated and more effective in reducing depression symptoms compared to Fluoxetine.
In some research studies, Mirtazapine’s effectiveness in treating depression was similar to tricyclic antidepressants like Amitriptyline, Clomipramine, and Doxepin, and even better than Trazodone and Fluoxetine in some cases (3).
Compared to tricyclic antidepressants and Trazodone, Mirtazapine was better tolerated because it showed fewer side effects. The research indicates that Mirtazapine can cause drowsiness in some people, but it’s usually related to low doses and can be minimised with proper dosing (3).
Overall, Mirtazapine seems like a significant advancement in depression treatment due to its dual action, simple use, and effectiveness with fewer side effects.
What are the side effects associated with Mirtazapine use?
Mirtazapine, although it is a well-tolerated antidepressant, is associated with some side effects. These include (4,5):
- Dizziness
- Nausea
- Confusion
- Drowsiness
- Dry mouth
- Vomiting
- Nightmares
- Anxiousness
- Constipation
- Increased weight and appetite
These side effects can vary from person to person and they generally begin to subside as the body adjusts to the medication.
However, it’s important to note that Mirtazapine may cause dangerous side effects in some people or some individuals may be allergic to this medication. In such cases, it’s important to seek immediate medical attention.
What to do if Mirtazapine is not helping your condition?
If Mirtazapine doesn’t seem to be helping with your condition, it’s important to discuss it with your doctor. There are many other antidepressant options available, so your doctor can help find one that may work better for you.
Your provider might also consider adjusting your Mirtazapine dosage, but this might not be suitable for everyone.
If it’s clear that Mirtazapine isn’t the right fit for you, your doctor will safely guide you through tapering off it and transitioning to a different medication.
Finding the best antidepressant can be a trial-and-error process, and it’s completely normal if one doesn’t work for you – there are other options to explore. Just make sure you don’t make any changes to your prescription on your own or without your doctor’s approval.
Conclusion
In this article, we have discussed the safety and efficacy of Mirtazapine – an antidepressant. We have also discussed the conditions Mirtazapine treats, some common side effects, and how one can ensure the safe and effective use of this medication.
Was this helpful?
References
1.-
Anttila SA, Leinonen EV. A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev. 2001 Fall;7(3):249-64. doi: 10.1111/j.1527-3458.2001.tb00198.x. PMID: 11607047; PMCID: PMC6494141. https://pubmed.ncbi.nlm.nih.gov/11607047/
2.-
Wheatley DP, van Moffaert M, Timmerman L, Kremer CM. Mirtazapine: efficacy and tolerability in comparison with fluoxetine in patients with moderate to severe major depressive disorder. Mirtazapine-Fluoxetine Study Group. J Clin Psychiatry. 1998 Jun;59(6):306-12. PMID: 9671343. https://pubmed.ncbi.nlm.nih.gov/9671343/
3.-
Kasper S, Praschak-Rieder N, Tauscher J, Wolf R. A risk-benefit assessment of mirtazapine in the treatment of depression. Drug Saf. 1997 Oct;17(4):251-64. doi: 10.2165/00002018-199717040-00005. Erratum in: Drug Saf 1998 Feb;18(2):123. PMID: 9352961. https://pubmed.ncbi.nlm.nih.gov/9352961/
4.-
The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. Remeron (Mirtazapine) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020415s035lbl.pdf
5.-
National Library of Medicine. Mirtazapine: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a697009.html
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