What to do if Mirtazapine is not working? (7 reasons why it can happen)

In this article, we will discuss the steps that you should take if Mirtazapine fails to help provide adequate relief for the symptoms. We will also discuss some reasons why Mirtazapine may fail to work. 

What to do if Mirtazapine is not working?

If Mirtazapine is not working or helping your symptoms adequately, please reach out to your healthcare provider. Your doctor will properly determine the exact reason why this is happening and will help you achieve your desired therapeutic outcome. 

In most cases, your doctor may do the following:

• Adjust your dose – If you’re taking a low dose of Mirtazapine, it’s now time to increase it. Your doctor will gradually increase the dose and see how your body reacts to it.

• Opt for antidepressant combination therapy – In some cases, antidepressant monotherapy may fail to provide promising results (1). In such cases, your doctor may pair Mirtazapine with a suitable antidepressant to help deal with your symptoms in a better way.

• Suggest therapy or counselling sessions – In some cases, therapies and counselling sessions help deal with your mental health symptoms in non-pharmacological ways (2). This, along with antidepressant monotherapy, can help make you feel better.

• Switch you to another medication – Mirtazapine may not be the best choice of medication for you. If there’s a better alternative available based on the details specific to you, your doctor will safely switch you to it.

What reasons can lead to Mirtazapine inefficiency? 

Several reasons can lead to Mirtazapine inefficiency. These include:

Improper administration

Taking Mirtazapine improperly may affect its therapeutic benefits. Make sure you take this antidepressant just as described by your doctor. Make sure you take it in the exact same way and at the exact same time each day (3). 

Dose skipping

Missing Mirtazapine doses frequently can affect a steady concentration of the drug in your body, which is essential for its effectiveness. Make sure you don’t miss a dose. Some people may deliberately do so, which is not recommended. Patient non-adherence can affect treatment outcomes.

If you accidentally miss a dose, take it as soon as you remember. However, if it’s close to the time for your next dose, skip the missed one. Do not double dose to make up for the missed one (3).

Underlying health conditions

If you have a psychotic illness, such as schizophrenia or bipolar disorder with psychotic features, Mirtazapine alone may not be sufficient for treatment. 

Psychotic illnesses often require antipsychotic medications to manage symptoms and such illnesses can trigger depression (4). These medications can be prescribed alongside antidepressants.

Treating an undiagnosed psychotic illness with Mirtazapine alone can lead to inefficiency and potentially worsen your mental health

Stressful lifestyle

High-stress levels can counteract the positive effects of Mirtazapine. If you have a stressful lifestyle, you should consider incorporating stress-reduction techniques into your daily routine, such as meditation, yoga, or counselling, to complement the medication’s benefits (5).

Substance abuse

Alcohol and drug abuse can not only interfere with Mirtazapine’s effectiveness but also pose serious health risks. Seek support and treatment for substance abuse if needed.

Medication interactions

Some medications, including over-the-counter ones, can interact with Mirtazapine. Always inform your doctor about all the medications, supplements, and herbal remedies you’re taking to ensure they don’t negatively interact with Mirtazapine.

Inadequate duration

Mirtazapine may take several weeks to a few months to provide its full therapeutic benefits. It’s essential to be patient and give it time to work. Abruptly stopping the medication without consulting your doctor can lead to inefficiency and withdrawal symptoms.

What are the alternatives to Mirtazapine if it does not work?

There are plenty of other antidepressants that can be used if Mirtazapine does not help your symptoms. These include: 

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Trazodone
• Bupropion

However, the decision to take the right antidepressant is not yours to make. Please reach out to your healthcare provider and discuss your concerns. 

If your doctor thinks that dose escalation may bear some fruitful results for you, your doctor will do that. However, if Mirtazapine is not the right choice for you, your doctor will switch you to another medication. Make sure you don’t take such matters into your own hands and trust your provider’s expertise. 

Conclusion

In this article, we have discussed the steps that you should take if Mirtazapine fails to help provide adequate relief for the symptoms. We have also discussed some reasons that may lead to it. 

References