Mirtazapine: From Mechanism to Clinical Applications
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- Опубликовано: 2 авг 2024
- The Psychopharmacology Institute is an online platform offering unbiased, practical psychopharmacology updates for healthcare providers, with content updated monthly. It also presents opportunities to earn CME and SA credits.
In this video, we discuss the unique attributes of mirtazapine, including its distinctive pharmacology, uses, and side effects. Whether it is its role in combating depression, anxiety disorders, negative symptoms of schizophrenia, or acting as an augmenting agent, mirtazapine is a versatile medication.
This is an excerpt from a video lecture. Find the transcript here: rb.gy/vbk0x
We invite you to visit our website, where you'll find content that allows you to earn CME credits. Take a look at the 2023-24 Psychopharmacology Update here: shorturl.at/inqHK
#Mirtazapine #Antidepressants #Psychopharmacology
Yeah. Been taking these for approximately a year and a half. Serious weight gain but it helps me sleep. I'm hooked
This drug is magnificent.Been taking it for six months, and it has done wonders with my depression and anxiety. In addition, it has been helpful with my insomnia. However, you’ll definitely gain weight!
My depression makes my appetite nonexistent and I get disgustingly gaunt and thin, I need it!!
@@AA-yc9dq believe me you’ll gain weight. Go see your psychiatrist right away. I suffered greatly for 51
Years prior to straightening out my overwhelming anxiety and depression.
I take 30mg at night and it’s given me a new lease on life. No more anxiety no more depression it has been among the best things that has happened to me
@@pauls4923 🤗❤️❤️ that's amazing to hear! I'm so glad its working so well for you
@@AA-yc9dq It works well for me at 15 mg. I can now sleep peacefully, and it doesn't make me drowsy during the day. I love it.
how much weight did you gain?
I have adhd and depression which caused me to have psychotic episodes not so much in the form of hallucinations but more with delusions and this pill with my antipsychotic sparine has worked wonders the worst thing is the nightmares it causes I’m not bothered about the weight gain though because I have a fast metabolism
Excellent explanation ...Thanks from Pakistan
Sir, Thanks for the Information. Really Helpful.
My psychiatrist use the California Rocket Fuel for me. It definitely helps me! I've tried few antidepressants and benzodiazepines but no improvement. When he use the combination of mirtazapine + venlafaxine, I can sleep on time and wake up on time without alarm. And I feel energetic on the day.
I just took this for the first time a few seconds ago, here to learn more about it.
@Shehzad Bhatti okay well I was told to take half the dosage so 15mg and boy have slept so much better. I was also told it would help with the depression but so far I feel exactly the same, just not as tired I guess. That's on me though, some days I don't take the medication because I'd rather drink my beer and fall asleep.
How is it working out for you?
@@STEINYY been getting plenty of sleep, a little too much sometimes, makes me feel relaxed, it's doing its job.
@@WillsCardBreaks good to hear man. My doc wanted to put me on this because I didnt feel the sertaline and still had all this anxiety in me. But we decided to just increased to 100mg sertraline along with some benzo. Then taper out the benzo down the line.
@@WillsCardBreaks mirtazapine does increase the nor-epinephrine and serotonin?
I’ve only been taking it some 3 weeks too early to show effects but I’m feeling like it definitely helps me sleep and wake up refreshed, my appetite is back and if it helps me gain weight then I’m all for it as I need to gain 2 stone, so definitely has my approval!
I did, It definitely increased my appetite ten fold. I was under 8 st before seeking help now I weigh in at 9 st, and I’m not considered underweight anymore. instead I am a healthy weight and when gyms open again I hope to increase my muscle mass significantly and since muscle weighs considerably more than fat ( not that I have any) doing resistance training and weights at gym I’m anticipating I’ll easily get to 9 & 1/2 stone. I hope this is helpful and wish you every success my babe xx
@Maria Kowalczyk 💯 % and you can get them in a fruit flavour that melts in your mouth, perfect if you can’t swallow tablets. Perfect 👌🏻
@@selinakelly186 hey I just started taking it for anxiety depression and to help gain some weight . I hope to gain weight I need to gain a stone 😩
@@brielleharmony7568 hey hun! Definitely you will feel an improvement in all areas, sleep, mood, appetite. It’s all about those gains! Good luck to you girl, you got this xx
Will it increase my appetite cus for the past 3 years I've I've forcing myself to eat never been really hungry will it help with that ?
Thanks! Great content and beautifully displayed. Got PharmD Board exam in a couple weeks, so this video was really helpful.
I love this medication because I can truly relax in the evening and sleep well and before I started I got little to no sleep so this drug is a life saver for me
Are you still taking it? Still working?
It made me sleep longer. The hangover however was horrible.. and I had many nightmares. It did not enhance my mood and I gained weight during the time I took it.
Absolutely knocks me out, and I cut the 15mg in half!
Thank you for the vid. Do you know which component of the medicine which promotes sleep ? Thanks
I’ve been taking 15 mg before bed for 6 years now and it’s totally kept my sleep and mood normal. Very thankful for this medicine. No weight gain for me but I’m always running or riding bicycles so people who aren’t addicted to endurance sports or exercise 4-5 days a week may see the weight gain. To anyone whose life has been changed for the better by mirtazapine I’m very happy for you !
Im scared to start cos of weight gain but I do a lot of exercise . I'm scared because I had a horrendous time on sertraline and still get withdrawal 6 months off swears chills , flu like symptoms
@@debbietaylor20 I have had no real bad side effects. From what I have read about Mirtazapine its very different than most contemporary meds. Its worth investigating
Did you not get constipation? Or distended abdomen on it? Also insulin resistance
@@j-uk2189 distended abdomen during the night and early morning now that you mention it. The other symptoms, no. Thank you for your input
@@HalJikaKick I wonder why it does this
I'm trying this combined with Bupropion.
Hey how has it worked for you? You still on it? I want to try this combo too
I take buspar (busprione) 45 mg a day, mirtazapine 30 mg, and trazadone 50 mg a day. It works wonders for me! My depression is gone, my mood is stabilized, my anxiety is mostly gone (managed), but I did gain weight which was frustrating but the benefits outweigh the side effects for me.
did it increase motivation/ energy???? Mirtazapine???
Thanks for the video. Do the side effects of feeling groggy the next day go away after a certain time ? thanks
I was on 45 mg and it was good for sleep and in The morning I felt like I’d had a smoke the night before but was nice , I Craved chocolate 30 minutes after taking and subconsciously put on 15 kg in 6 months. If you can control the chocolate it’s a useful drug but after going through all these synthetic drugs I’m sticking with good old fashioned pot. It works the best
Bro please reply but if you were smoking pot on medication or mirtapzhine did it lower the effects of smoking for you like while I was on mirtapzhine I was smoking and not getting the same effects once I got off the medication smoking was more enjoyablle hbu?
@@Devronn_ 0:36
Mirtazapine worked wonders on my depression, but the weight gain was unacceptable (20 kg in half a year, in spite of sporting regularly and not eating more). So I had to quit the med, and suffered from withdrawal a couple of weaks (nausea, headaches, dizziness). Hadn't the weight gain been a problem, I probably would take it again, as my depression is back with a vengeance.
Pincer88 LMFAO brooooo or sisssss weight gain from this drug is strictly caused by an increase in appetite and is NOT due to blood sugar increases or slow metabolism. Only appetite increase.
You should probably learn how to eat clean. I can eat tons of calories of healthy food with no weight change. As soon as I eat shit food, with less calories, I'm packing on weight.
Then the body will react to low blood sugar level by releasing fat and sugar from muscles and so on. Its all up to your eating habit. Mirtazapine only affects appetize
That’s complete nonsense. It’s slows down your metabolic rate. I was eating 700 calories a day, running 5 miles a day and hitting be gym 6 days a week and was packing on belly fat. I’ve been off the drug now for 5 weeks and still have the additional weight gain. And my diet is clean as you can get. I’m wondering how long until my metabolism will get back to normal.
@@j-uk2189 What is your calorie maintenance? Have you ever tried reserving dieting?
@@j-uk2189 well, either you are a midget or you're lying about your calorie intake and physical activity.
I've been taking this at 15mg for 5 days now. It has been a god send in the sleep department but I have been eating twice as much as normal and it has began to effect the weight loss I had prior to starting. I'm hoping this is a side effect that will go after the first 4 weeks because everything else has been positive so far
Hello Pharmacist here! Yes mirtazapine is known for its side effect in weight gain, specifically it can make you crave carbs more. Therefore we often recommend patients consult with a dietician to come up with meals that aren't so carb focused (eg. substituting normal carbs with shirataki noodles). Anyways, hope this helps!
@@JuriBeautyHouse hey, thanks for your advice. After 2 months my appetite did drop back a little. I spoke to my doctor and also went online to work out a better diet and exercise plan. I still take 15mg with a very low dose beta blocker to control my increased heart rate and BP because of my anxiety. It's been working wonders and I now have a relatively normal life. This drug has been a miracle for me after suffering from constant panic attacks and crippling insomnia
Super
The best
Is Mirtazapine a weak D2 antagonist due to ist 5ht2 blockage?
I started taking this 2 months ago and it has helped me immensely. The first couple of weeks are rough. You are going to eat and sleep a lot, but once you power through that, you will start to feel normal. If you are a male, this would be a great time to start weightlifting. I very rarely feel down, I have more energy and a stronger desire to pursue hobbies and my studies. It's not a perfect drug, but compared to Wellbutrin and Celexa(SSRI), it is miles better. I recommend staring on 15mg which is what I am still on now. Also if you have any questions I'll answer them.
Thanks for sharing! I am a male and wish to try this next. Been on many SSRIs since 18 (29 now). Tried Effexor and pristiq too with no success. Afraid to try Wellbutrin on its own, as I have very bad anxiety along with my depression. I’ve been on antipsychotics too, which are the worst class for me I’ve ever shoved down my throat. Tried lithium and lamictal. I just hope that remeron can calm the anxiety down enough to try Wellbutrin along with it or something else. Is remeron all you take??
BigPoppaPenguin Yes, Remeron is all I take. Without taking any substances I have terrible anxiety, mainly social. Remeron has decreased a lot of my anxiety; I wouldn’t say it’s a night and day difference but it definitely has helped a lot, anyone would notice it. Nothing I’ve ever taken has done more for my anxiety than Remeron. The motivation boost is also helpful.
I tried Wellbutrin for a couple months that I later paired with buspar. Had a terrible reaction to it that I wouldn’t wish upon anyone. I wouldn’t let that deter you from trying Wellbutrin as I did notice a positive effect on my depression.
InstaGraham thanks bro for being so encouraging! I’m on my third day of mirtazapine at 15mg. The first day was really strange. It induced a hangover effect on me, like an alcohol afterglow. Very enjoyable. Right now I do feel a little shitty but I know that it will pass with time. The sedation isn’t as bad as I thought it would be. I can still get up and do shit, but I still feel sluggish and exhausted often throughout the day. Also hoping this passes. Are there any energy supplements or things you do to counteract the sluggishness? I am definitely active with exercise, but this is gonna be difficult this week with getting out an exercise due to the riots and curfews in effect here in California.
BigPoppaPenguin Sorry I don’t really have too much advice on that, when I initially started it I had a very light schedule so I spent a lot of time doing nothing. Caffeine would help for sure, that’s all I really used. Good luck though you should be feeling pretty great in a few weeks.
what time do you take it
watching this vid while high on mirtazapine :) I gained 20kg over 6 months on this drug.
Did you eat more?
@@joshuataylor3550 I had a very noticeable increase in appetite on the drug, so yes, I ate more. I have also read that Mirtazapine hinders metabolism, which also contributes to weight gain.
Is it for anhedonia ?
I’m technically obese with a bmi of about 33 and I’m scared to death of gaining more weight because of the medication. I’m taking this as I have chronic insomnia and depression anxiety
Hello how this medicine help you I have the same . And the doctor just prescribed me that ?
It’s killing me with weight gain really sad
Is there any difference for depression/anxiety with a 15mg dose compare to a 7.5 dose??? Is there more sedation?
It's only used for sleep at 7.5mg. Not effective for anxiety or depression at this dose.
would mirtazapine work for adolescents?
There is anyone who is the new one with this med?? It's my first medication in my life, Gp. Was giving me because I had stress collapsing, insomnia and fear after all of those episodes I was getting depressed 😔 Im on 30mg 3 weeks but not a big results. I had apetitt first 5 days and now only felling dizzy, also my mod are changing every day so it's strange, ones I had a lot of energy and then I'm very tired. There is someone who can tell when this medicine kick in ??
How are you now?
i just took this last night and it’s the next morning now, i’m very tired but ofc it’s only been 12 hours so i’m hopeful for it to work in a few weeks :)
How you feeling with anxiety ?
@@swisherlife This helped with my anxiety a lot.
@@swift23219 I've been taking it for about 4 days now I'm seeing improvement so far with just this little bit of time with little to no side effects! Its awesome and relieving
@@swisherlife are you still taking it?
@@stevej4328 I’m not I couldn’t get over feeling like a zombie anymore im on Paxil now
15 mg or 30 mg mirtazapine make you more hungry?
Does mirtazapine indirectly increase dopamine too?
Yes, in some parts of the brain. Google it.
Hii doctor iam on mirtaz 30 mg for past 3 months for my insomnia, was sleeping well. But for past 10 days again the disturbed sleep reappear. I have no anxiety stress. I exercise regularly. Shall i titrate my dose from 30 to 45 mg???
Talk to you physician about it, im sure you can work something out 🙂👍
Interesting fact: a recent trial came out that said added to SSRI/SNRI is not effective at reducing depression and cause a lot of weight gain for patients!
Can you link the trial please?
Not effective for people with normal depression and anxiety. But works more for major depression and anxiety.
Can Mirtazapine cause emotional numbness?
Watching this while waiting for my body to absorb my meds
How you doing on it?
Me doing the same 11 months later
@@paypap_7277 me coming back a year later
@@stevej4328 great so far. i gained weight, so had to cut down carbs which i don't mind.👍
It can cause RLS.
Does it make agressive/angry?
Users please comment?
It doesn't seem to have much of an effect on temper, but it might just be me.
Thanks for the great presentation \FYI at 9:27, there is a typeo where the word "mirtazapine" is switched out for "MOA" on the first bullet point
I've been taking Mirtazapine (with Venlafaxine) for years and it's been great for my anxiety, but the weight gain is fustrating to deal with! 😖
Mitrazapine slows down your metabolism so that you will find it much more difficult to lose weight. Any low-calorie diet can also lead to slow down the metabolism, unfortunately because the metabolism needs to rev up by eating a lot. However, any certain medications will have the opposite effect to prevent rising the metabolic rate.
I am taking Mirtazapine for the anxiety too.
How bad would you say? I just started taking it but I’m excited for the extra weight
@@black168382 It’s not safe to put on weight more than 2.5lbs per week. Maybe you will not gain any weight if your metabolism is very high. Mirtazapine has an appetite-stimulating effect, though.
did it increase motivation/ energy????
@@STEINYY depends if you weren’t sleeping I guess. I’m definitely sleeping better not waking up in the middle of the night.
Hay que tomar clases de fonética inglesa.
I would love nothing more then to stop thinking about killing myself 24/7. Can’t even go 2 hours without thinking about it. And also having crippling anxiety. I’ll try anything at this point.
I’m on Prozac, Wellbutrin xl, and now this
You need xanax
call out to (or simply pray) Jesus Christ! I said a prayer for you, but you've gotta decide on your own to call out for help from your Creator. Take the same mindset you have with experimenting with medicines for help, and try Jesus for a change. He will change your life. Praying for you and love you!
ps.
i take some psych meds too, so that's ok. but Jesus is the only answer to *demonic* thoughts of suicide. I know that sounds "hardcore" to the average joe, but do you *want* to be thinking about suicide all the time? No? Then where are these thoughts coming from? A chemical reaction that makes you want to die? I'm sorry, but that's a myth. Your brain is there to help you *survive* and *thrive*, not to convince you to die...that's the work of the *spiritual realm* and it's evil. Please ask me any questions you may have!
Mirtazapine and recently venlafaxine here, want to die so bad. Already made a plan and I’m too afraid to tell anyone
@@baileyfilms7609 Please don't. As painful as it is, keep holding on, and know that there are treatments out there. It's just about finding what works for you.
@@zephorianvephorian777 meds were already my last resort now I have to deal with this while I’m suffering side effects with no benefits? There isn’t anything that can help I’ll be like this forever
Withdrawing off it its rough but need to lose the weight i gained
Does it increase energy?
Not Mine,
yes, It definitely can. it depends on how your brain reacts to the medication. if not it may not be for you.
I’m on zoloft 100s. Thinking about switching to prozac or mirtazapine. Mirtazapine is really just a sleeper
@@STEINYY I was up to 200 Zoloft. And tried 20mg lexapro at one point. SSRIs seem to aggravate my depression and worsen my anxiety. Same thing with SNRIs. Mirtazapine is an atypical class. So it acts totally different form other antidepressants. It still helps with serotonin but also has a bigger effect on dopamine. The lower the dose the more sedative effect it has also. Again everyone’s brain works differently. Mine seems to get along with mirtazapine.
@@shanedeeley4741 the trial and error thing it just got me mad eyy so I just stopped on zoloft. After trying 2 different SNRIs
I had been taking, and not gotten any effect from 4 different anti depressants for 5 years before I was put on mirtazapine. When I started taking it I had daily ptsd flashbacks and haven't had them since. It also made me able to sleep again
I have gained some weight and I still have really bad anxiety but was a life saver for me
I have taken this over the years because any gp or doctor will give you it. But it has given me major weight gain and major nightmares.
I only take it for sleep but it's seriously as damaging as any other pills in my opinion. Even if it's "non addictive"
It also has a recreational value if you take over 50 mg
Lol u need to drink alcohol with it apparently it doubles the effects
Only 60 psycopractor
What does it do if you take 60
What effect?
@@andreasaasen5950 I barely knew much at the time of this comment lol but I wouldn't take over 50mg now some people say it causes psychedelic like hallucinations at doses over 75mg but from experience over the years all it did was make me extremely nauseous and have very faint hallucinations so i wouldn't say it feels good
My best drug
How much is your dose
1week@@Yasen1791
15 mg
Its a life saving drug.
Yes it is think God
Just started today. Have been on Effexor then Zoloft these last few month. Neither have worked for me. Fingers crossed.
@@shanedeeley4741 how you getting on
@@Irish00 doing great actually thanks askin
@@hrvojestilin6256 it’s been a little over a month now on 30mg... wow... such a difference in mood and sleep. I’m happy to report that I can say I’m happy. For once. In a loooong time.
Τhis drug made me from slender into an obese person with health issues.
People talk about how great this drug is … wait till it poops out and ruins your life and you try to get off it you’ll literally wish you were dead. This drug should be illegal.
I was on it for I would say for about 1 -2 years it never really helped with my anxiety but I just kept taking it because I became dependent on it. It helped me skip a dose of Xanax occasionally cause it would put me to sleep for a very long time. The withdrawal symptoms are pretty brutal. But not nearly as bad and any benzodiazepines. I would recommend to everyone to only take any kind of anti depression medication for a extremely short period of time and do tons of exercise if it’s actually helping and to slowly wean off of it.
How long were you on it for and at what dosage?
@@stevej4328 2 years and the dose was 30mg but I would always cut it in half the stuff is strong
What dose were you on?
@@stevej4328 15mg a day
Mirtazapine.
I'm dozy. I'm fat. I'm numb.
Huh?
This drug ruined my life.
Probably because it alters your neurotransmitters and has very powerful antihistamine affects and coming off it is a fucking nightmare. Life ruining and will make you wish you were dead … that’s how.
Are you please able to say why?
How?
Beware u don't come out in a rash, skin sensitivity