Mirtazapine

If you need help or want to talk to somebody about your mental health, you can get support from any of the following:

• Free call or text 1737 any time for support from a trained counsellor
• Lifeline 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
• Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
• Healthline 0800 611 116
• Samaritans 0800 726 666.

• The usual starting dose of mirtazapine is 15 mg once a day and the usual ongoing dose is 30 mg daily.
• Some people may need higher doses.
• Your healthcare provider will start you on a low dose and if needed, will increase your dose slowly. This allows your body time to get used to the medicine and reduces side effects.
• Always take your mirtazapine exactly as your healthcare provider has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.

• Timing: Mirtazapine is usually taken once a day, at night, before going to bed. Take mirtazapine at the same time each day.
• Swallow the tablet with a glass of water: Don't chew it. 
• Food: You can take mirtazapine with or without food.
• Missed dose: If you forget to take your dose, take it as soon as you remember that day. But if it's nearly time for your next dose, just take the next dose at the usual time. Don't take double the dose.

Here are some things to know when you're taking mirtazapine. Other things may be important as well, so ask your healthcare provider what you should know about.

• Alcohol: Avoid or limit alcohol while you're taking mirtazapine. Drinking alcohol can increase side effects of feeling sleepy, putting you at risk of falls and other accidents. This is especially important when you first start treatment.
• Driving: Be careful when driving or using tools until you know how this medicine affects you.
• The effects of mirtazapine aren’t immediate: It may take a few weeks before you notice the full benefits. Keep taking mirtazapine every day.
• Don’t stop taking mirtazapine suddenly: Talk to your healthcare provider before stopping. The dose is usually gradually reduced to avoid side effects.
• Other medicines: Mirtazapine interacts with a number of medicines, herbal supplements (such as St. John's Wort) and rongoā Māori. Check with your healthcare provider before starting mirtazapine or before starting any new medicines, especially pain relief medicines and other medicines that can cause drowsiness.
• Signs of an infection: If you have a fever, sore throat or sore mouth while taking mirtazapine, let your doctor know immediately. It’s rare, but the medicine can decrease the number of blood cells you make and this can affect how your body fights infections.

Like all medicines, mirtazapine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Suicidal behaviour

The use of antidepressants has been linked with self-harm or suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are most at risk. This is most likely during the first few weeks of starting treatment or if the dose is changed. It's important to look out for signs of suicidal behaviour such as suicidal thoughts, self-harm, worsening of low mood, agitation or aggression. If you notice any of these signs, contact your doctor immediately.

If you need urgent help or are concerned, phone:

• Lifeline 0800 543 354 (available 24/7), or
• Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.

Other side effects

Read more about medicines and side effects and reporting a reaction you think might be a side effect.