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What Factors Affect a Sufficient Mirtazapine Dose?

By Madeleine A.
Updated May 17, 2024
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Factors that affect a sufficient mirtazapine dose include the patient's age, his current medical conditions, and other medications he is taking. The usual starting mirtazapine dose for the treatment of depression is 15 miligrams daily. Depending upon the effectiveness of the medication, the health care provider may increase or decrease the starting mirtazapine dose. Mirtazapine is used in the treatment of depression, and sometimes to treat tremors. This medication is used for adults only, and not children.

Side effects can occur even with the lowest mirtazapine dose, but the medication is generally well-tolerated by most people. If side effects are experienced, they may include drowsiness, increased appetite, and dry mouth. In addition, weight gain, constipation, dizziness, and high cholesterol may occur. Other commonly seen side effects might include weakness, muscle pain, fluid retention, and abnormal dreams. These side effects are usually mild and often resolve soon after mirtazapine therapy begins.

Serious side effects might also occur when taking mirtazapine and may include suicidal thoughts, agitation, high blood pressure, and extreme mood swings. In addition, the inability to sit still, hallucinations, palpitations, and sore throat may occur. When these side effects are experienced, the health care provider may recommend a decrease in the mirtazapine dose, or may elect to discontinue this medication altogether. Depression is a serious condition, and it is important for people to know that if they experience side effects from one medication, there are other treatment options that can help relieve their feelings of sadness and restore hope.

Rare side effects from mirtazapine include seizures, asthma, hypothyroidism, and migraine headaches. Sun sensitivity, hiccups, and urinary tract infections may also rarely occur. Severe allergic reactions are also a possibility when taking mirtazapine and can cause difficulty breathing, wheezing, chest pain, and throat swelling. These symptoms indicate a medical emergency and need to be evaluated and treated as soon as possible to avoid respiratory or cardiac arrest, organ failure or shock.

It may not be safe to take mirtazapine when pregnant or breast feeding. This medication may cause fetal side effects and might pass through the breast milk of the nursing mother. If depression occurs during pregnancy or breast feeding, the mother should discuss her symptoms with her health care provider, and he can recommend a safe and effective treatment plan. The health care provider may also recommend drug-free treatments for depression, which may include exercising, eating a health diet, practicing medication, and managing stress.

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Discussion Comments

By candyquilt — On Aug 31, 2013
@fify -- Usually, doctors will prescribe 15mg starting out and will increase it to 30mg after a month or two if the patient is tolerating the drug but the depression symptoms are not getting better. But 7.5mg/day starting out is not unheard of either.

Mirtazapine effects some people very badly because it contains an antihistamine. Not everyone has the same tolerance to antihistamines. Some doctors prefer to start off with a very low dose-- like 7.5mg/day and then slowly raise the dose to see if the patient will be able to tolerate it.

By fify — On Aug 31, 2013

Does anyone know why a doctor would prescribe 7.5mg/day of mirtazapine? Isn't it this too little a dose?

By burcinc — On Aug 30, 2013

I think everyone should be given the lowest possible dose of mirtazapine at first. If it doesn't help, the dose can always be increased.

My doctor started me off on a higher dose of mirtazapine. I was taking 45mg/day for depression and insomnia. But I had some side effects from it and I asked my doctor to reduce it. He reduced it to 30mg/day which helped but didn't resolve all the side effects. I then reduced my dose to the usual 15mg/day.

This dose has been perfect for me. It doesn't cause side effects, I sleep like a baby and my mood is better. I have no idea why I didn't start off with this dose from the beginning.

I'm very tall, so maybe that's why my doctor felt that a higher dose would work better. But I think the lowest effective dose is the best dose. It's up to us to figure out the best dose because we know how the drug is effecting us the best.

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