Common questions about mirtazapine

Mirtazapine is a type of antidepressant medicine.

It works by increasing the activity of mood-enhancing chemicals called noradrenaline and serotonin in your brain.

You may see an improvement in your symptoms after a week although it usually takes between 4 and 6 weeks before you feel the full benefits. That's because it takes around a week for mirtazapine levels to build up in your body, and then a few weeks longer for your body to adapt and get used to it.

Do not stop taking mirtazapine just because you feel it is not helping your symptoms. Give the medicine at least 6 weeks to work.

Antidepressants like mirtazapine help to gradually lift your mood so you feel better.

You may notice that you sleep better and get on with people more easily because you're less anxious. You'll hopefully be more relaxed about things that used to worry you.

Mirtazapine will not change your personality, it will simply help you feel like yourself again.

Do not expect to feel better overnight, though. Some people feel worse during the first few weeks of treatment before they begin to feel better.

Mirtazapine is generally safe to take for a long time. There do not seem to be any lasting harmful effects from taking it for many months or years.

If you've been feeling better for 6 months or more, your doctor may suggest coming off mirtazapine.

Your doctor will probably recommend reducing your dose gradually over several months, or longer if you've been taking mirtazapine for a long time.

This is to help prevent you getting any withdrawal symptoms as you come off the medicine.

Side effects can include:

• feeling anxious, dizzy or sick
• numbness or tingling in your hands or feet
• headaches
• shaking

Mirtazapine is not any better or worse than other antidepressants. Sometimes people get on better with one antidepressant than another.

If you're not feeling any better after 6 weeks, talk to your doctor. They may suggest that you try a different medicine.

Taking antidepressants, including mirtazapine, is just one of many ways to treat depression.

Other treatments that may help include:

• talking therapy such as cognitive behavioural therapy
• exercise programmes
• help to get a good night's sleep

Choosing a treatment that's most suitable for you depends on:

• how long you've had depression
• your symptoms
• whether you've had depression before
• whether previous treatment has worked
• how likely you are to stick with your treatment
• the potential side effects
• your preferences and priorities

Mirtazapine will not affect any type of contraception, including the combined pill, progestogen-only pill or emergency contraception.

However, if mirtazapine makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Some people cannot concentrate properly while they are taking mirtazapine. It can also make you feel sleepy.

When you first start taking mirtazapine, it's a good idea to stop driving and cycling for the first few days until you know how this medicine makes you feel.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking mirtazapine. GOV.UK has more information on the law on drugs and driving.

You can drink alcohol while taking mirtazapine but it may make you feel sleepy and unsteady on your feet.

It might be best to stop drinking alcohol for the first few days of treatment until you see how the medicine affects you.

Drinking alcohol every day or in large amounts can make your symptoms worse. It also makes it harder for mirtazapine to work properly.

You can eat and drink normally while taking mirtazapine.

Mirtazapine can make you feel more hungry than usual, so you may put on weight.

If you start to have problems with your weight while taking mirtazapine, talk to your doctor or pharmacist.

Taking cannabis with mirtazapine can make you feel very sleepy, especially if you've just started taking mirtazapine.

It can be dangerous to take mirtazapine with:

• methadone
• stimulants like MDMA (ecstasy) or cocaine
• hallucinogens like LSD
• novel psychoactive substances (which used to be known as legal highs) like mephedrone

Find out about the side effects of some recreational drugs on the Frank website.