MIRTAZAPINE

Indications & Dose:

 Major depression

• BY MOUTH

Adult: Initially 15–30 mg daily for 2–4 weeks, dose to be taken at bedtime, then adjusted according to response to up to 45 mg once daily, alternatively up to 45 mg daily in 2 divided doses 1-2 wk; effective dosage range 15-45 mg qd

• BY MOUTH

• Preoperative insomnia: PO 15 mg 

Contraindications:

Concurrent MAO inhibitor therapy 

Side Effects:

CNS: Abnormal dreams, anxiety, cerebral ischemia, confusion, dizziness (7%), drowsiness (54%), EPS, hallucinations, migraine, seizures (<0.01 %), tremor, vertigo

CV: Angina, bradycardia, CHF, hypertension, hypotension, MI, syncope ventricular extrasystoles

EENT: Dry mouth

GI: Constipation (13%); appetite. weight gain

HEME: Agranulocytosis and neutropenia (0.1%) ,anemia: lymphadenopathy, lymphocytosis; pancytopenia, thrornbocytopenia

METAB: Elevated cholesterol 

Cautions:

Precautions:

Elderly, hepatic insufficiency, renal insufficiency, mania or hypomania, seizure disorder 

Interaction:

Drugs 

MAOIs: Possible serotonin syndrome (hyperthermia, autonomic instability, seizures, death) 

Warnings:

Adverse Effects:

Lactations:

Unknown if excreted in breast milk 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: