Doctor of Pharmacy Reviews Mirtazapine, Remeron, Antidepressant

  Рет қаралды 14,347

Isaac Wade PharmD

Isaac Wade PharmD

Күн бұрын

In this video, we review the popular antidepressant, mirtazapine. Mirtazapine is indicated for depression but may also be used in PTSD, OCD and insomnia. Mirtazapine has a unique mechanism of action that gives it an interesting side effect profile - drowsiness and weight gain are common while sexual dysfunction and nausea are rare. A large network meta analysis found that mirtazapine stacks up favourably compared to other antidepressants in terms of efficacy and acceptability. In my opinion, Mirtazapine is best suited for those with depression and insomnia who do not mind gaining a bit of weight.
References:
Product monograph: www.merck.ca/static/pdf/REMER...
Mechanism of action: www.ncbi.nlm.nih.gov/books/NB...
Network meta analysis: www.thelancet.com/journals/la...
Hope this video is helpful!
All the best,
Isaac

Пікірлер: 101
@lisweetie1556
@lisweetie1556 Жыл бұрын
Hugely helpful. Improves sleep architecture. Improves appetite. It's basically an antidepressant with unique properties that help with physical recovery. Frankly, it's the only antidepressant drug that actually did make me feel better. 7.5mg. No issues with weight gain but I am an amateur bodybuilder so honestly sleeping and eating more is something that could be good for me. Cheers
@Haloitzchris
@Haloitzchris Жыл бұрын
I smoke weed everyday since i was 16 and now find myself at 23 trying to slow down and be more productive so i went to my psychologist and doctor and they prescribed concerta 18mg and this to sleep at 15mg. Its mainly because ive been having trouble until around 3am when i tend to KO so this should help... had no idea it was an antidepressant and a weight gain SE isnf a bad thing for me. I weigh 130 since middle school so i hope i can go to the gym and add some muscle. Eventually if i smoke once a week ill be 🎉🎉 happy.
@jamayaholt-qz7wm
@jamayaholt-qz7wm 28 күн бұрын
@@Haloitzchrisupdate?
@Deba7777
@Deba7777 2 жыл бұрын
Great discussion, thank you!
@AlexMcFly77
@AlexMcFly77 Жыл бұрын
Had mirtazapine as an occasional sleeping meds. It was working perfectly for me.
@sehrniedrich9383
@sehrniedrich9383 3 жыл бұрын
Looking forward to the video about the mechanism of action! Ive been prescribed mirtazapine for anxiety but im scared to try it wich is ironic...but yeah i thought learning about the drug might help
@isaacwadepharmd3969
@isaacwadepharmd3969 2 жыл бұрын
Will be coming eventually! Thanks for watching, hope your therapy works out!!
@DaRyteJuan
@DaRyteJuan 2 жыл бұрын
Have you tried fluoxetine yet? I have PTSD and I was hesitant to start taking it too. My GP prescribed me 10 mg for the first 7 days, then 20 mg thereafter. But after reading the comments on a FB support group, a lot of people were complaining about 10 mg & 20 mg. As an experiment I took a half a pill one day followed by another half a pill about three days later to see if I was gonna suffer major side effects. After I survived those two test doses, I started myself on 2.5 mg/day for the first two weeks. Then last week I did a whole week at 5 mg. So I started seeing some of the benefits but no major side effects except for one. This week I’m doing 5 mg again. Like I said the “starting” dose is 10 mg/day (or 1 whole tablet). The one side effect I’ve noticed is some bruising on each hip. This could be be partly due to my belt as I don’t have much body fat and often have to pull my belt kinda tight to keep my pants up.
@garysimone4977
@garysimone4977 2 жыл бұрын
@@DaRyteJuan Dhow you doing
@stevej4328
@stevej4328 Жыл бұрын
Did you try???
@DanielSRosehill
@DanielSRosehill Жыл бұрын
"This is one of my all time favorite molecules " - - you had my subscription there and then my friend! Jokes aside, thanks for the excellent and informative video!
@robk7129
@robk7129 2 жыл бұрын
You say "one of my favourite molecules" … but have you ever tried this medication ??? You are talking of this medication like it’s a candy
@strongwallers
@strongwallers 2 ай бұрын
It’s a dangerous drug.
@sontwo3948
@sontwo3948 7 ай бұрын
Thanks for your informative video. I've been on 7.5 mg. Mirtazapine for almost a year. It seems to help with my sleep issues...I sleep better on it. It does also make me feel drowsy daytimes so have gotten into the habit of afternoon naps...which I like.. The day naps are not an issue because I am over 70, and retired. The one side effect that is a problem is constipation. However, I do take Magnesium Citrate (600 mg gummies) that keeps it from becoming too uncomfortable. I did try getting off Mirtazapine due to the sedative an constipation but went back to taking it after a few days because of the rebound anxiety effects that were pretty severe. Have to talk with my doctor about the constipation because I have recently begun have stomach cramps in my upper abdomen, just below the rib cage that make me kind of anxious, and may be related to the constipation. Will try to post something 'later' about what my doctor says about the stomach cramping.
@strongwallers
@strongwallers 2 ай бұрын
Do you have ringing in your ears yet? This med has serious side effects. Black Box warnings demonstrate serious and deadly outcomes for some ppl.
@Thagy1973
@Thagy1973 Жыл бұрын
Just started this medication. And I actually need to gain a little weight. I have noticed an increase in my appetite and I sleep good on this med. Hopefully it continues to work well!
@Haloitzchris
@Haloitzchris Жыл бұрын
I smoke weed everyday since i was 16 and now find myself at 23 trying to slow down and be more productive so i went to my psychologist and doctor and they prescribed concerta 18mg and this to sleep at 15mg. Its mainly because ive been having trouble until around 3am when i tend to KO so this should help... had no idea it was an antidepressant and a weight gain SE isnf a bad thing for me. I weigh 130 since middle school so i hope i can go to the gym and add some muscle. Eventually if i smoke 1 a week ill be 🎉🎉 happy.
@brettisenberg2498
@brettisenberg2498 7 ай бұрын
@@HaloitzchrisI’m in the same exact spot as you and am about to start this medication, how did it work for you???
@mirofe70
@mirofe70 3 жыл бұрын
Hello Isaac sending my full support its marife
@isaacwadepharmd3969
@isaacwadepharmd3969 3 жыл бұрын
Thank you Marife, hope you are doing well!!!
@Haloitzchris
@Haloitzchris Жыл бұрын
I smoke weed everyday since i was 16 and now find myself at 23 trying to slow down and be more productive so i went to my psychologist and doctor and they prescribed concerta 18mg and this to sleep at 15mg. Its mainly because ive been having trouble until around 3am when i tend to KO so this should help... had no idea it was an antidepressant and a weight gain SE isnf a bad thing for me. I weigh 130 since middle school so i hope i can go to the gym and add some muscle. Eventually if i smoke 1 a week ill be 🎉🎉 happy.
@laurenclark1480
@laurenclark1480 Жыл бұрын
I was given for burning mouth. Pain worse bones hurting throat burning. Is this normal? Im scared Ill start throwing up if quit. Effexir put me in ICU epileptic like seizure over an hour. What can I take if so many side effects from all meds tried? I take pain killer and scared of interaction.
@michaelthau1007
@michaelthau1007 2 жыл бұрын
Hi Dr Thank you for a wonderful video Im 52 and chronic insomnia for 3 years. I have tried all the sleep hygiene, meditation , even Z drugs. Nothing has worked. My Dr has suggested 7.5 mg for insomnia. Do you feel its safer than the Z drugs? Also do you think it would work cutting the 7.5 in half? Im exhausted daily looking for something to give some relief
@dawoodbhayat9509
@dawoodbhayat9509 Жыл бұрын
Hi I tried 3.75 once now is second week two weeks ago I took today I'm very low mood . How's you feeling plz let me know I also tried ( flouxotine+ olanzipine) combination it was help full for insomnia in the beginning
@michaelthau1007
@michaelthau1007 Жыл бұрын
@@dawoodbhayat9509 Hello, hope you are well! Are you still taking 3.75mg of Mirtazapine for insomnia? Do you think it works at that dose? Any bad side effects? Weight gain? Constantly hungry? Next day sedation? I still have not tried it yet. I have been taking Sonota, its one of those z drugs my Dr prescribed. For me. Only last 2 hours so only good if you wake up in the middle of the night, not very helpful.
@BlackRose-vi2yg
@BlackRose-vi2yg 2 жыл бұрын
I have been on it for years and years. And I had no weight gain so see how it works for you and don't listen to people 🤘🤘
@javi.r.acosta
@javi.r.acosta 2 жыл бұрын
De manera continuada? Lo dejaste fácil? He oído hablar de lo duro que es la retirada. Tengo miedo de empezar y a la larga me destroce la noche, más allá de las benzo
@michaelthau1007
@michaelthau1007 2 жыл бұрын
Does 7.5 really help woth chronic insomnia? Is the next sedation terrible and food cravings terrible? Also wondering if there is withdrawl with this medication? I was on klonopin and coming off was terrible! May God Bless you with Good health
@becky2235
@becky2235 Жыл бұрын
I find it helps with sleep and appetite but does nothing for depression and anxiety
@cheemahsaaab1328
@cheemahsaaab1328 Жыл бұрын
Same here
@jakehixon4073
@jakehixon4073 Жыл бұрын
Sorry to hear that. For other readers That’s not the same for everyone as it definitely eliminated my anxiety and panic attacks. Started noticing a significant reduction in my anxiety after 2 weeks.
@jessebarker1616
@jessebarker1616 Жыл бұрын
Works different for everyone example, it works great for my anxiety and depression, I can keep weight of and even loose weight on it
@Haloitzchris
@Haloitzchris Жыл бұрын
Prescribed for my sleep after Concerta all today
@vparker2987
@vparker2987 Жыл бұрын
same here
@arexec1
@arexec1 Жыл бұрын
What are your thoughts on Mirtazapine’s effect on Triglyceride levels and body fat levels? There do not seem to be any comprehensive studies on this I can find.
@isaacwadepharmd3969
@isaacwadepharmd3969 Жыл бұрын
Not sure. I would guess that it would need to be addressed on a case by case basis. For patients who are obese or have type 2 diabetes or dyslipidemia, it would probably be best to use a different antidepressant. But for those who must take mirtazapine, it would be good to discuss diet and exercise with the patient. My understanding is that antidepressant-induced weight gain is mostly caused by increasing the appetite of the patient. As long as calories in match calories out, weight gain and the impact of the drug on cholesterol levels and body fat should be avoidable. I do know some psych doctors who like to prescribe the weight loss drug, semaglutide, alongside drugs that cause weight gain (antipsychotics mostly). But obviously, not everyone has the coverage/funds for ozempic (semaglutide) or would want to start another drug.
@drvaisakhmedical3778
@drvaisakhmedical3778 2 жыл бұрын
Doctor i was given 15 mg mirtazapine for insomnia. As it didnt work now taking 30 mg, iam sleeping well at night but significant daytime drowsiness. Shall i try 22.5 mg tablet??
@isaacwadepharmd3969
@isaacwadepharmd3969 Жыл бұрын
That sounds reasonable! But As always, discuss with your healthcare provider!
@user-ct7cd4jd6o
@user-ct7cd4jd6o Жыл бұрын
Can this help with anxiety/panic attacks and depression. arising from ADHD?
@Haloitzchris
@Haloitzchris Жыл бұрын
I smoke weed everyday since i was 16 and now find myself at 23 trying to slow down and be more productive so i went to my psychologist and doctor and they prescribed concerta 18mg and this to sleep at 15mg. Its mainly because ive been having trouble until around 3am when i tend to KO so this should help... had no idea it was an antidepressant and a weight gain SE isnf a bad thing for me. I weigh 130 since middle school so i hope i can go to the gym and add some muscle. Eventually if i smoke 1 a week ill be 🎉🎉 happy. Its important to note I have adhd noted by a neurologist and I was on meds until I hit puberty. Now its my first day on concerta
@jessdixon2438
@jessdixon2438 Жыл бұрын
I’ve been given it for depression I’m starting in a few weeks nervous
@ilianiperez2398
@ilianiperez2398 Жыл бұрын
Hey how are you feeling?
@amyn3001
@amyn3001 2 жыл бұрын
Can 7.5 mg Mirtazapine be taken for insomnia on an "as and needed basis"? Also should I expect weight gain on a low dose of 7.5 mg?
@97indianuk
@97indianuk 2 жыл бұрын
I would still take it as usual. Don’t stop and start that’s not good for your body
@amyn3001
@amyn3001 2 жыл бұрын
@@97indianuk Thank you. Does a small dose cause weight gain?
@97indianuk
@97indianuk 2 жыл бұрын
@@amyn3001 probably a tiny bit, but it’s important to be as strong as you can and not give into cravings. Weight gain comes from the increased appetite
@amyn3001
@amyn3001 2 жыл бұрын
@@97indianuk Thanks for your input, Were you on 15mg or higher?
@97indianuk
@97indianuk 2 жыл бұрын
@@amyn3001 I’m on 15mg, been on it for 1 week so I just started. It depends what you’re taking it for. Is it depression, anxiety or difficulty sleeping?
@Johnconno
@Johnconno Жыл бұрын
Help me Doc, just 50 grains of morphine?
@rigas333
@rigas333 Жыл бұрын
Ive been on it for a few days now for anxiety. How bad are the withdrawals?
@MyBenzoHell
@MyBenzoHell Жыл бұрын
Awful . Please google them before deciding to stay on them for years ! All the best
@robin-sk2cc
@robin-sk2cc Жыл бұрын
​@@MyBenzoHell that's why it's better the doctor gives you for 6 months or a year max, after that most are useless with negative effects.
@jakehixon4073
@jakehixon4073 Жыл бұрын
I had no withdrawals after 2 years of use.
@vedatzorro
@vedatzorro Жыл бұрын
15 mg or 30 mg mirtazapine make people hungrier?
@Shattered-Realm
@Shattered-Realm 8 ай бұрын
100% I'm on 30 mg but even 15 is enough. I usually ate 1-2 meals a day and had a stable weight of 78 kg. after 6 weeks it's 80. 20 minutes after you take the pill hunger sets in. the only solution is to have your meal after taking the pill. but eating late at night and then sleeping.... well that's also not going be good to help you keep trim.
@Light00121
@Light00121 Жыл бұрын
I take it only when I have insomnia and it helps me, within 30mins I'll fall asleep. Is it bad if I don't take it consistently? Could it cause me mental health problems?
@danh2310
@danh2310 8 ай бұрын
How did u get on taking it as PRN
@Light00121
@Light00121 8 ай бұрын
@@danh2310 Actually it doesn't work for me if I take it more than 3-4 days in a row. So I basically take it whenever I want to sleep (couple times a month) and it works instantly, I fell asleep in 30 mins.
@danh2310
@danh2310 8 ай бұрын
@Light00121 yeah the sedation effect wears off quite fast although it helped me with my insomnia around the 6 week mark but I gave myself sleep anxiety I was worried all day thinking about another bad night. Must of lowered the anxiety
@Light00121
@Light00121 7 ай бұрын
@@danh2310 I feel you. TBH it also made me depressed... Have you tried anything else that has helped you with insomnia?
@danh2310
@danh2310 7 ай бұрын
@Light00121 I really need to try cbti to change by thoughts and behaviour. I'm on week 8 of mirtazapine have good and bad days I had 300mg of pregablin yesterday afternoon then my mirtazapine at 9pm I slept like a baby. Don't want to be reliant on drugs. But if I can't beat insomnia I'd rather take drugs and sleep
@alisonalibongo3177
@alisonalibongo3177 Жыл бұрын
i wish i would gain weight.. been taking this for 3 years now.
@peaky-stackmusicistheanswe1063
@peaky-stackmusicistheanswe1063 Жыл бұрын
Hei can I ask did it helps you ? I'm on this medication 3 weeks and don't fell antydepresant effects and I'm very tired about panic attacks 🥲
@MrStooge.
@MrStooge. 4 ай бұрын
One of your all time favourite molecules? Have you ever tried getting off this stuff? Not such great barrel of laughs. Of course they don't tell you that when they put you on it.
@cherther13
@cherther13 11 ай бұрын
Getting off due to weight gain and increased appetite!!!!
@hollykitsune
@hollykitsune 11 ай бұрын
Gained 15 pounds in 1 1/2 months as a highly active person who eats pretty clean. No thanks man. Would be perfect if it didn’t make me wanna eat all the time. Also made my sense of smell heighten like crazy. I can smell a fart in a wind storm, I swear. I’m not a fan now. I stopped yesterday.
@Bunnnnbuns
@Bunnnnbuns Жыл бұрын
Great medicine! I gained weight in the right places. Had to buy new clothes. ❤
@volt8684
@volt8684 Жыл бұрын
Has this guy left school yet. Another person who not taken it
@j-uk2189
@j-uk2189 3 жыл бұрын
Can this cause diabetes? Because of the sheer weight gain!
@j-uk2189
@j-uk2189 2 жыл бұрын
@arron frederick Anyone can get type two diabetes mate.
@j-uk2189
@j-uk2189 2 жыл бұрын
@arron frederick mate. You’re talking rubbish. You can get diabetes even if it’s not genetic. I’ve known people who have got type two diabetes and have no family history. Ask any doctor.
@j-uk2189
@j-uk2189 2 жыл бұрын
@arron frederick So if I go on a sugar diet and and become 14 stone overweight, I won’t get diabetes?
@eileendoherty2836
@eileendoherty2836 2 жыл бұрын
A lot of antidepressants cause diabetes
@javi.r.acosta
@javi.r.acosta 2 жыл бұрын
@@eileendoherty2836 Why?
@garysimone4977
@garysimone4977 2 жыл бұрын
Ok no BS....THIS MED CAUSES SERIOUS WEIGHT GAIN SERIOUS.. AND OK I AM SURE IT HAS HELPED MANY OOOO AND NEXT DAY TIRED AS ALL HELL.. BUT NO BullS@#$T.....HOW HARD TO WEEN OFF ????????
@EE-ie9gm
@EE-ie9gm 2 жыл бұрын
Does it affect your sex drive? Delayed ejac?
@robin-sk2cc
@robin-sk2cc Жыл бұрын
​@@EE-ie9gm no it does not effect your sexual health
@jonathand8873
@jonathand8873 Ай бұрын
Nuggs
@DaRyteJuan
@DaRyteJuan 2 жыл бұрын
Sounds like a nightmare drug. No thanks.
@jennymike8636
@jennymike8636 2 жыл бұрын
I have been talking mirtapinze for 2 years now can it prevents me from getting pregnant I have been trying to get pregnant for a year now but sometimes I feel this drugs is preventing me from getting pregnant please I will be glad if I get a reply from you thanks
@jennymike8636
@jennymike8636 2 жыл бұрын
Ok thank you i will ❤️
@N_K12695
@N_K12695 Жыл бұрын
As a doctor, I only prescribe mirtazapine as an alternative to e.g. benzodiazepines or Z-drugs for long-term sleep problems. It only works against the actual depression in very few patients. translated by Google
@Shattered-Realm
@Shattered-Realm 8 ай бұрын
Wish you were my doctor. There is huge stigma against benzodiazepine. I got put on mirtazepine and 6 weeks in i don't know. I suffered from mainly insomnia and delayed sleep phase syndrome. Used Z drugs for 10 years and they lost some of their effectiveness. I need 1.5 pills to sleep. Due to that concern I went to a psychiatrist. My mood after 6 weeks is maybe 10% better I feel a bit off like this isn't it. I gained 2 kg as well. But the sedative effects are non-existent after 2 weeks. I take the tablet 2x15 mg 20 minutes late basically no change in cognition or any sedation but I get hungry even if I had a big dinner 2 hours ago. It feels like a hunger stimulant 4 days after starting mirtazepine + duloxetine as advised I got my first ever panic attacks so now I'm using zopiclone twice per day to calm down and sleep. Before my first visit to the psych doctor I always used the zopiclone pills between 23:00 and 1:00 am to sleep depending on what time i planned to get up and never felt I NEEDED or CRAVED it. Now I'm using zopiclone to terminate panic attacks at 18:00 and again at 23:00 for sleep. Feels really bad to use them like that. and I know SSRI's are the cause because the symptoms started exactly when I started using them. Upon discontinuing duloxetine after 4 days my panic resolved by about 70% but 30% is still here. I will continue becuase my doctor said 4-6 weeks results should be seen. It's been about 5 weeks now Considering alprazolam but they say it's super addictive and bad. Any advice? cause I got to a psych doctor here it's 5 minutes and bam here's your perscription.
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