Can mirtazapine be taken as needed for treatment?

From the Guidelines

Mirtazapine should not be taken as needed, but rather as a regularly scheduled medication, typically once daily at bedtime, to maintain consistent blood levels for effectiveness. This recommendation is based on the understanding that mirtazapine works by gradually adjusting neurotransmitter levels in the brain, particularly serotonin and norepinephrine, a process that takes time, usually several weeks, to achieve therapeutic effects 1. Taking it inconsistently or only when symptoms appear would prevent the medication from working properly and could potentially worsen mood fluctuations.

Some key points to consider when taking mirtazapine include:

• The starting dose is typically 7.5 mg daily, with dosage increases made in 7.5-mg increments up to a maximum of 45 mg daily in divided doses, based on response of target symptoms and side effects 1
• Treatment duration can range from several weeks to several months, and it's essential to follow the healthcare provider's instructions for regular daily use
• Stopping and starting mirtazapine can lead to withdrawal symptoms such as dizziness, nausea, headaches, and sleep disturbances, emphasizing the importance of a consistent dosing schedule

It's crucial to consult with a healthcare provider if concerns about side effects or the medication's effectiveness arise, rather than adjusting the dosing schedule yourself. By following the recommended dosing schedule and consulting with a healthcare provider as needed, patients can maximize the benefits of mirtazapine while minimizing potential risks and side effects.

From the Research

Mirtazapine Dosage and Administration

• Mirtazapine is typically administered once daily at bedtime, with a recommended initial dosage of 15 mg/day 2, 3, 4.
• The effective daily dosage range is 15-45 mg 2, 3.
• Mirtazapine has an elimination half-life of 20-40 hours, which enables once-daily dosing 2.
• The drug is extensively metabolized in the liver, with a mean elimination half-life of approximately 22 hours 4, 5.

Efficacy and Safety of Mirtazapine

• Mirtazapine has been shown to be effective in the treatment of major depression, with a rapid onset of action and sustained improvements in depressive symptoms 3, 4, 5, 6.
• The drug is generally well tolerated, with common adverse effects including somnolence, increased appetite, weight gain, and dizziness 2, 3, 4, 5.
• Mirtazapine has a low potential for inducing seizures and is safe in overdose, with no significant cardiovascular or respiratory effects 2, 4.

Use of Mirtazapine as Needed

• There is no specific information in the provided studies regarding the use of mirtazapine "as needed" 2, 3, 4, 5, 6.
• However, the studies suggest that mirtazapine is typically used as a daily medication, with a recommended dosage range and administration schedule 2, 3, 4, 5, 6.