From the Research
Mirtazapine is not typically associated with causing hypoglycemia, and it may even have an anti-hyperglycemic effect in certain cases, as suggested by a study published in 2019 1. This antidepressant, which belongs to the noradrenergic and specific serotonergic antidepressant (NaSSA) class, actually tends to have the opposite effect - it may slightly increase blood glucose levels in some patients. Mirtazapine works by enhancing noradrenergic and serotonergic neurotransmission while blocking certain serotonin receptors, which affects mood regulation but doesn't directly impact insulin secretion or glucose metabolism in a way that would lead to hypoglycemia. Some antidepressants, particularly certain selective serotonin reuptake inhibitors (SSRIs), have been associated with changes in blood glucose control, but mirtazapine is generally not considered a medication that causes low blood sugar. If a patient taking mirtazapine experiences symptoms of hypoglycemia (such as shakiness, dizziness, confusion, or sweating), they should consult their healthcare provider as these symptoms might be related to another condition or medication interaction rather than a direct effect of mirtazapine. The most recent and highest quality study on this topic, published in 2019, found that mirtazapine may show an anti-hyperglycemic effect by decreasing GLUT2 through altering the leptin and galanin expression in the liver of type 1 diabetic rats 1. Other studies have also found that mirtazapine does not worsen glucose control in diabetic patients and may even improve it in some cases 2, 3. However, it's essential to note that individual results may vary, and patients should be closely monitored for any changes in blood glucose levels while taking mirtazapine. In summary, mirtazapine is not typically associated with causing hypoglycemia, and it may even have a beneficial effect on blood glucose control in certain cases.