Patient/caregiver was educated on precautions to be exercised while taking Mirtazapine as follows:
- Mirtazapine intake carries the risk of lowering the threshold for seizures, thereby, resulting in seizure activity, especially in individuals with history of the same. Notify your doctor of any new development or worsening seizure episodes, so that, a change in your plan of care could be considered.
- Mirtazapine use can result in high levels of serotonin in the blood. Avoid using mirtazapine along with a few other antidepressants, such as, phenelzine, tranylcypromine, citalopram, fluoxetine, and sertraline, which also have the potential to increase the serotonin levels in the body. Caution must be exercised even when discontinuing on any of the above mentioned antidepressant medications with potential to increase serotonin levels and starting on mirtazapine, by observing a window period of atleast 2 weeks, before the transition to mirtazapine is made. Using mirtazapine with these medications closely can result in dangerously elevated serotonin in the blood, leading to development of serotonin syndrome, which can contribute to nausea, vomiting, diarrhea, rapid heart rate and dangerous arrhythmias, mania, agitation, and hallucinations.
- Mirtazapine carries the risk of lowering the blood pressure, leading to episodes of hypotension that can contribute to the dizziness caused by the medication. Observe compliance with every day blood pressure recording and log maintenance for easy follow-up. Report to your physician regarding any blood pressure numbers that are being consistently low, leading to exacerbation of dizziness and confusion, so as to facilitate a change in your plan of care.
