Patient/caregiver was educated on contraindications for using Remeron as follows:
- Avoid using Remeron 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 Remeron, by observing a window period of atleast 2 weeks, before the transition to Remeron is made. Using Remeron 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.
- Remeron carries the risk of causing and aggravating some underlying cardiac arrhythmias, leading to severe debility and death. Remeron could be avoided or used with extreme caution in individuals with history of poorly controlled cardiac arrhythmias. Avoid using Remeron along with other medications that have a serious potential to cause or aggravate cardiac arrhythmias, such as, a few other antidepressants and antibiotics.
