Can you take 50mg sertraline and 15mg mirtazapine together? (5+ possible side effects)

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In this blog post, we are going to talk about the concomitant use of 50mg sertraline and 15mg mirtazapine. Both sertraline and mirtazapine are antidepressants and are approved to treat mild to severe episodes of depression and several other mental health conditions. 

This blog will cover all there is to know about the safety and efficacy of sertraline and mirtazapine combination therapy. We will also discuss who should not take these two meds together. 

Can you take 50mg sertraline and 15mg mirtazapine together?

Yes, you can take 50mg sertraline and 15mg mirtazapine together, but only if prescribed by your healthcare provider. The good thing about this regimen is that both of these antidepressants are used at lower doses. The combination therapy of antidepressants at higher doses can be dangerous. 

This is because both of these meds are supposed to increase the amount of excitatory neurotransmitters in your brain. Too much excitatory activity can cause drastic consequences and can increase the risk of a rare condition called serotonin syndrome. 

What are the possible side effects associated with the use of 50mg sertraline and 15mg mirtazapine together?

The possible side effects associated with the use of 50mg sertraline and 15mg mirtazapine together include:

  • Loss of appetite
  • Tiredness
  • Feeling angry or agitated
  • Weight gain
  • Inability to digest food
  • Nausea
  • Diarrhoea
  • Loss of libido
  • Sweating/Night sweats
  • Tremors or shaking
  • Insomnia
  • Decreased sex drive
  • Impotence
  • Inability to ejaculate
  • Mood swings

This combination is also associated with some serious side effects. These include:

  • Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
  • It could cause low sodium levels which can result in psychological symptoms like confusion, agitation, inability to understand surroundings, memory loss etc.
  • Convulsions 
  • QT prolongation 
  • Pain and tightness in chest
  • Arrhythmia 
  • Flu like symptoms 
  • Hypothyroidism (low thyroid gland function)
  • Bone marrow failure associated with low blood counts
  • Thrombocytopenia
  • Neutropenia 
  • Abnormal behaviour/mania 
  • Suicidal thoughts
  • Feeling guilty all the time
  • Extrapyramidal symptoms

These side effects can vary from person to person. People who are on higher doses are more susceptible to these side effects. If you fail to understand how to use the drug properly or have any other question, ask your doctor or pharmacist.

In case of overdose, immediately reach out to the hospital. Make sure you properly guide them about how much drug you have taken and when. If you have accidentally missed a dose and you’re way past the usual time at which you take your med, do not take it. 

It will cause you to overdose when you take your next dose, which is not too far away. It’s better to skip the missed dose and take the next one. If you remember your missed dose earlier, it’s safe for you to take it.

What is the difference between sertraline and mirtazapine?

Sertraline (zoloft) is a selective Serotonin Reuptake Inhibitor (SSRI). It works by inhibiting the reuptake of serotonin from the synaptic cleft (space between a neuron and its target cell). It increases the availability of serotonin in your brain. 

If you’re wondering what serotonin is, it is a neurotransmitter (a chemical) released by our brain which is responsible for modulating mood, cognition, reward, learning, memory, and various other psychological processes. 

It improves sleep quality, increases appetite, boosts energy levels, reduces the frequency of panic attacks and much more. One major thing you need to know about antidepressants is, they do not treat depression instantly. 

Sertraline usually takes 4 to 6 weeks for the drug to start working properly because these medicines try to make changes in your brain and it needs more time than usual to do so. Sertraline is used for the following conditions:

  • Sertraline can increase the amount of excitatory neurotransmitters to counteract the symptoms associated with depression.
  • Sertraline is used to treat symptoms of OCD. It is a condition characterised by troublesome thoughts that won’t go away, no matter what you do, and a weird urge to do things over and over again. 
  • Sertraline has proven to be a suitable treatment option for treating panic attacks. They are sudden, uncontrollable attacks of fear and worry. A patient might unwillingly exaggerate a certain condition and gets frightened, often to the point where he gets attacked by seizures. 
  • Sertraline can be used in high doses to counteract the symptoms of PTSD. It is concerned with extreme psychological symptoms that develop after a disturbing incident, such as death of a loved one or a horrific accident. 
  • It has proven to be effective in the treatment of social anxiety disorder or social phobia. It is a condition in which the patient fears facing crowds or social gatherings, and doesn’t really know how to react among people. 
  • Sertraline is also used to treat premenstrual dysphoric disorder, including symptoms like mood swings, irritability, bloating, and breast tenderness. 

Mirtazapine, on the other hand, does not belong to any typical class of antidepressants and its mechanism of action is different from SSRIs and SNRIs. It does not block the reuptake of serotonin by any pathway. 

Mirtazapine (Remeron) belongs to the tetracyclic antidepressants. It has a dual mode of action. Mirtazapine is believed to be responsible for the activation of 5-HT1 receptors, which are one of the serotonin receptors. This antidepressant also acts on the noradrenergic system. 

Experts believe that remeron enhances the stimulatory action of the noradrenergic system which increases the secretion of serotonin. It also prevents the inhibitory action of the noradrenergic system which hinders the release of serotonin. 

This way, it actively increases the amount of this excitatory neurotransmitter in your system. Mirtazapine is used for the treatment of following mental health conditions:

  • Mirtazapine is used in the treatment of mild to major depression disorder (MDD). It is a state of mind which is concerned with disturbing thoughts, especially about one’s self. 
  • Experts believe that mirtazapine is a good option to treat depression that has been resistant to normal SSRI or SNRI treatment. 
  • Mirtazapine has been a good antidepressant to treat depression and the disturbing symptoms associated with it in geriatric population. The drug seems to control mood problems quite well in such patients. 
  • Mirtazapine can also be used to help control nausea that usually becomes a problem after operative procedures.
  • Mirtazapine can also be used to control alcohol dependence or alcoholism. Its mode of action in this case is still a topic of research and so is its safety and efficacy. 
  • Mirtazapine can significantly help improve your sleep cycle by providing relief in the disturbances that might occur when you try to fall asleep. It also increases the duration of your sleep and reduces the frequency of nighttime wakefulness, especially in people who have insomnia comorbid with depression. 
  • Mirtazapine can also be used for neuropathic pain. The med can significantly reduce the intensity of this throbbing kind of pain and increase the frequency of pain-free episodes. 
  • Mirtazapine can be used to boost appetite in people who are not always hungry. Several studies revealed that mirtazapine can significantly help people with anorexia nervosa.

How to ensure the proper use of sertraline and mirtazapine?

Take sertraline and mirtazapine exactly as directed by your healthcare provider. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your doctor.

Both sertraline and mirtazapine come with a suicidal warning in people younger than 24 years of age. If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can.

Inform your doctor if you’re pregnant or trying to conceive. It is extremely important to ensure safety of your meds during your pregnancy. Some meds can cross placenta and are capable of causing unwanted side effects in the growing fetus. 

Inform your doctor if you’re a breastfeeding mother. Both of these antidepressants may be capable of passing into the breastmilk and may cause side effects in newborns. 

Do not stop sertraline or mirtazapine abruptly. If it’s time for you to stop one or both of these meds, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

Make sure you use this combination or any other medication only when your doctor has advised it. Using medications which can affect your brain is not something ideal and should not be encouraged unless it is absolutely necessary to do so. 

Conclusion

In this blog post, we discussed the concomitant use of 50mg sertraline and 15mg mirtazapine. Both sertraline and mirtazapine are antidepressants and are approved to treat mild to severe episodes of depression and several other mental health conditions.

You can take these two together, but only if prescribed by your healthcare provider. Make sure you discuss everything in detail with your healthcare provider and ask if you’re at the best possible doses of sertraline and mirtazapine. 

Also inform your doctor if you’re taking any other medication. Drug interactions should be an important consideration before taking two or more medicines together.

FAQs: 50 mg sertraline and 15mg mirtazapine

Can you use sertraline and mirtazapine together?

Yes, you can take sertraline and mirtazapine together, but only if prescribed by your healthcare provider. This combination should be used at lower doses. The combination therapy of antidepressants at higher doses can be dangerous. 

This is because both of these meds are supposed to increase the amount of excitatory neurotransmitters in your brain. Too much excitatory activity can cause drastic consequences and can increase the risk of a rare condition called serotonin syndrome. 

What antidepressant works well with mirtazapine?

Several studies have suggested that mirtazapine works well when it is used in combination with an SSRI or an SNRI. However, a combination of antidepressants can only be taken when prescribed by your healthcare provider. 

This is because when two meds for the same illness are used, the doses are adjusted. Individual therapy comes with higher doses, while combination therapy has to be adjusted on the comfortable doses to help avoid the side effects. 

Is 15mg of mirtazapine enough for depression?

Yes, 15mg mirtazapine is a good initial dose for depression. Normal recommended doses include:

  • For adults: The treatment is usually started from 15 mg/day, taken usually at morning or whatever time is suggested by your healthcare provider. However, the dose can be adjusted by the healthcare provider if needed and should not exceed 45 mg/day. 
  • For children: Dose is suggested by the doctor according to the condition and body weight.

Is sertraline more effective than mirtazapine?

Both sertraline and mirtazapine are quite effective for the treatment of depression. However, several research studies show that mirtazapine starts working way earlier than sertraline because sertraline can take up to 6 to 12 weeks to produce noticeable therapeutic results. 

Does sertraline have immediate effects?

No. sertraline, or any other antidepressant, does not show results overnight. It usually takes 4 to 12 weeks, depending on the severity of your disease and your physiological makeup. As stated earlier, the time taken by sertraline to work varies from person to person. 

References

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