Can you use mirtazapine and buspirone together?

In this blog post, we are going to answer the question, “Can you use mirtazapine and buspirone together?”. Mirtazapine is an antidepressant which is used to treat a number of mental health related problems. 

However, this antidepressant can interact with other medications. This blog will cover the safety and efficacy of the concomitant use of mirtazapine and buspirone. 

Can you use mirtazapine and buspirone together?

No, you should not use mirtazapine and buspirone together. Both of these medications can increase the level of serotonin in your body and the concomitant use can increase the risk of serotonin syndrome, which is the condition associated with too much serotonergic activity. 

Experts believe that this combination should be avoided, but if this combination can be effective for comorbid diseases then it can be used but the doses should be adjusted as to avoid the possible drug-drug interaction. 

The concomitant use can also dangerously lower the amount of sodium in your body, a condition called Hyponatremia. However, monotherapy with either mirtazapine or buspirone is considered safe and effective for the treatment of depression and anxiety. 

Serotonin syndrome is associated with the following signs and symptoms:

• Excessive sweating 
• Fever with chills
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Diarrhoea
• Bradycardia
• Tremors
• Muscle twitching and muscle pain
• Shivering and goosebumps
• Mental confusion 

Make sure you ask your healthcare provider before you start using any medication. It is not recommended to self medicate.

However, if your doctor has prescribed the medications together then you should take them in the best possible way in order to maximise the benefits and minimise the side effects or any possible interaction. 

Several studies have indicated that the combined treatment of mirtazapine and buspirone is a good option to cure treatment resistant generalised anxiety disorder (GAD). 

However, a 2001 study indicated that this combination drugs can not only interact with each other, but also with other medications. The concomitant use can interact with analgesics and can significantly reduce the pain killer action of such meds. 

It is recommended to use painkillers with caution when you’re on the combination treatment of mirtazapine and buspirone. Another study included a case study which showed signs of serotonin syndrome while being on the combination treatment.

Several other researchers revealed that this combination can not only cause serotonin syndrome, but can also dangerously lower the amount of sodium in your body, a condition called Hyponatremia. 

This is also associated with mental confusion, arrhythmia, forgetfulness and impaired motor coordination. Make sure you use this combination only if your healthcare provider has prescribed it.

What is the difference between mirtazapine and buspirone? 

Mirtazapine and buspirone are two separate medications that may end up producing the same kind of effects, which is why it is not suitable to use them together. 

Mirtazapine (Brand name: Remeron) is an antidepressant. It 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 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 mirtazapine 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 can be used to treat the following health conditions:

• Depression 
• Anxiety 
• Treatment resistant depression 
• Depression in elderly patients
• Post-operative nausea
• Alcohol dependence
• Insomnia or inability to fall asleep 
• Neuropathic pain
• Inability to feel hungry/hunger suppression

Buspirone (Brand name: Buspar), on the other hand, is an anti-anxiety medication. Its mechanism of action is completely different from other anxiolytics including benzodiazepines, Barbiturates and selective serotonin reuptake inhibitors (SSRIs). 

Buspirone is a non-benzodiazepine azapirone and acts by working on the neurotransmitters in your brain. It is believed to be a serotonin receptor agonist which works on 5-HT1 receptors. 

Buspirone is considered a good option and can be used for the treatment of generalised anxiety disorder (GAD), which is resistant to other treatment options. 

Experts believe that buspirone also increases the amounts of norepinephrine and dopamine and can make the reward pathway more pronounced, which not only makes you feel happy and relaxed, but also relieves the physical symptoms of anxiety. 

It can be used in combination with antidepressants, but doses should be appropriate in order to prevent harmful side effects.

Side by side comparison of side effects

Mirtazapine	Buspirone
Sleepiness or drowsiness Excessive tiredness or fatigue Dizziness or lightheadedness Xerostomia or dry mouth Anxiety Agitation Confusion Gain of appetiteWeight gain Nausea, vomitingDiarrhoeaConstipation	Nausea Vomiting Diarrhoea Abdominal pain Dizziness Drowsiness Fatigue Tiredness or confusionExcitement Insomnia or inability to fall asleep Headaches Tingling and numbness

These side effects are considered common side effects and they can vary from person to person. However, both mirtazapine and buspirone are capable of causing serious and rare side effects in certain individuals. 

Both can cause an 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. 

Both mirtazapine and buspirone can also cause Swelling or tenderness in different parts of the body and can alter your vision. These meds can also cause seizures in patients who either take too much of these meds or stop them abruptly. 

Mirtazapine comes 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. 

How to ensure the proper use of mirtazapine and buspirone? 

Immediately talk to your healthcare provider if you experience unusual side effects while taking mirtazapine and buspirone together. Do not recommend this combination to someone else and use it as long as your doctor has advised. 

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 drugs are capable of passing into the breastmilk and may cause side effects in newborns. 

In case you suffer from an overdose on any one or both of these meds, call a helpline as soon as you can. Inform them properly how much is taken and when. Make sure you keep these pills away for your children and pets, if any. In order to do that, keep the bottle out of their reach. 

If you have 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.

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

Conclusion 

In this blog post, we have discussed the possible interactions between mirtazapine and buspirone. These two may interact with each other and increase the risk of serotonin syndrome, which is the condition associated with too much serotonergic activity. 

Experts suggest that these two medicines should be used at low doses if they are used together. However, monotherapy with either mirtazapine and buspirone is considered safe and effective for the treatment of depression and anxiety. 

Make sure you use these medications 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. 

FAQs: mirtazapine and buspirone 

Can you take Buspar and mirtazapine?

No, you should not use mirtazapine and buspirone together. Both of these medications can increase the level of serotonin in your body and the concomitant use can increase the risk of serotonin syndrome, which is the condition associated with too much serotonergic activity. The concomitant use can also dangerously lower the amount of sodium in your body, a condition called Hyponatremia.

Can you take BuPROPion and mirtazapine together?

Both bupropion and mirtazapine are capable of inducing seizures and may make your condition worse. Make sure you don’t use them together, unless your healthcare provider has prescribed this combination. In that case, your doctor will adjust the dose to maximise the beneficial effects and minimise the side effects. 

Can you take buspirone with antidepressants?

You should not use buspirone with antidepressants, especially those which actively increase the amount of serotonin in your system. This is because buspirone can also produce this effect which can increase the risk of serotonin syndrome, which is associated with disturbing symptoms of its own. 

What medications should not be taken with mirtazapine?

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 
• Alcohol 

How quickly does buspirone work for anxiety?

Buspar, brand name for Buspirone, is an anti-anxiety medication. Its mechanism of action is completely different from other anxiolytics including benzodiazepines, Barbiturates and selective serotonin reuptake inhibitors (SSRIs). Buspirone is a non-benzodiazepine azapirone and acts by working on the neurotransmitters in your brain. It is believed to be a serotonin receptor agonist which works on 5-HT1 receptors. 

How long does it take for mirtazapine to leave your system?

Mirtazapine is a long acting antidepressant with a half life of about 20-40 hours. It means that the concentration of the drug is reduced to half after this time period. The remaining amount is further reduced to half in the next  20-40 hours. This process keeps on ongoing until the drug is completely washed out from your body. 

References 

• Drug Interactions between buspirone and mirtazapine https://www.drugs.com/drug-interactions/buspirone-with-mirtazapine-441-0-1640-0.html#:~:text=Using%20busPIRone%20together%20with%20mirtazapine,shivering%20or%20shaking%2C%20blurred%20vision%2C
• National Library of Medicine – Mirtazapine https://medlineplus.gov/druginfo/meds/a697009.html 
• Mirtazapine Tablet – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-13706-4047/mirtazapine-oral/mirtazapine-oral/details
• National Library of Medicine – Buspirone https://medlineplus.gov/druginfo/meds/a688005.html