How good is the concomitant use of sertraline and mirtazapine? (3+ reviews) 

In this blog post, we are going to discuss what people have experienced so far after the combination therapy with sertraline and mirtazapine. Both of these agents are antidepressants and can be used for a number of mental health related problems. This blog will cover the safety and efficacy of this combination therapy. 

How good is the concomitant use of sertraline and mirtazapine?

The combination of sertraline and mirtazapine is considered quite effective at low doses. Both of these meds are strong antidepressants and when given at appropriate doses, the combination can significantly help improve your mental health condition. 

However, it may not be a good option for everyone. Make sure you use these two antidepressants together only when prescribed by your healthcare provider. 

What actual people have experienced so far? 

Many people have come forward and shared their experiences with the combination therapy of sertraline and mirtazapine. One user stated:

“I have been taking sertraline and mirtazapine together for more than 2 years now. My doctor recommended me to take sertraline in the morning and mirtazapine at night. The combination did work amazingly well, but sertraline in the morning was a bit of a problem for me.”

The user continued:

“I consulted my doctor again because sertraline caused gastrointestinal side effects in me. I switched to take sertraline at night and it helped me significantly. I’m glad my doctor gave me this combination.” 

Another user stated:

“I have heard people talk about the benefits of the combination treatment of sertraline and mirtazapine, but it did not work on me. Both of them caused significant sedation and it made me sleepy and dizzy all day long.”

The user further stated:

“This made my journey unbelievably difficult. Not only sedation, but it caused terrible gastric side effects in me. It caused nausea, vomiting and explosive diarrhoea just after 2 days of taking this combination. My doctor later asked me to stop using it.”

This indicates that the combination of sertraline and mirtazapine does not work out for everyone. Antidepressants are not that easy to bear and some people are generally sensitive to medications. One more user stated:

“My journey with antidepressants was not an easy one. First when I was newly diagnosed, my doctor put me on prozac. I continued to take prozac for almost a week and I suffered from a number of terrible side effects.”

The user continued:

“I suffered from nerve-racking insomnia. I could not sleep no matter when I took prozac. I used to take it at night so my doctor suggested that I take it in the morning instead and she hoped that my insomnia would get better, but that did not happen. Instead, it got worse.”

The user further stated:

“That’s when my doctor put started tapering off prozac. Though i have not been using it for a long time, my doctor suggested taking it slowly and asked me not to stop taking prozac together. After this, my doctor put me on the combination of zoloft and remeron. That’s when things started to get under control. The combination worked pretty well on me and helped me overcome my depression.”

Indeed, choosing the perfect antidepressant is not an easy task. These antidepressants, as stated earlier, are not easily tolerated and you may need to switch in order to find out which antidepressant works best for you. For some people, one antidepressant is enough. 

However, some people have drug-resistant depression and no single antidepressant provides adequate relief. For such people, the combination of antidepressants at low doses can do wonders. 

Low doses are preferred to reduce the intensity of the possible side effects. Antidepressants are associated with a number of adverse effects, including sertraline and mirtazapine. This is why it is crucial to start from the lowest effective doses. 

Another user stated:

“The combination of sertraline and mirtazapine has worked out for the best. It not only helped my depression, but also helped me get rid of my OCD. I used this combination for more than 3 years. I won’t say that I did not suffer from any side effects. At the time I was starting my treatment, I knew antidepressants are no bed of roses.”

The user continued:

“I suffered from multiple side effects, but I somehow found a way to work around them. Later my body settled in and the side effects subsided. When I no longer felt depressed, my doctor slowly started to taper off both of these meds as you can’t always depend on medicines and I wanted to be free.”

The user further stated:

“It wasn’t so easy either, antidepressant withdrawal. It took an entire year for me to be completely free from antidepressants. At last I did it and now I am a happy, healthy and depression free person.”

This indeed is heartwarming. It feels amazing to see how these medications can help people change their lives. Mental health related problems are no joke. They can ruin your entire personality, your career, friendships, and relationships. Antidepressants, if used properly, can significantly help us get rid of our depression. 

How sertraline and mirtazapine are different from one another? 

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. 

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.

What are the side effects associated with the use of sertraline and mirtazapine? 

The possible side effects associated with the use of sertraline and 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.

Conclusion 

In this blog post, we have discussed the reviews of the combination therapy of sertraline and mirtazapine. 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: sertraline and mirtazapine together reviews 

Can mirtazapine and sertraline be used 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 best 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. 

Can you take SSRI and mirtazapine together?

Yes, you can take mirtazapine with selective serotonin reuptake inhibitors (SSRIs), but only if prescribed by your healthcare provider. This is because the combination of antidepressants doesn’t always work for the best. The physiological composition of the person taking it matters a lot. Some people can not tolerate this combination and may suffer from a number of disturbing side effects. 

Can mirtazapine and sertraline cause serotonin syndrome?

Mirtazapine and sertraline can cause serotonin syndrome if you take higher doses at the same time. Both of these meds work to increase the amount of active serotonin in your body. Too much serotonergic activity at the same time can give rise to the disturbing symptoms associated with serotonin syndrome. 

Which is better, sertraline or mirtazapine?

Both sertraline and mirtazapine are good antidepressants and both are approved by the Food and Drug Administration (FDA) for the treatment of depression and several other mental health conditions. However, it depends on the person taking it that which one of them suits him or her better. 

References 

• Debbie Tallon, Nicola Wiles, John Campbell, Carolyn Chew-Graham, Chris Dickens (2016) – Mirtazapine added to selective serotonin reuptake inhibitors for treatment-resistant depression in primary care (MIR trial): study protocol for a randomised controlled trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526304/
• Mirtazapine Tablet – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-13706-4047/mirtazapine-oral/mirtazapine-oral/details#:~:text=Mirtazapine%20is%20used%20to%20treat,(neurotransmitters)%20in%20the%20brain.
• National Library of Medicine – Mirtazapine https://medlineplus.gov/druginfo/meds/a697009.html 
• A L McRae et al. Expert Opin Pharmacother. 2001 – Review of sertraline and its clinical applications in psychiatric disorders https://pubmed.ncbi.nlm.nih.gov/11336629/
• Singh HK, Saadabadi A. – Sertraline https://www.ncbi.nlm.nih.gov/books/NBK547689/