Is there any interaction between mirtazapine and valium? (5+ possible side effects) 

In this blog post, we are going to talk about the possible interactions between mirtazapine and valium. Both of these meds are prescription medications and are associated with a number of side effects. This blog will cover the safety and efficacy of the concomitant use of mirtazapine and valium. 

Is there any interaction between mirtazapine and valium?

Mirtazapine and valium may interact with each other and cause the following side effects:

• Increased sedation
• Dizziness 
• Fatigue 
• Impaired senses 
• Impairment of motor coordination 
• Difficulty in concentrating 
• Blackouts

These side effects can vary from person to person and they depend on the doses of this combination. If you are at low doses, the most common thing you can experience is dizziness and sleepiness. 

However, higher doses can break a havoc on a person’s mind and it can cause major complications. Elderly patients are more susceptible to these side effects and may suffer from additional effects like memory loss, impairment of motor coordination and troubled judgement. 

However, these two meds are still used together. Doctors usually adjust the doses when they prescribe more than one medication. Pre-existing health conditions are also considered before determining the appropriate dose. 

Medications are not solely responsible to produce effects as your body’s response to them can make a huge difference. Some people are extremely sensitive and they can’t even bear one medication, let alone the combination of more meds. 

This can result in therapeutic failure and you have to discontinue the treatment. It is extremely important to inform your healthcare provider of all the medications you’re taking. Drug interactions should be an important consideration before taking two or more medicines together. 

Yes, drugs in combination are often used to achieve better therapeutic response but this is not the case with every interaction. 

Some drugs are highly incompatible with one another. They often cancel out each other’s effects or antagonise them. Some drugs are so incompatible that they end up changing the entire chemical composition of one another. 

Some interfere with metabolism or bioavailability (the rate and extent at which the active drug moiety enters systemic circulation/blood). This can lead to drug accumulation in different parts of the body. 

It is always advised to inform your healthcare provider of any medicine you take before getting a new prescription. Your doctor will make sure not to prescribe any such drug which might interfere with those you are already taking. 

What is the difference between mirtazapine and valium? 

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

Valium, on the other hand, is a brand name for diazepam, which is one of the oldest benzodiazepines. It is used to help control anxiety, convulsions and panic attacks. This medication basically mimics inhibitory chemicals in your brain, like GABA, to control the excessive neuronal activity. 

Antidepressants, including mirtazapine, do not work overnight and they are expected to kick in within 4-6 weeks of your treatment. However, these meds start to produce the side effects way earlier. 

One of the most commonly experienced early side effects of mirtazapine is anxiety. This anxiety can be controlled by valium or any other benzodiazepine. 

The treatment is usually continued till your antidepressant kicks in. These meds together can control multiple overlapping symptoms of anxiety and depression. 

These symptoms include:

• Restlessness 
• Extreme distress
• Irritability 
• Suicidal behavior 
• Inability to engage in daily life activities 
• Weight loss or gain, depending on the effect of the condition on eating habits
• Excessive sweating 
• An urge to get isolated
• Hopelessness 
• Worthlessness 
• Confusion 
• Social disconnection 

A few studies indicate that benzodiazepines may play an important role in the management of depression and can be used in combination with antidepressants for the treatment of major depressive disorder (MDD). 

The same study revealed that GABA can make an impact on your depression through GABA depression theory and benzodiazepines can control this effect. 

Another 2019 research study monitored the effects of this combination of antianxiety and antidepressants for the treatment of MDD. The study used various standardisation techniques and concluded that it is indeed an effective combination and can significantly help to reduce the early anxiety caused by antidepressants. 

Another study confirmed the early anxiogenic side effects of antidepressants by experimenting on mice. The study monitored both control and test groups. Control groups only received mirtazapine and the test group received mirtazapine with diazepam. 

The study was based on two findings. The first one confirmed that SSRIs cause anxiety after acute administration, and the other finding indicated the beneficial effects of benzodiazepine in this situation. 

Make sure you ask your healthcare provider before using any medication. It is not recommended to self medicate, as it may make your symptoms much worse. 

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

Both mirtazapine and valium are associated with some side effects. It is impossible to take an antidepressant, a drug that affects your brain, without having any unwanted effects. 

The intensity of these side effects depends on how much med you’re taking. If you’re at higher doses, you are more likely to suffer from them. Side effects associated with the use of mirtazapine include:

• Sleepiness or drowsiness 
• Excessive tiredness or fatigue 
• Dizziness or lightheadedness 
• Xerostomia or dry mouth 
• Anxiety 
• Agitation 
• Confusion 
• Gain of appetite
• Weight gain 
• Gastrointestinal side effects including nausea, vomiting and diarrhoea/Constipation 

Mirtazapine is also associated with some serious side effects, which may 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. 
• Convulsions 
• QT prolongation 
• Pain and tightness in chest
• Arrhythmia 
• Flu like symptoms 

Valium is also associated with some side effects. These include:

• Dizziness
• Tiredness or fatigue 
• Drowsiness 
• Muscle pain
• Vision problems 
• Headache 
• Hypersomnia 
• Forgetfulness 
• Troubled or intrusive thoughts
• Impairment of motor coordination 
• Constipation or diarrhoea 
• Nausea 
• Vomiting 
• Increased or decreased appetite 

Serious side effects include:

• Allergic reaction associated with symptoms like redness of skin, itching, painful blisters, blue-purple patches, burning sensation etc. 
• Serious respiratory depression which lowers down breathing rate and can decrease the availability of oxygen in the blood. It could be life-threatening for people suffering from asthma or chronic obstructive pulmonary disease (COPD) 
• Dementia 
• Abnormal behaviour
• Blackouts 

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. 

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. 

Valium also comes with a number of warnings, especially for people who are suffering from asthma, chronic obstructive pulmonary disease (COPD) and diabetes. 

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 concomitant use of mirtazapine and valium. These may interact with each other and increase the risk of sedation, dizziness, fatigue, impaired senses and difficulty in concentrating. 

Elderly patients are more susceptible to these side effects and may suffer from additional effects like memory loss, impairment of motor coordination and troubled judgement. However, these two meds are still used together. 

The dose at which you take these two drugs can make a huge impact on your health. Make sure you use these two meds only when the combination treatment is preferred by your mental healthcare professional. Do not start any other medication along with your prescribed antidepressant. 

FAQs: valium and mirtazapine 

Can you take Valium with antidepressants?

Yes, you can take valium with antidepressants if your healthcare provider has prescribed these meds together. Valium and other benzodiazepines can be used to control early anxiety caused by antidepressants.

What medications should not be taken with mirtazapine?

• Monoaminoxidase inhibitors (MAOIs) 
• Pimozide 
• Non-steroidal anti-inflammatory drugs (NSAIDS) 
• Antipsychotics 
• Controlled substances 
• Alcohol 

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. 

Does mirtazapine help with anxiety?

Yes, mirtazapine does help with anxiety. It can also be used for the following health conditions:

• Depression 
• 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

What medications are contraindicated with Valium?

• Other anti-anxiety medications or sleeping pills. The concomitant use can dangerously increase the sedation and may cause confusion. 
• Antipsychotic medications
• Opioid drugs, including painkillers and anti-tussive (cough relieving) medications. The concomitant use can cause serious psychological side effects and respiratory depression. 
• Alcohol

References 

• Drug Interactions between diazepam and mirtazapine https://www.drugs.com/drug-interactions/diazepam-with-mirtazapine-862-0-1640-0.html#:~:text=Interactions%20between%20your%20drugs&text=Using%20diazePAM%20together%20with%20mirtazapine,%2C%20judgment%2C%20and%20motor%20coordination.
• Valium – Uses, Side Effects, and More https://www.webmd.com/drugs/2/drug-11116/valium-oral/details
• J W Tiller et al. Br J Psychiatry. (1989) – Is diazepam an antidepressant? https://pubmed.ncbi.nlm.nih.gov/2692764/ 
• 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