Why is your mirtazapine not working?

As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided

In this blog post, we are going to answer the question, “Why is your mirtazapine not working?”. Mirtazapine is an antidepressant which is used to treat a number of mental health related problems. 

However, this antidepressant may not work as well as it should. This blog will cover the reasons which may make your mirtazapine inefficient. 

Why is your mirtazapine not working?

Your mirtazapine may not work because of one or more of the following reasons:

  • Addition of another prescription medication 
  • Excessive use of alcohol and cigarettes smoking 
  • Other health conditions
  • An increase in stress levels 
  • Aging
  • Mirtazapine tolerance 
  • Worsening of depression 

Addition of another prescription medication 

An addition of another medication can cause your mirtazapine to stop working. Drug interaction is an actual problem but it is often neglected. Two drugs don’t just produce unwanted side effects when they interact together. 

Some drugs interact pharmacokinetically, which means that drugs can interfere with each other’s absorption, distribution, metabolism and excretion, abbreviated as ADME. There are plenty of drugs that can inhibit the proper absorption of your mirtazapine. 

You can’t expect your med to work if it doesn’t absorb in your blood properly which serves as a vehicle and takes the med to its respective binding receptors. Antibiotics are well known for making your mirtazapine and many other antidepressants ineffective. 

Steroids can also play a huge role and not just that, they can even make your depression worse. The heightened symptoms of your mental health illness makes the current dose of your antidepressant inefficient. 

The escalation in dose may help to gain that effectiveness back, but if Steroids are continued with it, there’s a chance of the same thing happening again. Make sure you don’t take any medication along with your antidepressant that can interact with it and make it inefficient. 

Excessive use of alcohol and cigarettes smoking 

Experts have indicated that excessive use of alcohol can really make your antidepressant inefficient. Not just this, but the combined use of alcohol and mirtazapine can make your symptoms much worse. 

Studies suggest that alcohol numbs down your brain and trigger an episode of depression and may also induce suicidal behavior. Alcohol can also mess with the absorption of your mirtazapine and as stated earlier, your med doesn’t work if it’s not absorbed properly. 

Cigarette smoking produces the same effect. Not just this, it also interacts with your symptoms while your mirtazapine still works. It can enhance the side effects of your antidepressant like insomnia and loss of appetite. 

Both cigarette smoking and alcohol can interfere with the metabolism of mirtazapine and may result in toxicity because so many toxins become difficult for your liver to metabolise and it may start malfunctioning. 

It is advised to not drink alcohol while you’re on mirtazapine, especially if you’re taking this antidepressant for major depressive disorder (MDD). 

Other health condition

Other health related problems may also contribute to the inefficiency of your mirtazapine. Studies suggest that people who have other chronic conditions like hypertension, diabetes or some respiratory illness may experience antidepressant inefficiency

This is because these conditions can reduce the quality of your life and may trigger episodes of depression that may become difficult for your mirtazapine to control. The appropriate dose of your antidepressant is determined carefully in order to match your symptoms. 

It’s like having 2 bullets to shoot 2 targets. When you have more targets, your 2 bullets won’t suffice. This is exactly the case with depression. If your depression becomes worse but you’re on the same dose, you will definitely experience inefficiency at some point of your treatment. 

Dose escalation may help but the treatment of your pre-existing health condition is crucial for the long term management of your depression. 

An increase in stress levels 

An increase in your stress levels can worsen the symptoms of your depression and anxiety and can decrease the effectiveness of your antidepressant. It’s extremely difficult to avoid stress because of the lifestyle we lead. 

People suffer from work problems, family issues, financial issues and many more. These problems keep your stress levels high and a person who’s already diagnosed with depression is affected badly. 

Make sure you add stress relieving activities in your routine to release all the built-up pressure and negative energy from your system. 

Aging

Aging could be another factor leading to the decreased effects of your antidepressant. As you grow old, the physiological functions of your body start to slow down. This includes drug metabolism as well, because the liver doesn’t work as efficiently as it once did. 

This effect is more pronounced in people who have been suffering from chronic illnesses. Aging also slows down the process of drug digestion and absorption, which may also be a reason for less beneficial effects of your mirtazapine. 

Mirtazapine tolerance

Mirtazapine tolerance occurs when your body gets used to your current dose of the antidepressant and stops responding to it. This problem is not that common with mirtazapine, but it can still occur in some individuals. 

Experts suggest that this problem can be overcome by increasing the dose but if the process keeps repeating, your condition will reach a point where dose escalation will no longer be possible. 

This indicates that mirtazapine tolerance eventually leads to the inefficiency of your treatment. If not today then after a couple of months you’ll start complaining about your mirtazapine not working the way you want it to. 

Worsening of depression 

Several studies have revealed that mirtazapine may not work well for some people and may not provide adequate relief from the symptoms associated with their depression. 

When your treatment doesn’t work and makes no changes in your mental health condition, it starts making your symptoms worse. When depression starts to become more pronounced, it gets even more resistant to your current treatment with mirtazapine. 

Make sure you report to your healthcare professional if you continue to take your antidepressant properly but still experience signs and symptoms of depression. This is not a good sign and it clearly indicates therapeutic failure. 

What other options do you have if your mirtazapine does not work anymore? 

There are several other options which may help to get rid of your depression or anxiety if your mirtazapine stops working. These include:

Selective serotonin reuptake inhibitors (SSRIs) 

SSRIs can be used to treat depression and other mental health related problems. These meds work by inhibiting the reuptake of serotonin by blocking serotonin transporters (SERT). 

Serotonin is an excitatory neurotransmitter responsible for modulating mood, cognition, reward pathway and other physiological functions. The excess amount of serotonin can significantly decrease your depression symptoms. Examples of SSRIs include:

  • Zoloft (Sertraline) 
  • Lexapro (Escitalopram) 
  • Prozac (Fluoxetine) 
  • Paxil (Paroxetine) 
  • Celexa (Citalopram) 

Serotonin-norepinephrine reuptake inhibitors (SNRIs) 

SNRIs are another class of antidepressants which can also be used for several other mental health illnesses. These meds work by inhibiting not only the reuptake of serotonin, but they also inhibit the reuptake of norepinephrine, which is another excitatory neurotransmitter. 

Examples include:

  • Effexor (Venlafaxine) 
  • Pristiq (Desvenlafaxine) 
  • Ixel (Milnacipran) 
  • Fetzima (levomilnacipran) 

Tricyclic antidepressants (TCAs) 

Tricyclic antidepressants are also used to control depression and anxiety. These agents were once used as the first line of treatment for depression, but later they were switched because of more side effects and were replaced by newer SSRIs which were proven to be much safer. 

However, TCAs are still a good option for people with depression which is resistant to the treatment with SSRIs. Examples include:

  • Elavil (Amitriptyline) 
  • Pamelor (Nortriptyline) 
  • Tofranil (Imipramine) 

Monoaminoxidase inhibitors (MAOIs) 

MAOIs are also used to help relieve the symptoms of depression. These agents work by inhibiting the enzyme monoaminoxidase which is responsible for the breakdown and metabolism of serotonin and norepinephrine. 

This results in increased amounts of these excitatory neurotransmitters which counteract the symptoms of depression. Examples include:

  • Nardil (Phenelzine) 
  • Marplan (Isocarboxazid) 
  • Emsam (Selegiline) 
  • Parnate (Tranylcypromine) 

Conclusion 

In this blog post, we have discussed the possibility of your mirtazapine not working anymore. Mirtazapine may stop working after a few months and may not produce the same beneficial effects as it did when it first started to kick in. 

Experts believe that the possible explanation of mirtazapine behaving this way is some other factor that might counteract the effects of your antidepressant. We have discussed all the possible causes of mirtazapine inefficiency. 

Make sure you reach out to your healthcare provider. If mirtazapine does not work well for you, your doctor may start to taper you off this antidepressant gradually and prescribe another one, aiming for better therapeutic outcomes.

FAQs: mirtazapine not working 

What happens when mirtazapine stops working?

When mirtazapine stops working, you stop seeing or noticing any of your depression or anxiety symptoms getting better. You may feel well and cheerful one day, but that feeling doesn’t last much longer because of mirtazapine’s inefficiency. It may lead to discontinuation of treatment with this antidepressant and your doctor may put you on another med to help relieve your disturbing symptoms. 

How do I know if mirtazapine is working?

When your mirtazapine stops working, you stop seeing any progress in your antidepressant treatment. Instead, you start feeling annoyed and agitated. It might make you feel good one day, but again makes you feel anxious. If this persists, even after the proper continuation of your treatment, this indicates that your antidepressant is not working. 

Does mirtazapine stop working over time?

Yes, mirtazapine may become ineffective after a couple of months of your treatment. Mirtazapine is usually well tolerated and it’s a good choice of antidepressant, but it may stop counteracting the symptoms of your depression as strongly as it did when you first started taking it. Experts believe that the possible explanation of mirtazapine behaving this way is some other factor that might counteract the effects of your antidepressant.

Can you build up a tolerance to mirtazapine?

Yes, you may build a tolerance to mirtazapine. In fact, a few studies suggest that mirtazapine may have more chances of developing a tolerance as compared to any other selective serotonin reuptake inhibitor. 

Mirtazapine intolerance occurs when your body gets used to your current dose of the antidepressant and stops responding to it. This problem is not that common with mirtazapine but it can still occur in some individuals. 

Is it normal for antidepressants to stop working after a few months?

Antidepressants may stop working after a couple of months and may not produce the same beneficial effects as it did when it first started to kick in. Experts believe that the possible explanation of your antidepressants behaving this way is some other factor that might counteract the effects of your antidepressant.

References 

What was missing from this post which could have made it better?

[Sassy_Social_Share type="standard"]