Switching A Patient To Or From A Monoamine Oxidase Inhibitor (MAOI) Intended To Treat Psychiatric Disorders
At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with REMERON (Mirtazelon) Tablets. Conversely, at least 14 days should be allowed after stopping REMERON before starting an MAOI intended to treat psychiatric disorders (see CONTRAINDICATIONS).
In healthy male subjects (n=16), Mirtazelon (30 mg daily), at steady state, caused a small (0.2) but statistically significant increase in the International Normalized Ratio (INR) in subjects treated with warfarin. As at a higher dose of Mirtazelon, a more pronounced effect can not be excluded, it is advisable to monitor the INR in case of concomitant treatment of warfarin with Mirtazelon.
9. Common questions
Mirtazelon is a type of antidepressant medicine.
It works by increasing the activity of mood-enhancing chemicals called noradrenaline and serotonin in the brain.
You may see an improvement in your symptoms after a week although it usually takes between 4 and 6 weeks before you feel the full benefits. That's because it takes around a week for Mirtazelon levels to build up in your body, and then a few weeks longer for your body to adapt and get used to it.
Do not stop taking Mirtazelon just because you feel it is not helping your symptoms. Give the medicine at least 6 weeks to work.
Antidepressants like Mirtazelon help to gradually lift your mood so you feel better.
You may notice that you sleep better and get on with people more easily because you're less anxious. You will hopefully take things that used to worry you in your stride.
Mirtazelon won't change your personality or make you feel euphorically happy. It will simply help you feel like yourself again.
Don't expect to feel better overnight, though. Some people feel worse during the first few weeks of treatment before they begin to feel better.
Once you're feeling better you're likely to keep taking Mirtazelon for several months.
Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed.
Stopping your medicine too soon can make depression come back. Most doctors recommend taking antidepressants for 6 to 12 months after you stop feeling depressed.
Mirtazelon is generally safe to take for a long time. There don't seem to be any lasting harmful effects from taking it for many months and years.
If you've been feeling better for 6 months or more, your doctor may suggest coming off Mirtazelon.
Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you've been taking Mirtazelon for a long time.
This is to help prevent you getting any extra side effects as you come off the medicine.
Side effects include:
- feeling anxious, dizzy or sick
- numbness or tingling in your hands or feet
Mirtazelon and breastfeeding
If your doctor or health visitor says your baby is healthy, Mirtazelon can be used during breastfeeding. It has been used by many breastfeeding mothers usually without any problems.
Mirtazelon passes into breast milk in small amounts. It has been linked with side effects in very few breastfed babies.
It's important to continue taking Mirtazelon to keep you well. Breastfeeding will also benefit both you and your baby.
If you notice that your baby isn't feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to your health visitor or doctor as soon as possible.