Course Summary

Mirtazapine is an antidepressant with a labeled use for the treatment of major depressive disorder. Ongoing studies are comparing the benefits and risks of mirtazapine in specific population groups, including the elderly and individuals with severe mood dysregulation. Mirtazapine is known to be well-tolerated and effective. Combination therapy for individuals with treatment-resistant depression has been investigated in terms of the clinical benefits of mirtazapine when administered with other psychotropic agents. Mirtazapine has a low potential to interact with antipsychotics, tricyclic antidepressants, and some selective serotonin reuptake inhibitors (CYP2D6 metabolizers), making it an option for non-responders to monotherapy for depression, anxiety symptoms, and sleep disturbance. The basic pharmacological profile of mirtazapine, clinical indications, and the potential for mirtazapine toxicity are discussed in the following sections, which include prescribing and current published information.

Course Format

Homestudy

Course Syllabus

• Introduction
• Pharmacological Profile and Uses
  • Available Forms and Dosing
  • Common Uses
• Drug Warnings, Contraindications, and Potential Adverse Effects
  • Drug-drug Interactions
  • Suicidality
  • Serotonin Syndrome
  • Anticholinergic Effects
  • Cardiovascular
  • Orthostatic Hypotension
  • Central Nervous System
  • Hypomania and Mania 
  • Hyponatremia
  • Ophthalmic
  • Hematologic
  • Weight Gain and Increased Appetite
  • Discontinuation Syndrome
  • Pregnancy and Breastfeeding 
• Case Study: Suicide Attempt by Mirtazapine Overdose
  • Discussion
• Summary

Author

Kellie Wilson, PharmD

Kellie Wilson is a Doctor of Pharmacy practicing in Anaconda, Montana, where she lives with her husband and four children. She attended the University of Montana in Missoula where she graduated in 2009 with a doctorate in pharmacy. She later worked in Boise, Idaho for a large, retail pharmacy for 2 years, and then returned home to Montana to oversee an independently owned retail and long-term care pharmacy in Anaconda. As an independent retail pharmacist she has become very involved in psychiatric pharmacy for two major behavioral health organizations that are located around all of Montana. Kellie’s passion is retail pharmacy because she enjoys the interactions with customers as well as the challenges and rewards of staying current with the continuous changes in the pharmacy field.