First report of mirtazapine overdose

Hoes, M.J.A.J.M.; Zeijpveld, J. H.B.

doi:10.1097/00004850-199611020-00009

Cited by 4 publications

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“…Only a few cases of mirtazapine overdoses have been reported and the patients seemed to suffer no serious medical consequences [1−5]. In this case the patient was somnolent and ataxic only for a few hours.…”

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confidence: 94%

A Non-Fatal Mirtazapine Overdose in a Suicide Attempt

Garlipp¹,

Brüggemann²,

Machleidt³

2003

Aust N Z J Psychiatry

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issue [1] and sadly I have to agree with most of what he had to say about the treatment of comorbidity or 'dual diagnosis' patients. In particular, MacQueen makes the pertinent point that most comorbidity in the substance abuse field is actually anxiety and depressive disorders and that the classic 'dual diagnosis' patient (e.g. a person suffering from schizophrenia who smokes marijuana), is only the tip of the iceberg. The incidences and prevalences of psychiatric disorder in those presenting with substance abuse are far higher than the incidence of substance abuse in those presenting with psychiatric disorders, so it turns out that it is much more relevant to train those in the drug and alcohol field in recognizing and treating psychiatric disorder, rather than the other way around [2].However, I do feel that MacQueen has basically missed the point in issuing his challenge to psychiatrists as individuals. In fact, psychiatrists have been put in an impossible position as the powers that be, for politically correct reasons, have artificially separated substance abuse and psychiatric services. They have, in fact, attempted to unscramble the egg and thus we now have this ludicrous situation with patients being bounced between the two services and never receiving adequate treatment.As Harvey Whiteford stated in this Journal,The high rates of comorbidity, especially with alcohol and illicit drugs confirms clinicians' experience. In the light of this I am even more certain that the administrative separation of mental health and substance abuse services makes little sense, especially to the consumer and their carers [3].

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confidence: 94%

A Non-Fatal Mirtazapine Overdose in a Suicide Attempt

Garlipp¹,

Brüggemann²,

Machleidt³

2003

Aust N Z J Psychiatry

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Anxiety Disorders: New Antidepressants

Hidalgo¹,

Davidson²

2002

Anxiety Disorders

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Mirtazapine: An Antidepressant with Noradrenergic and Specific Serotonergic Effects

1997

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Mirtazapine is a unique antidepressant that refines the specificity of effects on noradrenergic and serotonergic systems. It is an antagonist of presynaptic α2‐adrenergic autoreceptors and heteroreceptors on both norepinephrine and serotonin (5‐HT) presynaptic axons, plus is a potent antagonist of postsynaptic 5‐HT2 and 5‐HT3 receptors. The net outcome of these effects is increased noradrenergic activity together with specific increased serotonergic activity, especially at 5‐HT1A receptors. This mechanism of action maintains equivalent antidepressant efficacy but minimizes many of the adverse effects common to both tricyclic antidepressants and selective serotonin reuptake inhibitors. Mirtazapine has an onset of clinical effect in 2–4 weeks similar to other antidepressants, although sleep disturbances and anxiety symptoms may improve in the first week of treatment. It has minimal cardiovascular and anticholinergic effects, and essentially lacks serotonergic effects such as gastrointestinal symptoms, insomnia, and sexual dysfunction. Sedation, increased appetite, and weight gain are more common with mirtazapine than with placebo. An elimination half‐life of 20–40 hours enables once‐daily bedtime dosing. The recommended initial dosage is 15 mg once/day at bedtime, with an effective daily dosage range of 15–45 mg. Cases of overdose of up to 975 mg caused significant sedation but no cardiovascular or respiratory effects or seizures.

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First report of mirtazapine overdose

Cited by 4 publications

References 0 publications

A Non-Fatal Mirtazapine Overdose in a Suicide Attempt

A Non-Fatal Mirtazapine Overdose in a Suicide Attempt

Anxiety Disorders: New Antidepressants

Mirtazapine: An Antidepressant with Noradrenergic and Specific Serotonergic Effects

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