Dangers Of Mirtazapine (Page 21)
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It seems to me that Mirtazapine is a potentially dangerous drug with little information known about it. My veterinarian prescribed this drug in small quantities for my cat as an appetite stimulant, so I began reading articles on the drug and its effects. Although it is supposed to be used as an antidepressant for humans, it has a wide reputation for causing suicidal tendencies in children and young adults. It causes weight gain (the side effect my vet was looking for in my cat's case). It also can cause feelings of depression, and wooziness. I spoke with a nurse who took it and she said the effects of sluggishness and dizziness lasted 2 to 3 days. It can also cause nausea and headaches. It seems to me that these side effects are anything but what a person who is already depressed should be feeling. (suicidal tendencies that they didn't originally have, feeling tired and unwell physically, and weight gain that could cause feelings of insecurity or increased depression) Giving this drug to my cat was the worst thing I ever did. About an hour after administering it to her, she began crying, looking confused, and she could not walk straight. We figured the effects would wear off, but they seemed to worsen. The next day she was holding her head down, walking in circles (trying to walk straight) and she could not focus her eyes. We brought her to the emergency animal hospital, and they called a poison center. Even the poison center had so little information on this drug (especially being prescribed to cats) that they did not know how to counteract the effects. We believe that the drug actually caused a mild stroke in our cat, and the vet said this looked like it might be the case. On top of that, it has a 72 hour half life, so we just had to wait the drug out for her to even feel better. If this drug could cause a mild stroke in my cat, I could only imagine what it could also do to a human. With so little knowledge of the effects, and such long-lasting effects, it seems to me that it is a dangerous and harmful drug for doctors to be prescribing. A few years from now, when it actually is studied more, I bet that it will be taken off the market as another one of those trial drugs that did not work out. Until then, how many people (and animals) will it harm?

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I'm really sorry to hear about your cat. The side effects seem similar to the anti-emetic (anti-vomiting) drug ' Maxalon' used by vets frequently to stop cats vomiting. One of my tom's had an injection of it ad he behaved the same as you describe your cat did after Mirtazapine. The same tomcat of mine has just been prescribed this drug to increase his appetite following bowel cancer surgery and subsequent weight loss. He had the surgery in February 2010. There is no way I would give him Mirzatipine-it's a major tetracyclic anti depressant and extremely powerful. I'm suggesting to the vet that he prescribes a small dose of antihistamine instead, that will increase appetite and is much safer for a small animal.

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Would like to follow up my previous entry. After 6-8 hours or so the restlessness and wobbliness settled down and he was in the most content state I had ever seen him in since I had him. He continued eating for a full week after the 1/4 tab dose. It was just this morning, a full 9 days after his first dose that I gave him just a touch less than 1/4 tab. I just broke a little piece off the 1/4 tab. It stimulated his appetite again without the initial strange effects. This medication has had such a profound positive effect on my CRF cat that I tinkered with the idea of keeping him on it regularly for the rest of his life, but decided to just use it on as as needed basis for now. This medication has bought us precious time and alleviated my stress immensely. I was really falling apart trying to get him to eat during his crisis. We will be doing f/u blood work shortly to see how his numbers look. I am particularly concerned with his phosphorous being in the upper 9's and have doubled his Aluminum Hydroxide as per Dr. Nagode's protocol.

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My 12 year old male cat has chronic renal insufficiency. I adopted him as an adult 2 years ago with this condition. He currrently weighs 11.2 lbs down from 12.8 in April. I had his disease stabilized for two years with high quality nutrition and phosphorous binders (Aluminum hydroxide). Within the last month things started progressing rapidly for the worse as far as is Creatine, BUN and more recently his phosphorous. He stopped eating two weeks ago for two days, then, suddenly started again. I thought his kidneys were officially shot and that he was a goner. A few days ago he stopped eating again. I have tried so many things to get him eating naturally that I have been an emotional wreck for the last month trying to keep him comfortable, hydrated, and nourished. I brought him in the vet today and we did blood work to see if his kidney function has regressed even further, and the vet gave him 1/4 of a 15 mg tab of mitrazipine as well as training me how to syringe feed. He has been recieving 100cc of subQ lactated ringers daily for the last month. He was prescribed Azodyl as well but have had difficulty pilling the large capsule and have not been too impressed with the studies on its efficacy. When I took him home today he immediately ate his canned food. He is showing some side effect. He is restless and a little wobbly, but does not seem too uncomfortable. In fact he seems kind of happy. This definitely has stimulated his appetite, but the restlessness has me edgy. His body language is positive and he is receptive to petting which he has not been in a long time. He's grooming more too. If he needs it again in 72 hours as prescribed, I will give a lower dosage to see if it still stimulates his appetite while reducing the euphoria if that is what it is. I'm just not sure. This must be one powerful medication to elicit such a profound effect in such a short amount of time at such a low dosage. Proceed with caution at the lowest dose possible but don't entirely discount it as an appetite stimulant for feline CRF is my opinion at the current moment.

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My cat had stopped eating a few weeks ago so I took her to the vet. They could not find anything obviously wrong after blood tests and x-rays. They performed exploratory surgery and took a biopsy of her intestines. She was diagnosed with cancer a few days ago. The vet prescribed Mirtazapine (1/4 of a 15 mg tablet every 3 days). Having not researched its effects, I gave it to her about 2 hours ago. She is now in agony. I remebered that she acted the same way the last time I gave it to her so I decided to do some research. My research led me to this discussion. Having read what you've said about your cats and seeing what it's doing to min, there is NO WAY I'm ever giving it to her again!

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Update: My 13 y.o. male cat with CRF has now had a few doses of mirtazapine. I've reduced the dose to 1/16 tablet every 3 days...this seems to be ideal for him. His appetite is still good on this dose, it's controlling his stomach acid and he's no longer restless as he was on the higher dose. He's acting like he did before the CRF, playing, picking on his sisters, getting into trouble and chowing down. He's put on a few ounces. He goes to the vet in two weeks for a blood draw. Hopefully his values have improved or not worsened. His quality of life right now is wonderful and I owe much of that to mirtazapine and kitty massages!

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My vet prescribed mirtazapine (at my request) for my 13 y.o. male with CRF. He had pretty much stopped eating and was not interested in food of any kind. He had gone from 20 lbs (he's always been a big boy) to 15.5. I wanted to nip the weight loss in the butt before it got any worse. Two nights ago I gave him 1/8 of a 15mg tablet and within a hour he was chowing down like crazy. He even ate the canned KD which he hates. Yesterday morning he was up and about when I got up asking for more food! It's hard to say if he was more vocal than usual as CRF cats produce excess stomach acid which causes them to howl. He did seem more restless (he was getting up in the middle of the night to go eat more and wanted me to pet him...the drugs makes them more affectionate since it affects the serotonin levels). So far I have not noticed any serious side effects. He was sleepy this morning but I'm going to attribute it to him being up most of the night. I'm going to give him another pill tomorrow (1/8 of 15mg. tablet every 3 days). I will keep a close eye on him and may even reduce the dose to 1/16 of a tablet.

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Well, the effects of Mirtazapine have finally worn off for Casper. Thankfully his condition did not worsen after the initial 24 hours. My vet has very little expereince with this drug and was surprised at the stong adverse effects. There is not much that could be done for Casper except wait for the drug to leave his system. The backup plan was to put him on IV drip to try to flush the drug out if needed.
I would definitely not use this drug again and would urge anyone who does to LIMIT the dose to 1/8 of a 15mg pill......discuss the dosage seriously with your vet !!!!!
Becky T.....it you check this site again I want to say that I am truly sorry for your loss. The experience that you and Abby had was very disturbing. I would urge you to go back to your records to verify the dosage that was prescribed to you. If in fact it was 15mg per dose; this would be an extreme overdose and the vet should be advised. I know that you would want to protect other pets from potential overdose.
Thank you all for posting your comments. Without you, I would not have known what was happening to Casper and might have pursued more serious medical intervention with dire consequences.

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My 16 yr old cat Casper developed severe anemia suddenly. Blood analysis by specialists show no apparent reason. abdominal and Thoracic x-rays show nothing. we gave hime a blood transfusion yesterday to help him until an abdominal ultrasound can be done as a final screening. the transfusion went very well and he came home looking for food. great news. he was prescribed Martazapine 15mg for the nausea and lack of appetite. I gave hime 1/4 pill and he started Yowling within an hour. He's been yowling since and seems disoriented. His rate of breathing has increased and he just seems uncomfortable. I will speak to my vet shortly to check if anything can be done. Hopefully this drug will not worsen his condition.....will post an update later.

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I am so sorry to hear about the horrible experience you had with your cat on mirtazapine. I am writing to all of those people considering giving it to their cat. Of course, I wouldn't want to try it if I heard that as well. I wonder if the dose was too high?

My cat was diagnosed another appetite stimulant when she stopped eating due to kidney disease, but it didn't work at all. We tried mirtazapine-I had to cut the tablet into an 1/8-sooo tiny. I love this drug! She eats what a normal cat would eat, she meows, plays, and acts like her old self. We give it every 72 hours-you can tell the difference the day we give it-she is like a kitten again, then as it slowly wears off, although she still eats a lot, she isn't as active.

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Gave my cat 1/4 tablet of Mirtazapine about 3 hours ago because she refuses to eat after experiencing a hit by car like trauma 3 days ago (we don't know what happened, but seems like spinal cord injury after x-rays showed no broken bones or internal damage). She is restless, pretty vocal, agitated, and generally acting like she's on a catnip binge, but she's finally eaten something and hasn't stopped purring for the past 2 hours. I'm keeping my eye out for other symptoms listed but have not seen them yet. My only concern is the restlessness since she needs to be lying still and resting. Right now she's lying on the couch next to me but keeps trying to get up. I was going to sleep in my bed tonight for the first time since her trauma, but after reading this I'm going to sleep on the couch again with her to make sure she's okay

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I gave my fifteen year old cat his first dose of Mirtazapine this morning,tand what a day we've had. After drooling and acting sick for a while, he began to cry. He has cried all day. At first I thought his constipation problems might be the cause of his discomfort. But after a successful trip to the litter box I realized there was another problem. It finally dawned on me to look up the side effects of this drug , and that led me to this site. I would never start a new medication for myself without checking it out first, and I'm very mad at myself for not giving my pet the same consideration.
He is quiet at the moment, and I just pray I don't end up at the emergency vet tonight.
Please always check out the side effects of any new medication, and don't start them on the weekend when vet's offices are closed. I have learned a lesson

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My alcoholic husband has been prescribed mirtazapine. He is now taking it and drinking. Anyone ever deal with this? I thought my husband was taking illegal drug because one minute he was fine and 10 minute later he was wasted. He has convinced his doctors to prescribe this for insomnia. Alcohol causes insomnia. He is passed out the majority of the time.

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Being a new vet tech, I accidently gave our hospitalized cat a whole 15 mg tablet of mirtazapine instead of a quarter tab which should of been given every third day. A few hours after he seemed disoriented and was vocalizing a bit. We gave him cyproheptadine to counter act any major side effects. He is doing okay thus far. I will post again tomorrow to update on his condition.

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I just stumbled across this post, and wanted to put my 2 cents in.

My 2 1/2 year old cat Winnie is severely anemic from a blood parasite. Unfortunately, she also has the feline leukemia virus, an opportunistic virus that can attack the bone marrow and suppress red blood cell generation.

Unfortunately, after visiting multiple vets, I realize there's nothing more to do for Winnie but to keep her happy and comfortable. As I had been syringe feeding her, which stresses both of us out, the last vet prescribed mirtazapine - 1/4 tablet every 3 days - to stimulate her appetite.

While she was agitated for about 45 minutes after I administered it the first time, she seems to be tolerating it much better this time around. And the drug has improved her appetite enough to make her eat.

She is dying, and deserves to die with whatever dignity she can. Mirtazapine is giving her - and me - the gift of relief from syringe feeding, making our last few days together much better.

In my opinion, for my dying feline companion, this is the least I can do. The benefit far outweighs the risk.

The bottom line here is to not allow your vet, doctor, specialist make these decisions for you. Be an active consumer in you - and your beloved pet's - healthcare. Ask questions, Google the meds, join on-line groups... these things will only make you more well informed, and reduce the risk of doing something you later regret.

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I am a nurse practitioner and my husband is a vet. There is lots known about mirtazepine. It is not a new drug and has been well studied.

ALL drugs have side effects- some serious. They should only be used when the potential benefit outweighs the potential harm. In order to determine this providers read articles conducted on thousand of people or animals and compare bad events in people taking the drug and those getting a placebo- because there are many factors to health and there will be people or animals that have bad things happen whether or not they are on a given group. So if 3% of people on a drug get a headache and 3% of placebo get a headache there is no increased risk. If on the other hand if 13% get a headache the risk of headache is increased by 10% by the drug.

Notice the LARGE groups. One case study tells us nothing about what happened. Anything could cause a person or an animal to have an event. Just because the event happened right aftera med or a vaccine or watching hockey does not mean it caused it. But if you look at 3000 people and 4% more folks had an event after a drug- that means something.

In humans the incidence of dizziness in mirtazepine is about 2-3% more than placebo. The incidence of sleepiness is much higher than placebo - about 30% depending on the study- and that is why it is dosed at night. There is NO increased risk of stroke documented in the literature. In fact there was a study specifically aimed at this as folks with depression have an increased risk of stroke in general. They looked at associations of antidepressants to stroke and mirtazepine did not increase stroke risk.

Many animals and people given this medication are SICK or ELDERLY and that is why they are losing weight. They thus could definitely have a side effect to mirtazepine but if a cat or person has a heart murmur- for example- they are may be (depending on the cause of the murmer) at an increased risk for stoke and to associate the stroke with mirtazepine (which despite the posters suggestion is NOT associated with increased risk of stroke) with mirtazepine would miss the whole picture.

I use (as do all the geriatric providers I know) mirtazpine on appropriate patients with weight loss. It has been well tolerated by the vast majority of my patients. I have taken about 1 in 20 off it as they complain of speepiness or dizziness which then resolves. I have never in 20 years had any reaction more severe in a patient. It could happen I am sure but the # folks helped with no problem at this point is very high.

My husband also uses mirtazepine. He has only taken one animal off it for an adverse event- it was too sleepy. He has noted it only work in a percentage of cases but when he uses it the weight loss is a serious health risk and thus the drug is worth trying even though it may not always work. He does note that generally the animals he prescribes it for are elderly or sick and they are losing weight due to reasons which often cannot be reversed.

I encourage those interested in researching medications to truly research them. Look at sites that base their info on research rather than suggestions of people who had a bad event. While it is always tragic when a person or animal becomes seriously sick or even dies- it is often not simple to determine the cause and to react by telling all people to ignore health care advice and stay away from a given drug is highly irresponsible.

I honestly don't understand the paranoia that seems to indicate providers are trying to harm their patients or don't care. Medicine is VERY complex and difficult and the providers I know spend many hours reading journals, attending conferences, and discussing cases with colleages to offer the best care to our patients. It is frankly astounding when I hear folks saying that based on their hour on the internet the providers are all incompetant and their advice should be ignored. I would never be so bold as to offer similar proclamations based on my personal experience with a bad investment let alone with other people's health.

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Update on our 17-year-old calico who we had given 1/4 tab of Mirtazapine: After my post, our cat's agitation increased, so I called the after-hours line for our veterinarian. The on-call vet did not seem particularly concerned with my situation, saying that Mirtazapine is safe and would not be dangerous considering our senior cat's heart murmer. She suggested we give the cat 1/4 tab of Benadryl (which acts as a mild sedative) to calm her down. So, once again hoping (stupidly) the vet knew best, we did so. The cat spit the pill out and immediately began to gag and salivate heavily, and then started to shake. She threw up yet again and then had diahrea on the floor, which she never has. At this point, I called a local 24/7 emergency vet, and they said to bring her in right away. They took this situation very seriously, especially considering our cat's heart murmer and the fact that she was breathing very rapidly. They examined her, cleaned her up, and put her in a room with me to quiet down, which presently she did (although she was still crying a bit, it was much less than before). The vet took our cat's history, went over possible scenarios, and showed me a large green manual (can't remember the name) which she said was sort of the veterinary bible of medications. On the Mirtazapine listing under side effects, it listed crying and nausea, but nothing to the extent that my cat or Jennifer's cat experienced. So this book is obviously not as thorough as it should be for this listing. My cat began to quiet down, the vet examined her again after about 1/2 an hour, and the color had come back to the roof of her mouth (it had been pale when I first brought her in), she seemed more focused, but was not interested in drinking. When I expressed my concern about this and dehydration, she offered to give the cat subcutaneous fluids, which she did. She advised us to stop the Mirtazapine (which I would have done anyway) and to try different cat foods as an appetite stimulant to see what our cat might respond to (she suggested Fancy Feast, which for a supermarket brand, she said is of good quality and has many different flavors). Now stabilized, I brought the cat home (now about 1:30 a.m.,, approx. 5 hours after the initial dose), where she proceeded to become more calm, and made it through the night relatively ok. This morning, she seemed normal and fine. I feel we were very lucky, and I'm very sorry to here of Becky's loss -- my sympathies. But anyone who is advised to give their cat Mirtazapine should do careful research and ask a lot of questions and consider a change in diets before pharmaceuticals of any kind. I bought some Fancy Feast today, and our cat ate it up. Mirtazapine -- regardless of some veterinarians' opinions -- is dangerous. Don't use it.

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i have been on Mirtazapine for 3 days to help me sleep as i have insommnia felt great the first day after i had woken up but have felt woozy and really tired for the last two days will these symtoms go away or should i see my doctor i sleep really well with them its just the symtoms during the day i am worried about

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(Please forgive my misspelling of the name Mirtazapine in my former post.)

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To Mike - Good luck with your kitty. Luckily, you only gave your baby 1/4 tab (mine was given the full 15 mg tab as prescribed by my vet). Please let us know what happens.

And to the Veterinarian who posted here -- Real people are posting real experiences with their pets. I don't think we should be reprimanded for that and told to be cautious when posting. Rather, veterinarians should be overly cautious when prescribing mitrazapine and should always inform the pet's owner of the full and possible consequences of giving their pet this pill. If I had known, you can be certain I would not have been so cavalier about giving it to him thinking in was just a pill and that the vet knows best. We buried my cat yesterday and all of the pain of losing him returned as well as my feelings of guilt for giving him something that caused his last hours of life to be filled with so much anxiety and fear -- the last thing I would ever intentionally do to an animal.

I encourage everyone who has a negative experience with giving their cat mitrazapine to post it here so the word gets out.

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Our female calico cat is approx. 17 years old and dropping in weight. She's never been heavy, but dropped in the past few months from 6.1 lbs. to 5.8 lbs. Our vet prescribed Mirtazapine 15mg, 1/4 tab) every three days. We gave her her first dose this evening and within an hour she was crying loudly and wandering around as if lost and confused -- the same reaction as posted by Jennifer, and the anxiousness and yowling reported by Becky. It's now about 2 hours since the dosage and she is still crying and agitated, and she just threw up everything she had eaten this evening (ironic, considering the purpose of the prescription in the first place), so it seems to have made her nauseus as well. We won't be giving this to her any more. We should have asked the vet about possible side effects or at least done our own research before accepting the prescription. Big lesson learned. Hopefully the effects will wear off sooner than the 72-hour period.

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