Dangers Of Mirtazapine (Top voted first)

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 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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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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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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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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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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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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Pete- good luck with your cat. Unfortunately I had to put Bill to sleep yesterday. His uremia was overwhelming him and any further treatment to artificially prop him up would have been cruel. I used the medication in discussion twice since the original post at a slightly lower dose than the 1/4 of a 10mg tab. He WAS eating until the end, but the other positive effects of the med were not achieved again. I kept my promise to him that he would not suffer, and he was deteriorating rapidly due to toxic uremia. I am very sad but feel like I did the right thing.

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Mirtazipine is relatively safe when used at low doses in felines for appetite stimulation. The above cat I believe had other issues, which were not caused by the mirtazipine. (black tarry stool is indicative of upper intestinal / gastric bleeding - and can be seen with lymphoplasmacytic diseases) It is a drug of last resort in cats that will not eat sufficient amounts to sustain themselves. And many of these cats will pass on due to the underlying disease. That being said each cat is individual and may react differently to each medication. Some cats have had fatal reactions to routine antibiotics. Please be cautious when posting as, although unfortunate for you and your cat, the medication works quite well in most cats with minimal to no side-effects.

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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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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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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 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 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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I have been using this drug for severe and recurrent depression for 10+ years. I ONLY experienced a deep sleepiness for a week or so. Once your body adjust to this medication, it works WONDERS for some people. I have an eating disorder and trouble sleeping also. IT SAVED MY LIFE- Literally. I was dropping weight so fast that I could no longer find bras or clothes to fit. I am 5'8" tall and weigh 100 lbs. I would NOT be here today if not for this LIFE-SAVING drug. However, with ANY medication patients should be monitored and be watchful for ANY changes. These need to be addressed with your physician. Many people dont know that TYLENOL is one of the most dangerous drugs there is, and parents feed it to their children. READ THE LABELS FOLKS and research ANY drug/vaccine PRIOR to giving it to yourself, your child OR your pet.

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I do animal rescue and have been prescribed and used Mirtazapine as an appetite stimulant (1/4 of a 15mg tab) given every 2 - 3 days to the cats in our program who are sick or otherwise anorexic. I have never had a cat have an issue from the Mirtazapine itself, although it hasn't always worked. We are talking about dozens of cats.

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I'm another veterinarian who has had wonderful results using this drug. While it's horrible to hear about such bad experiences, any given person animal can have a reaction to routinely used medication on any given day. It doesn't mean that you have a bad vet, quite the contrary, they were trying to find something to help- it just didn't in this case. Many other animals have been greatly helped with this medication, so try not to make a judgement call based on one or two really terrible experiences

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I have been taking Mirtazapine for two years without any side effects. I have been taking medication for Bi-Polar, Depression and Anxiety for 13 years. Mirtazapine has had the fewest side effects and the best results of all that I have tried.

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Hello again. I must hold up my hands and say I was wrong about Mirtazapine. I said in my last posting that I would not give my 13-year-old cat this medication because it is a major tetracyclic antidepressant. I decided to give him a dose of 1/8th of a tablet every 3 days. The vet said the dose should be ¼ of a tablet every 3 days, but I was Erring on the side of caution. It has worked wonderfully and my cat's appetite is great. Mirtazapine has similar side effects to Maxolon, an anti emetic drug to stop nausea and vomiting in cats. Following the administration of the mirzatapine, my cat started meowing very loudly, became unsettled and was unsteady on his feet. These side effects lasted 2 or 3 hours only, but it's quite distressing to watch. Happily he is eating 3-5 meals a day so the prognosis is better for the long-term outcome following his bowel cancer. He is taking a drug developed in France that is a chemotherapy drug. It's one tablet every two days to prevent the reoccurrence of the tumour. Taking a tablet every two days is better than having to leave him in a vets animal hospital for the usual chemotherapy, which involves a line into a vein in his leg to administer the chemotherapy medication.

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Yeah relax dude. Mirtazapine is probably one of the safest and most effective anti depressents out there. In my opinion its one of the best.

All anti depressents have some degree of risk and usually they'll be a period of a few days to week for the medication to settle in. That period is usually the worst especially if you don't know what's coming and have no support. And what is massively missing from the medical profession is early stage care and warning while someone is taking such medications.

In my case I didn't have any side effects as I was already in very bad place by the time I took it. It helped me get to sleep which I hadn't been able to for literally 3 weeks!!

Its definitely a better medication for people with depression vs SSRIs and it helped me gained weight that I'd lost massively from depression.

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My cat Tigger is 17-18 years old. In the last month or so, he hasn't been very interested in food and he was throwing up a lot -- sometimes food, sometimes a foamy liquid that would indicate some problems with stomach acid. When he didn't eat hardly anything for 2 days, it was time to take him to the vet.

He was given a subcutaneous injection due to dehydration, and the doctor ordered some blood tests. He was worried it might be chronic kidney failure (my best guess too, but some symptoms didn't fit) or possibly cancer. The blood test showed normal kidney functions and I opted not to get the x-ray for cancer. At the time of his vet visit, the cat was down to less than 8 pounds. He was never heavy, but this was a few pounds under his norm.

I asked the vet about how to get him to eat again and he suggested 1/4 pill of Mirtazapine every 72 hours. I looked it up and found this site... after reading all of these horror stories, I was very concerned about giving him the drug. But he wasn't eating and there wasn't a lot more I could do but watch him starve to death.

I called the vet again and asked if he was sure the drug was safe. He said that other than some drooling, they have not had many issues with it.

I decided to half the dosage and gave my cat 1/8 of a pill instead. He did drool for a few minutes, but I saw no other symptoms other than him being a bit more active than usual. Within an hour of taking the pill, he was gobbling down his food and wanting more. I was happy to see him eating again!

Over the next few days, he continued to have a healthy appetite but I could see that the effects of the pill were wearing down. I gave him his second pill 72 hours after the first (1/8 of a pill again) and his appetite picked up. It has now been about two days after the second dose and he is eating like a little pig and gaining weight slowly. Best of all, he is keeping his food down (for the most part) and his upset stomach seems to be less of an issue.

I would eventually like to ease him off the drug if he continues to eat on his own, but if I have to I will continue to give him the drug. He has suffered no obvious side effects, and I am really amazed by how quickly the Mirtazapine turned things around for him.

I'm very sorry to hear about the complications other cats have had on this drug, but my guess is that there was some other imbalance in their bodies that caused the negative reactions. I wanted to post my story here in case other people find themselves in my situation and have few alternatives. Maybe I was just lucky, but I am very glad that I decided to give him the drug. It really made all the difference and saved him from starving to death.

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