Dangers Of Mirtazapine (Page 2) (Top voted first)

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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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354

I am a vet tech and can personally tell you that with mirtazapine there is always a risk for an adverse reaction. However, when it works, it works wonders. If your kitty does react poorly, there are other alternatives such as cyproheptadine that you can discuss with your vet as an alternative. Although these side effects have been reported, I have yet to see a cat or dog die from the adverse effects reported. I would not let this site deviate anyone who's pet is suffering from an illness that may be affecting appetite as it is a case by case situation. My 14 year old cat has high grade lymphoma which has a very poor prognosis of 3 to 6 months and thanks to this medication, he is eating voraciously and gaining weight. I was aware of the possible side effects prior to giving the medication and knew what signs to look for in the event my kitty reacted in such a way. You should also be aware that certain medications can increase the adverse effects reported such as reglan (metoclopramide) which is commonly used in veterinary medicine to treat nausea and sometimes prescribed in conjunction with treatment for certain diseases that could cause nausea (such as kidney failure, cancer, etc). Worth giving it a try but be aware of possible side effects so that you are able to better determine if your kitty is a good candidate for the medication. I have seen vets follow two different protocols, there's the 1/8 of a 15mg tablet every 24 hours or the 1/4 of a 15mg tablet every 72 hours. I have never seen a respectable veterinarian prescribe a full 15mg tablet to be administered at once nor should anyone follow those instructions if it is prescribed to your kitty. Hope this helped.

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363

How dare you say these horrible things! You know NOTHING about me! I trusted my vet and tried this med ONCE. After my kitty's reaction to it, I never gave it to him again. I take excellent care of my fur babies and used to work as a veterinary assistant. It's because of people like you that I dislike people more and more every day and wish I could be surrounded by animals only. Get off of your high horse and stop attacking people who are only trying to help our beloved pets!

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30

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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36

I'm a little surprised at some of the dosage instructions some have shared here for using Mirtazipine in cats. My vet first suggested using Mirtazipine after a Diazepam (Valium) compound made him a little too wobbly. The Mirtazipine dosage I was given was 1/4 of a 15mg tab every 4-7 days. Every 3 days seems like too much based on *my* experience, because there is a visible response to (what I assume is) the seratonin levels increasing. My 17 year old year old male cat with CRF (diagnosed at 16) went from 10+ lbs. to 6.5 lbs. in a year. I started him on Mirtazipine just before his 18th birthday. He started gobbling up his food and has put on just over 2 lbs. in 10 months, averaging an ounce per week at times. I've settled on once every 6-7 days for a 1/4 tab, which I feed inside a Greenie's Pill Pocket (half of one is great for the size of 1/4 tab of Mertazipine).

I'm extremely happy with the results, but I know I wouldn't be if it weren't a success. Please don't take my experience as a guarantee that you and your cat will have similar results. I shared so that anyone reading in the future has another reference to dosage. A full tab of Mirtazipine seems like way, way too much.

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39

I have given my 18 year old kitty a few doses for low appetite. She has renal disease and has been continuing to lose weight. She actually stopped eating and so the vet recommended mirtazapine. It does seem to increase her appetite though she is hardly ravenous. I have noticed that she cries after we give it to her, but my cat is very vocal and anxious as it is so it is hard to say whether the medication causes it. I'm just trying to make her as comfortable as I can at the end of her life and so far, I haven't noticed any major side effects. I would say the improvement is minor but it is still an improvement.

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126

Lol Mirtazapine ain't like LSD or Marijuana. You can get a high off Mirtazapine but that's usually when you're breaking into the medication and trust me it don't last. I had a few highs early on taking it but that were kinda random. Also a high on Mirtazapine isn't like a natural high when you ain't depressed its just you feel better and that's about it. Now as for a real high I did get one off a 5htp and Citalapram combo but the next day woo that was nasty. Mirtazapine takes the edge off extreme mood dips associated with depression and helps with sleep and panic attacks. Its a good medication and one of the best anti depressants that's for sure!!

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5

I also wanted to add that I have lost 40 pounds while on Mirtazapine for the past two years. I am careful with my diet and I exercise. Too many people use their medication as an exuse for this or that. If you are gaining weight then eat less and exercise. If you beleive that your medication is causing you to behave in ways you don't like then stop taking it and talk to your doctor about another choice. Not every medciation works the same for every person and there is no perfect medication for anything. One drug may work well for me and not for you, that's the nature of being human...we are all different.

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10

Jennifer, We have used Mirtazapine on one of our cats after trying many other options, including a feeding tube. He had lost almost 9 pounds- down to 8.5 from 17... the dosage was 1\8 of a 15 mg tablet every 3 days, and even at that small dosage we noticed what seemed like nervousness the first day after giving him the medication. You did not mention what dosage you gave your cat, from your comment it would seem you gave too strong of a dose. Our vet warned us this was a dangerous drug if overdosed, and we used it with caution and it worked wonders for us, along with a lot of patience....

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122

I just wanted to weigh in. I have been giving my 15 year old male cat 1/2 of a 7.5mg tablet of Mirtazapine every 3 days as he has had 14 of teeth extractions in less than a month's time due to stomatitis. When he gets a dose, it actually makes him happy & within 10 to 15 minutes he wants to eat (on his own). Before the Mirtazapine, he had a very hard time eating & I had to either finger feed or spoon feed him with a soft-tipped baby spoon. He has been on it since 9/27 and I can't wait to give him another half tab when the time comes as it starts to wear off just before the 3 days are up.

That said, he is a fairly healthy cat for his age otherwise. His blood tests are all good. The only problem he has, other than stomatitis, is that he has inflammatory bowel disease and all his life, has had only 1 functioning kidney (the other one is atrophied).

I wonder of those having trouble with this drug have cats with some other underlying cause (for instance, it says to be careful with it if the cat has liver disease).

It helps when people express their experiences with this drug but that said, it would be even more helpful to also add if their animal, prior to the drug administration, had any other underlying diseases such as liver or kidney problems or whatever, to start with, and what prompted their vet to prescribe the drug.

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127

My cat, Zenobia, is 3 months shy of turning 19 years old. She has never been sick, ever. A few months ago she began eating less and less, and is now skin and bones. She hasn't stopped eating, but losing any more weight would probably hasten her demise from old age, which seems to be the only thing "wrong" with her. Her vet prescribed mirtazapine 1/4 of a 15 mg tab every other day starting yesterday. Now she is eating great and having no side effects that I can discern. As a psychiatric patient of more than 20 years, formerly very suicidal with depression, bipolar disorder and terrible panic attacks (doing much better after a long and frightening struggle), I have taken a lot of drugs and had side effects and/or was not helped by almost all of them. My Dr. and I after much trial and error finally arrived at what I now take. It was NOT a pleasant experience, but I did not want to die, so I persisted. Prescription drugs work differently in every body, human or animal, because we all have wide genetic variations among us. I weep for anyone who has lost a loved pet or a loved person- there are 2 suicides in my family. Medicine is not an exact science, unfortunately, and I gve this medication to my cat knowing she could have a bad reaction. Since she is so old, I wanted to help her feel better if I could, and luckily for her it is working so far. Doctors just need to be sure that they supply all the information about any drug and work closely with the patient and/or owner concerning side effects and therapeutic gains. It is a process, and I have been very firm when necessary about discontinuing medications because of side effects or because they weren't working. Ask questions, observe, educate youself and make sure you have a doctor who will work with you. I'm alive and no longer suicidal, thanks to just such a doctor. Losing Zenobia is coming, I know, and it will break my heart. After 19 years I will miss her forever. Such is life.

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374

Dear sweet cat person. I feel your pain. My cat died the day after I gave him mirtazapine after suffering hallucinations, disorientation, yowling, backing into corners, looking frightened, etc. he also had huge pupils when I took him to the vet, where I left him to be treated. The vet called me later to say he'd had a heart attack and died. He was only ten years old. I will never forgive myself for leaving him there alone and scared and crying for me to take him home. After 7 years I still cry when I think of that day, and I feel so guilty for giving him the pill that I believe with all of my heart led to his death. So I understand completely where you are coming from. Still, I think you did everything possible to be an excellent cat parent and gave Kibble a wonderful, long life. I imagine at the end you were caressing him and telling him how much you loved him so he could go peacefully. We do what we can for our babies. Sometimes it's just time, whether we like it or not, to say goodbye. I think you were a wonderful cat dad and you shouldn't feel guilty for doing what was probably best for your boy. It was an extremely unselfish act on your part to let him go. I only wish I could have been there for my boy. Although the vet technician told me they were all with him, talking sweetly to him and petting him when he died, I don't know if that was true. I should have been there. What made it worse for me was that, like you, I gave my cat a larger dose. For me, though, it was accidental because the pharmacy had put the wrong dosage on the label. Even so, I gave him the pill when he was really doing very well and may not have even needed it. My thought was that it couldn't hurt. Man, was I ever wrong about that. My guilt is enormous and no one has been able to talk me out of it. I don't expect anyone will ever be able to soothe your guilt entirely either, but I hope you can come to find peace with yourself. You obviously loved Kibble immensely, and did everything you could to give him a good life. He knew he was loved. And you helped him transition from what was no longer a good life for him. I think you did the right thing. God bless you!!

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385

Neat, I'm glad you have no side effects. Charlotte, as you can read all of our other comments here, this drug can cause terrible effects on animals. I will NEVER give it to any of my cats again. It would break your heart watching your dog go through this if it happened. Please talk to your vet for an alternative option.

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3

I use remeron as a sleep aid, 45mg. at 9, sleeping like a baby by 10.

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90

Just wanted to say my 4 yr old domestic short hair hadn't eaten in three months (I was feeding by syringe down an esophagal tube) until a vet decided to try mirtazapine. In 48 hours he had his appetite back and has been fine for the last 6 years. Certainly a drug of last resort but when desperate it's worth a try!

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111

Hi! This is quite a "popular" thread. I have no idea how many will make it through all the replies to find this information, but here it goes..

I'm not a medical or veterinary professional, and unlike some people, I'm very careful about using the words "advise" or "recommend." However, I have read about and studied the effects of drugs for over 10 years.

It does appear to be clear that in the case of Mirtazapine, one has to be very careful with dosage. I've taken it; I know. I had some terrible dizzy spells, once or twice, when I was first adjusting to it.

15 milligrams is commonly the dosage -Adult Humans- are started on. Does a cat weigh 1/4 what a 150 lb human does? Almost never! The 1/16th and 1/8th dosages make much more sense. I believe the drug can be had in 7.5 mg tabs, which would make dosing easier. I can't imagine cutting a tablet into 8ths and getting an accurate dosage from that!

The side effects people describe are very familiar to me, look up "akathisia." If you've ever had it, it's as maddening as can be. Edginess, restlessness, irritability, anxiety. I have to be very careful with any anti-histamine drugs..they nearly all give it to me at a normal dose. Many antidepressants also carry this side effect. I suspect it's a major factor in this whole "risk of suicide from antidepressants" issue. If I were a cat (and cats are known for their natural wariness) I'd be scared half to death, I'm sure.

Adding benadryl would be a horrific idea, making the akathisia even worse. The people who mentioned cyproheptadine were mostly on the right track, it counters some of the neurotransmitter effects, though it also is an antihistamine.

I'm mildly disturbed that there are people giving "advice" that Capitalise Every Word In A Very Long, Rambling Paragraph. It can be taken as a sign of mental illness when someone writes so strangely, so consistently. I'm more disturbed that there may be people who will follow advice from that person. There's a lot of preaching to the choir.

People whose pets reacted badly or died are obviously going to hate the drug that, by all their observations, harmed/killed a beloved friend, the vet that rx'd it, the company that made it, etc, chiming in to further their agenda, when all they really wish for, is a chance to go back in time. I am truly sympathetic, believe me. My eyes have misted over several times, reading the thread, and writing this.

Let it be said, again..that losing a pet, or seeing them suffer, is very hard, and strikes at the core of our emotions involving mortality, and the helplessness it can engender. I can also understand feeling victimised, and going on a crusade.. I would not argue against the stance that drug companies are powerful, well connected, and hungry for profit. Often enough their tactics for making that profit are less than ethical. This does not mean that everything they sell is useless poison.

Likewise, someone who is bereaved is likely speaking wholly from emotion, and rational advice can seldom be had from that viewpoint.

The lesson, however, should be painfully clear. Be very careful with your dosages! You can always up a dosage that's ineffective, but a bad reaction takes time to recover from, and erodes trust. Use drugs that aren't formulated for animals very carefully, and use judgement to determine whether caution is even possible when you're dealing with tiny slivers of a pill.

PS: The user Forest Riggs mentioned an incident after "bombing" their house to deal with their cats' flea problem. The pesticide Permethrin acts as a nerve toxin, and is a very common household product. Cats are vulnerable to this poison, though humans and most dogs metabolise it without consequence. Adding psychoactive drugs that aren't the antidote likely makes matters worse.

What was described sounded a lot like permethrin toxicity. This stuff is the reason that many products for dogs tell you not to use them on cats. I'm horrified how few pet owners are aware of this danger. Please pass it on!

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119

I'm sorry for all those who have experienced negative side effects with mirtazapine in their cats.

My cat is only eight years old and was diagnosed with end stage kidney failure back in January. I was told that he would likely be gone in four months. He was immediately put on fluids every day along with a pill regimen consisting of three antibiotics/day, Pepcid AC 2x/day, and an antihistamine to stimulate his appetite. He looked drugged out and uncomfortable most of the time (which we now attribute to the antihistamine) and he went from 16 pounds down to about 9.5 pounds. Three weeks ago I was seriously considering euthanasia as well as looking at a site to bury him. Our vet decided to give one last try with Mirtazapine. For the past three weeks, we have been giving him 1/4 of a 15 mg tablet. The transformation for my cat has been nothing short of a miracle. From reading the previous posts, I realize that my cat could have been unlucky, but for my cat (and those of us who love him), his quality of life is back. He eats all the time (I may have to put him back on the diet that he was on before he became sick) and also wakes my daughter up every morning to go out on his leash for a walk. If your cat is truly at death's door as was mine, I think it is worth trying this medication. If I hadn't tried this medication, I would have put him to sleep to end his suffering. Now, I am hopeful that we'll have many more months of true quality time with him.

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138

John Holbert, you may be in the wrong forum. This is a human medicine, you are correct on that but veterinarians also prescribe this to stimulate an animal's appetite. The very first post in this forum, from Jennifer, was about her cat. Perhaps you are the one who needs to find the right forum.

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399

I give my cat mirtazapine as vet dose :1/4 of 15mg pil . Within 10 minutes he start eating, but minutes later - around 15 minutes he is whining and start acting confusing, drooling , walk here and there.....a little bit faster breathing , My God, I am so worry... I called my vet office , they busy and will get back to me soon. So I calm this little boy - pet him , and put him next to me in a quiet environment.... couple minutes past... he stop whining, and less drooling, his breathing still bit fast, but now he sit calm next to me. I pray may the side effect goes soon....I seeing he now try to sleep.
My heart go roaler coster with this situation- I am keep praying.... May he is normal again soon.

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1

I have used mirtazepine as a last resort for depression (it is not commonly prescribed unless other drugs have failed or if weight loss is a big problem), and while the side effects are horrible, it really worked for me. It gaves me bundles of energy and motivation, which I had none of before this treatment

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8

Luckily, I had enough mental capacity to stop taking Mirtazapine and recommend that everyone steer clear of this horrid medication. -quote

Excuse me, but you have no right to recommend anything.
I could say the same about many anti depressents but I dont, because its true...different medications work for different people.

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