Mirtazapine in Comorbid Major Depression and Alcohol Dependence: An Open-Label Trial PMC
Subjects were given 15 mg of mirtazapine for the first two weeks of the trial and 30 mg for the last six weeks of the medication trial. Protocol assessments were conducted weekly in the first month and biweekly in the second month. Pill counts were also used to ensure compliance with protocol medication. To ensure a high level of participation for these evaluations, a $20.00 payment was made to patients completing each assessment (Festinger, Marlowe, Dugosh, Croft & Arabia, 2008). Participant-rated depressive symptoms were assessed with the Beck Depression Inventory (BDI) (Beck, Ward, Mendelson, Mock & Erbaugh, 1961).
Antidepressants and alcohol: What’s the concern?
Mirtazapine demonstrated a large effect size for treating depression and a moderate effect size for treating alcohol craving. Efficacy for decreasing level of alcohol use could not be assessed, because neither of those two studies assessed level of drinking. Consequently, we cannot compare the results of the current study to the results from those other two studies on the important outcome variable of level of alcohol use. Therefore, we believe that our current study is the first study to report a significant decrease in level of drinking in a comorbid major depressive disorder/alcohol dependence population treated with mirtazapine.
Mirtazapine may interact with other medications
It might be best to stop drinking alcohol for the first few days of treatment until you see how the medicine affects you. Talk to your doctor or pharmacist if you’re unsure whether it’s safe for you to drive while taking mirtazapine. GOV.UK has more information on the law on drug rehab statistics success rates drugs and driving.
- Mirtazapine is not any better or worse than other antidepressants.
- Some medicines that you might never have suspected can react with alcohol, including many medications which can be purchased “over-the-counter”—that is, without a prescription.
- Do not suddenly stop taking this medicine without first checking with your doctor.
- Few of those studies demonstrated efficacy for treating depression, and even fewer demonstrated efficacy for treating alcohol or other substance use.
Some people feel worse during the first few weeks of treatment before they begin to feel better. Using mirtazapine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
This includes prescription or nonprescription (over-the-counter OTC) medicines and herbal or vitamin supplements. Mirtazapine may cause drowsiness, trouble with thinking, or trouble with controlling body movements. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that requires you to be alert, well-coordinated, and able to think well. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, how to safely taper off alcohol and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Using this medicine with any of the following medicines is not recommended.
Dangers and Effects of Mixing Mirtazapine and Alcohol
Your doctor may decide not to treat you with this medication or change some of the other medicines you take. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Mirtazapine has not been properly tested with recreational drugs. Talk to your doctor if you think you might use recreational drugs while taking mirtazapine.
If you are taking mirtazapine for a genuine condition like depression, mixing mirtazapine and alcohol can actually make the condition worse. This is because mirtazapine works by blocking the effects of certain neurotransmitters in the brain, like serotonin and norepinephrine. Alcohol has similar effects on these neurotransmitters, which can lead to an increase in feelings of depression, anxiety and irritability when mixed with mirtazapine. Some people want to magnify the effects of alcohol and mirtazapine either to provide extra relief from the symptoms of mental health conditions or for recreational purposes. Taking the two substances together can lead to serious health risks, addiction and even death by overdose. If you are struggling with mirtazapine and alcohol addiction, Primrose Lodge offers effective treatment which can help you break free from this cycle.
The norepinepherine system may be involved in the modulation of brain reward circuit, which can be related to level of drinking. Participants were required to be outpatients between 18 and 55 years of age at baseline to be included in the study. The MINI has demonstrated good reliability, validity, and clinical utility (Sheehan et al., 2008). The comorbid presence list of foods that contain alcohol of both current alcohol dependence and current major depressive disorder was required for inclusion in the treatment study. The MINI provides guidelines for identifying substance-induced mood disorders. Persons with substance-induced mood disorders were excluded from participation in the current study.
Subjects were prescribed a flexible dose schedule of mg/day of mirtazapine based on the clinician’s judgment. No subjects reported serious adverse events; all adverse events related to mirtazapine were reported to be minimal to moderate. No subjects in the study dropped out due to side effects of mirtazapine. The findings of that study indicated that both medications resulted in a reduction of depression and alcohol craving.