Dangers Of Mirtazapine

Jennifer Says:

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?

429 Replies (22 Pages)

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Bagpuss Says:

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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Verwon Says:

I am very, very sorry to hear about what you went through with your cat. That poor baby, I would have to say I would be causing that vet major problems if that happened to me and my furbabies.

As to the side effects that you read about this drug, if you check other antidepressants, you will actually find those are common to most of them. It can be very hard, when treating depression, for a doctor to have to make the decision to use something based on the benefits and risks to the patient.

However, I have never before heard of this being used in cats, and yes, waiting it out is pretty much your only solution. Making sure your car eats, even if you have to tempt them to do so, and drink plenty of water, is something you can remember in the future to help hurry it along and out of their system if such at hing would happen again.

Some cats just don't eat a lot and are naturally small and underweight. Other than trying various different foods, including some people food tidbits, to try to tempt them to eat more, there isn't a whole lot you can do about it and your vet should have known that. As long as the cat is staying primarily healthy, then it is not worth trying such a risky drug.

I have a cat like that, he is so much tinier, weight wise, than my other 3 boys, however, his fur is shiny, he had energy, he plays, he does eat when he is hungry, so he is basically healthy and I would not let the vet try to give him anything to make him eat more, since he was staying healthy and not dangerously thin, I felt it did not warrant the risks. He is now almost 8 years old and still as healthy as can be, just thin.

I would not ever go back to that vet if I were you. Your furbaby deserves better.

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kendogone Says:

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

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Brian Says:

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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Brian Says:

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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BB Says:

Mirtazapine is the worst anti-depressant there is. I thought I knew what depression was, until I took Mirtazapine. It sent me into a downward spiral that resulted in me wanting to die. I can really understand now how a drug can actually make people kill themselves. Luckily, I had enough mental capacity to stop taking Mirtazapine and recommend that everyone steer clear of this horrid medication.

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kate Says:

all anti depressants have risks of suicidal tendencies and increasing depression. if you feel that, the medicine is wrong for you and you just stop taking it and try a different one. obviously this was the wrong medicine for your CAT since the medicine was designed for HUMANS.

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AJ Says:

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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JJ Says:

Kate, please chill out. Some reputable vets prescribe mirtazapine for cats who are losing weight because of chronic health problems. That said, animal guardians are right to be concerned about their animals taking such a strong drug, given that there's no way to know how the animal is feeling (anxious? depressed? disoriented?) once on the drug. My vet, who is excellent in all other ways, has just prescribed this for my cat (weight loss from kidney trouble), and now that I know what it is and how strong the side effects can be, I have no intention of giving it to my cat. I would encourage other animal lovers to look for other alternatives; antidepressants are incredibly powerful drugs, the mechanisms of which are only partly understood, and the side effects can be debilitating. I know: Over the past 15 years, I've taken Prozac, Zoloft, nortriptaline, Lexapro, Celeca, Effexor, and Cymbalta, and I've experienced strong, albeit varied, side effects from each, and insufficient relief from each to warrant continuing any of them. I reiterate: I would *not* give mirtazapine, or any other antidepressant, to my animals under any circumstances.

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jh Says:

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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Becky T Says:

The vet prescribed Mirtazapine 15 mg for my cat yesterday. Within an hour or two after giving him the first pill, he became anxious, seemed uncomfortable, disoriented, and started crying. He's been crying off and on all night so I've been trying to console him. We gave him this drug to try to stimulate his appetite after he had a bad reaction to Clavamox which caused him to quit eating. I stopped the Clavamox and about 15 hours later, he ate some turkey babyfood. Unusally a ravenous pig, he didn't want to eat anything else even five hours later so I decided to give him the Mirtazapine. Unfortunately, he's now having a very bad reaction. It scares me that Jennifer's cat seemed to have a stroke. I don't know how long this is going to last and don't know if I should take him to the vet again today. Right now I'm afraid to trust the vet again. No one told me the side effects and I stupidly didn't look them up. I've called the vet hospital and they were rather nonchalant about it and said the symptoms should go away. This pill has not made my cat eat at all so I'm now afraid he will go 72 hours without food, since that is the length this drug works. He's crying right now. I don't know what to do.

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Becky T. Says:

Update -- A couple of hours after my last post I took my cat to the emergency vet. His temp had dropped to 94 degrees, he was acutely anemic, his heart was very small in the x-ray, and he was getting shocky, according to the emergency doctor. His eyes were extremely dilated, he was yowling, seemed very uncomfortable and anxious. It was horrible and sad to watch. At noon I left him with the vet who said he should be okay after blood transfusions. At 4:30 the vet called to say he'd had an episode - that his heart had stopped and he'd stopped breathing. They were able to get his heart started again and he was breathing on his own but was unconscious. The vet hoped that if they continued the transfusions, he would respond. 15 minutes later the vet called again to say he'd passed. When I went to pick up his little body, I noticed black tarry looking stuff coming out of his behind. The vet said it was obvious the cat had been bleeding into his GI tract and that he'd bled out. Prior to this day, my cat had not had any history of GI problems. He was being treated for lymphocytic plasmacytic rhinitis -- a nasal disease. He'd had a blood test the week before and had a normal blood count at the time, and was not anemic at all. How he could suddenly bleed to death internally is a mystery. The only thing I can attribute it to at this time is that I gave him mirtazapine and 15 hours later he was dead. The vets insist that mirtazapine wouldn't have this effect and say they give it to their patients all of the time. I think they may be covering for each other. I think that the anxiety caused by the drug must have made my little guy's heart pound so much that he popped a blood vessel somewhere inside and then the blood continued pounding right out. Jennifer (above) says she thinks her cat had a stroke, which is one of the documented side effects of this drug, so why couldn't a blood vessle pop somewhere besides the brain? It was a horrible experience for my cat and for me. Please pass the word on to all you know that mirtazapine should be used with great caution on small animals. If my Abby died so other animals might be saved, then his death wouldn't be in vain. I feel his pain and the fear, confusion, and anxiety he experienced in his last hours were completely unnecessary. People - read up on drugs before you give them to your pets. I know I will from now on.

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A veterinarian Says:

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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Mike Says:

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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Becky T Says:

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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Becky T Says:

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

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alison Says:

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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Mike Says:

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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Diane Says:

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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Kitty Mama Says:

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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