Mirtazapine 15mg Overdose Effects & Safety

My 24 year old overdosed on paracetamol and aspirin last week. She took over 40 tablets. After being released from hospital and seeing her local GP she has been given 14 day supply of this drug. I am concerned to allow her to keep all the tablets.

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Hi, I had overdosed on 15mg mirtazapines and had the Dr's check me over about 3 days later. Do you think all is ok?

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This is an antidepressant that is used to treat various mental health conditions. If you are concerned, it might be best for you to keep the tablets and dispense one to her each day, for her own safety, that is often what is done in mental health units, when someone is suicidal and they want to be cautious.

The NIH lists the typical side effects as possibly including nausea, dizziness, dry mouth, mood swings, headache, and weight changes.

How is she doing, now?

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It's a common error people trying to commit suicide make, trying to do it using paracetamol and aspirin. Although that quantity is very toxic to the liver and other organs, it's a very slow painful way to kill yourself which can take weeks as the liver and other organs shut down. You're more likely to vomit it up and do some possible liver damage.

Regarding Mirtazapine, toxicity and overdose risk... it's certainly possible to overdose on it, so I would do as others suggest and dispense these one per day if you think there's a risk, or just give a weeks supply.

In some people, especially younger people (in the early stages of starting the drug especially) there can be an increased risk of suicidal thoughts and suicidal tendency brought on by the drug paradoxically.

You would have to take a lot of Mirtazapine for a fatal overdose as it's fairly non-toxic except at massive doses (60-100+ tablets) which I think would be difficult to keep down.

Here's what I found supporting this:

"Mirtazapine is considered to be relatively safe in the event of an overdose, although it is considered slightly more toxic in overdose than most of the SSRIs (except citalopram). Unlike the tricyclic antidepressants, mirtazapine showed no significant cardiovascular adverse effects at 7 to 22 times the maximum recommended dose. Case reports of overdose with as much as 30 to 50 times the standard dose described the drug as relatively nontoxic, compared to tricyclic antidepressants.

Twelve reported fatalities have been attributed to mirtazapine overdose. The fatal toxicity index (deaths per million prescriptions) for mirtazapine is 3.1 (95% CI: 0.1 to 17.2). This is similar to that observed with SSRIs.

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