What are mirtazapine-induced dreams?

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In this blog we will discuss what Mirtazapine dreams are.

We will also discuss what you can do if you are having dreams and nightmares related to mirtazapine as well as what the drug is, how it is used, and what it’s side effects are. 

What are mirtazapine-induced dreams?

Mirtazapine-induced dreams refer to distressing dreams and nightmares that have been reported by patients who are being treated with Mirtazapine for depression. 

There have been a number of case studies that have mentioned the use of Mirtazapine and its side effect of nightmares. Researchers of one of the first case studies recording the side effects of Mirtazapine dreams and nightmares believe that this is caused by an increase of REM sleep. 

Mirtazapine is a relatively new tetracyclic antidepressant that is part of the piperazine group of antidepressants. 

It works by increasing noradrenergic and serotonergic transmission by blocking 5HT-2 and 5HT-3 receptors, thereby increasing the action of serotonin in the brain. 

The drug also has sleep inducing properties which is why this drug is often used to treat depression related insomnia by most medical providers. 

However, the sedating effects of this drug is believed to increase REM sleep as it reduces the suppression of REM leading to more dreams and nightmares. 

Nightmares and dreams occur in the Rapid Eye Movement stage of sleep called REm sleep and most antidepressants suppress REM sleep which is why dreams and nightmares are rarely reported. 

However, with Mirtazapine, researchers believe that this is because the drug has shown to increase REM sleep within the first few days of administering the drug- two days even- and it has also been observed that sleep time increases and the dreams do not subside even after weeks of use- as most side effects do. 

It is not only Mirtazapine that has recorded side effects of dreams and nightmares, in fact it has also been reported in the use of other antidepressants as well. It is this particular side effect that impacts adherence to treatment due to the distress this antidepressant causes. 

What should I do if I have Mirtazapine induced dreams?

If you have been noticing that you are having  frequent dreams and nightmares after you have started a course on Mirtazapine and it is affecting your sleep, your ability to go about your daily life- it is highly suggested that you slepa to your doctor about this side effect. 

Researchers that have presented two separate case studies on the dream and side effects of mirtazapine, reports that when the individual who were experiencing the dreams and nightmares were taken off the drug- the dreams and nightmares stopped.

The nightmares for both cases were reported to have disappeared 1- 2 days after cessation of mirtazapine. 

Your doctor can have a discussion about your side effects related to distressing dreams and consider an alternative medication for treatment by gradually weaning off mirtazapine and replacing it with another antidepressant. 

What is mirtazapine?

Mirtazapine is a prescription drug that is commercially available under the brand name
Remeron” and it comes as an oral immediate-release tablet or an orally disintegrating (dissolving) tablet.

Mirtazapine is a relatively new tetracyclic antidepressant that is part of the piperazine group of antidepressants. It works by increasing noradrenergic and serotonergic transmission by blocking 5HT-2 and 5HT-3 receptors, thereby increasing the action of serotonin in the brain. 

Mirtazapine is often used as part of a combination therapy to treat depression with other antidepressants and medications. 

What is mirtazapine used for?

Mirtazaohine is a relatively new antidepressant that is used for the treatment of Major Depressive disorder or clinical depression in adults. 

As of present, there is not enough research that has been done to determine if this drug can be used for children to treat depression. 

What are the Mirtazapine side effects?

The common side effects of Mirtazapine include:

  • sleepiness
  • increased appetite
  • weight gain
  • dry mouth
  • constipation
  • dizziness
  • strange dreams
  • Restlessness

These side effects are mild, and they may go away within a few days as you get acquainted with the drug in your system, however if it persists for more than a week it is advised that you meet your doctor to discuss these side effects. 

Mirtazapine causes drowsiness and may affect your ability to make decisions, think clearly, which is why it is advised that you shouldn’t drive, use machinery when you are using this drug.

More serious side effects of this drug include:

  • Suicidal thoughts or actions. 
  • Acting on dangerous impulses
  • Acting aggressive or violent
  • Thoughts about suicide or dying
  • New or worsened depression
  • New or worsened anxiety or panic attacks
  • Trouble sleeping
  • Changes in behaviour or mood
  • Manic episodes. 
  • Weakened immune system making you more likely to get infections.
  • Serotonin syndrome. 
  • Eye problems. 
  • Seizures
  • Low sodium (salt) levels in your blood. 
  • Sleepiness
  • Severe skin reactions.
  • Severe allergic reactions.
  • High cholesterol and triglyceride levels
  • Rhabdomyolysis (a serious muscle problem). 
  • Kidney problems

If you notice any of these symptoms, it is advised that you seek medical attention imagery. Do not stop the dose on your own and suddenly, instead if you want to get off the drug it is advised that you do it under the supervision of your doctor. 

How should I take mirtazapine?

The best way you can take mirtazapine is to take mirtazapine exactly as prescribed by your doctor or you can choose to follow all directions on your prescription label and read all medication guides.

You should attempt to take the medication at the same time everyday, during night time and take it with water, with or without food. 

For an adult, the regular dosage for depression according to WebMd includes:

  • Initial dose: 15 mg orally once a day at bedtime
  • Maintenance dose: 15 to 45 mg orally once a day
  • Maximum dose: 45 mg/day

This dosage can increase over time, as you respond to the medication and as to what is observed with respect to the impact the drug has on your condition.

It is important that you and your doctor reassess the need for the drug periodically as well as keep an eye on the side effects that you might experience. 

If you miss a dose of the drug, take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose so as to avoid double dosing. 

It is advised that you do not chew the medication, rather dor the orally disintegrating medication- you place it on your tongue and swallow as it dissolves. 

It is important for you to know that it might take a few weeks for symptoms of depression and the side effects to improve and alleviate, even if you feel better do not stop using mirtazapine suddenly, or you could experience unpleasant withdrawal symptoms.

What are the risks and precautions when taking Mirtazapine?

There are some risks and precautions that need to be taken when administering mirtazapine. These include:

Before you start a course on this medication, make sure that you set your medical provider know if you are allergic to the drug or if you have any other allergies that could be part of the drug composition. So take time to learn about the drug from your doctor or pharmacist. 

It is important that you mention your medical hisortry of mentla disorders in your family such as bipolar/manic-depressive disorder), history or family history of suicide attempts, liver disease, kidney disease, seizures, high blood cholesterol or triglyceride levels, heart disease (such as recent heart attack, angina), stroke, severe loss of body fluids (dehydration), low blood pressure, personal or family history of glaucoma (angle-closure type).

Mirtazapine might also increase the risk of a heart condition that affects heart rhythm which can lead to dangerous conditions that require medical attention which is why it is not suggested for people with health conditions or family history of heart conditions or if you are taking any other medications that cause QT prolongation. 

This drug may make you dizzy or drowsy. Mirtazapine causes drowsiness and may affect your ability to make decisions, think clearly, which is why it is advised that you shouldn’t drive, use machinery when you are using this drug.

Alcohol or marijuana (cannabis) can make you more sedated which is why you should limit your intake of either of these substances and inform your doctor if you do take these substances. 

Older adults are more sensitive to the side effects of this drug, especially drowsiness and QT prolongation thus it is important that you keep a check on the side effects that you are expiring and consult your doctor regularly. 

This drug should be taken with a lot of caution for pregnant women since it can lead to some negative effects in the unborn child. One should also know that this drug can pass through mothers milk, which is why pregnant and breastfeeding mothers should consult with doctors before starting a course on this drug.

Conclusion

In this blog we have discussed what Mirtazapine dreams are.

We have also discussed what you can do if you are having dreams and nightmares related to mirtazapine as well as what the drug is, how it is used, and what it’s side effects are. 

FAQ related to mirtazapine-induced dreams

Do mirtazapine dreams go away?

Researchers that have presented two separate case studies on the dream and side effects of mirtazapine, reports that when the individual who were experiencing the dreams and nightmares were taken off the drug- the dreams and nightmares stopped.

The nightmares for both cases were reported to have disappeared 1- 2 days after cessation of mirtazapine. 

Why do antidepressants cause vivid dreams?

It is not clearly known why antidepreassants cause vvid dreams however, researchers suspect that it is caused by the increased levels of neurotransmitters in the brain that has some influence on one’s REM cycles. 

Does mirtazapine interfere with REM sleep?

Researchers of one of the first case studies recording the side effects of Mirtazapine dreams and nightmares believe that this is caused by an increase of REM sleep. 

The sedating effects of this drug is believed to increase REM sleep as it reduces the suppression of REM leading to more dreams and nightmares. 

References

Mathews, M., Basil, B., Evcimen, H., Adetunji, B., & Joseph, S. (2006). Mirtazapine-induced nightmares. Primary care companion to the Journal of clinical psychiatry, 8(5), 311. https://doi.org/10.4088/pcc.v08n0510b

Menon, V., & Madhavapuri, P. (2017). Low-Dose Mirtazapine-Induced Nightmares Necessitating its Discontinuation in a Young Adult Female. Journal of pharmacology & pharmacotherapeutics, 8(4), 182–184. https://doi.org/10.4103/jpp.JPP_116_17

Mirtazapine. Drugs.com. Retrieved on 7th march 2022. https://www.drugs.com/mirtazapine.html

Mirtazapine Tablet – Uses, Side Effects, and More. WedMd. Retrieved on 7th March 2022.https://www.webmd.com/drugs/2/drug-13706-4047/mirtazapine-oral/mirtazapine-oral/details

Mirtazapine, oral tablet. University of Illinois, Retrieved on 7th March 2022. https://www.medicalnewstoday.com/articles/mirtazapine-oral-tablet#interactions

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