{"id":59095,"date":"2024-02-28T05:41:43","date_gmt":"2024-02-28T05:41:43","guid":{"rendered":"https:\/\/medsname.com\/mirtaz\/"},"modified":"2026-04-30T10:24:04","modified_gmt":"2026-04-30T10:24:04","slug":"mirtaz","status":"publish","type":"product","link":"https:\/\/medsbase.com\/nl\/mirtaz\/","title":{"rendered":"Mirtaz"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8d6;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">\u26a1 Snel antwoord<\/h3>\n<p style=\"margin-bottom:0;\">Mirtaz (Mirtazapine 7.5 \/ 15 \/ 30 \/ 45 mg) is a tetracyclic antidepressant (NaSSA) for major depression, particularly when insomnia, anxiety, weight loss, or anorexia are dominant symptoms. Strongly sedating at low doses, less sedating at higher doses (counterintuitive \u2014 see below).<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Wat u krijgt bij MedsBase:<\/strong> WHO-GMP gecertificeerde fabrikant \u00b7 Discrete verpakking \u00b7 Wereldwijde verzending \u00b7 1.400+ geverifieerde <a href=\"https:\/\/medsbase.com\/nl\/reviews\/\">klantbeoordelingen<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Elke bestelling is gedekt door onze <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.<\/p>\n<h3>Waarom bestellen bij MedsBase<\/h3>\n<p>Mirtaz at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance Policy<\/a> \u2014 20 werkdagen levertermijn of wij sturen kosteloos opnieuw \u2014 en komt in aanmerking voor ons <a href=\"https:\/\/medsbase.com\/nl\/loyalty-points\/\">klantenloyaliteitsprogramma<\/a>. Wereldwijde verzending is beschikbaar naar de meeste bestemmingen.<\/p>\n<h2>What Mirtaz is and how it works<\/h2>\n<p>Mirtaz is a 7.5 \/ 15 \/ 30 \/ 45 mg mirtazapine tablet supplied by Sun Pharma. Mirtazapine is structurally and mechanistically distinct from SSRIs\/SNRIs\/TCAs. It is a noradrenergic and specific serotonergic antidepressant (NaSSA): it blocks central \u03b12-adrenergic autoreceptors (raising NA and 5-HT release indirectly), 5-HT2A and 5-HT2C receptors (anxiolytic, sleep-promoting, no sexual dysfunction), and H1 histamine receptors (sedation and appetite stimulation).<\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Counterintuitive dose-sedation curve<\/strong><\/p>\n<p style=\"margin-bottom:0;\">At 7.5\u201315 mg, mirtazapine is most sedating. At 30 mg+, the noradrenergic component (which is more linearly dose-related than the H1 antihistaminergic component) starts to offset the H1 sedation. Many patients describe 30 mg as &#8220;feeling more energised&#8221; than 15 mg. If a patient wants more sleep, lower the dose \u2014 not raise it.<\/p>\n<\/div>\n<h2>Indicaties en dosering<\/h2>\n<table>\n<thead>\n<tr>\n<th>Indicatie<\/th>\n<th>Startdosering<\/th>\n<th>Streefdosering<\/th>\n<th>Maximaal<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Depressie<\/td>\n<td>15 mg HS<\/td>\n<td>30 mg HS<\/td>\n<td>45 mg<\/td>\n<\/tr>\n<tr>\n<td>Depression with insomnia<\/td>\n<td>7.5\u201315 mg HS<\/td>\n<td>15 mg HS (often sufficient)<\/td>\n<td>30 mg<\/td>\n<\/tr>\n<tr>\n<td>Depression with weight loss \/ anorexia<\/td>\n<td>15 mg HS<\/td>\n<td>30\u201345 mg HS<\/td>\n<td>45 mg<\/td>\n<\/tr>\n<tr>\n<td>SSRI augmentation<\/td>\n<td>7.5\u201315 mg HS added to SSRI<\/td>\n<td>15 mg HS<\/td>\n<td>30 mg<\/td>\n<\/tr>\n<tr>\n<td>Oudere volwassenen<\/td>\n<td>7.5 mg HS<\/td>\n<td>15 mg HS<\/td>\n<td>30 mg<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Belangrijke veiligheidsoverwegingen<\/h2>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Weight gain and metabolic effects<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Mirtazapine is one of the heaviest-weight-gain antidepressants \u2014 typical 4\u20137 kg over 6 months. Useful in patients with depression-related weight loss; problematic in obese or metabolic-syndrome patients. Check fasting lipids and HbA1c at 6 months.<\/p>\n<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Agranulocytosis (rare)<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Reversible neutropenia and rare agranulocytosis described \u2014 incidence approximately 1 in 1000. <strong>Stop immediately and check FBC if fever, sore throat, mouth ulcers, or other signs of infection appear in the first 8 weeks.<\/strong> Routine FBC is not required.<\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Restless legs and PLM<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Mirtazapine commonly worsens restless legs syndrome and periodic limb movements of sleep \u2014 relevant in patients with prior RLS or sleep complaints.<\/p>\n<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Zwarte waarschuwing voor su\u00efcidaliteit (onder 25)<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Alle antidepressiva dragen een FDA zwarte waarschuwing voor verhoogde su\u00efcidale gedachten bij pati\u00ebnten onder de 25.<\/p>\n<\/div>\n<h2>Veelvoorkomende bijwerkingen<\/h2>\n<ul>\n<li><strong>Sedatie:<\/strong> universal at 15 mg; lessens at 30+ mg; bedtime dosing harnesses it as benefit.<\/li>\n<li><strong>Weight gain and increased appetite:<\/strong> 4\u20137 kg typical at 6 months.<\/li>\n<li><strong>Dry mouth:<\/strong> common, mild.<\/li>\n<li><strong>Constipatie:<\/strong> mild anticholinergic action.<\/li>\n<li><strong>No sexual dysfunction:<\/strong> distinct advantage over SSRIs.<\/li>\n<li><strong>Vivid dreams:<\/strong> some patients describe unusually intense dreams.<\/li>\n<li><strong>Cholesterol \/ triglycerides:<\/strong> small mean rise.<\/li>\n<\/ul>\n<h2>Geneesmiddelinteracties<\/h2>\n<ul>\n<li><strong>MAO-remmers<\/strong> \u2014 14-day washout each direction.<\/li>\n<li><strong>Strong CYP3A4 inhibitors \/ inducers<\/strong> \u2014 moderate effect on mirtazapine levels.<\/li>\n<li><strong>CNS-depressiva<\/strong> (alcohol, benzodiazepines, opioids, Z-drugs) \u2014 additive sedation.<\/li>\n<li><strong>Andere serotonerge geneesmiddelen<\/strong> \u2014 serotonin syndrome described but uncommon (mirtazapine&rsquo;s 5-HT2A antagonism is partly protective).<\/li>\n<li><strong>Warfarine<\/strong> \u2014 small INR rise; monitor.<\/li>\n<\/ul>\n<h2>Zwangerschap, borstvoeding, pediatrie<\/h2>\n<p>Pregnancy: limited data; weigh against untreated maternal depression. Breastfeeding: passes into milk; sometimes used in postpartum depression where insomnia and weight loss are concerns. Paediatric: not first-line.<\/p>\n<h2>Opslag<\/h2>\n<p>Bewaren bij 15\u201330 \u00b0C in originele verpakking.<\/p>\n<h2 id=\"faqs\">Veelgestelde vragen<\/h2>\n<h3>Why is Mirtaz more sedating at 15 mg than at 30 mg?<\/h3>\n<p>Mirtazapine has dose-dependent effects on different receptors. At 15 mg, the H1 antihistamine action dominates \u2014 strongly sedating. At 30 mg+, the noradrenergic action ramps up and offsets the sedation. This is the opposite of intuition and is the most-asked question about mirtazapine. If your sleep is too heavy, raise the dose; if you want more sleep, lower it.<\/p>\n<h3>Will Mirtaz make me gain weight?<\/h3>\n<p>Yes \u2014 typically 4\u20137 kg over 6 months. This is one of the most reliable side effects. In patients with depression-driven weight loss it&rsquo;s a feature; in obese patients it&rsquo;s a problem. Discuss this trade-off explicitly before starting.<\/p>\n<h3>Why is Mirtaz taken at bedtime?<\/h3>\n<p>The H1 antihistamine sedation peaks 2\u20133 hours after the dose. Bedtime dosing recruits the sedation as a sleep benefit instead of daytime drowsiness. Morning dosing produces unacceptable drowsiness in most patients.<\/p>\n<h3>How is Mirtaz different from an SSRI?<\/h3>\n<p>Different mechanism (\u03b12 + 5-HT2A\/2C + H1 blockade vs SERT inhibition) translates to: more sedation, more appetite, more weight gain, no sexual dysfunction, less GI upset, less anxiety surge. Useful when those SSRI side effects are problematic or when insomnia\/weight loss are dominant symptoms.<\/p>\n<h3>Can Mirtaz be combined with an SSRI?<\/h3>\n<p>Yes \u2014 the so-called &ldquo;California rocket fuel&rdquo; (SSRI\/SNRI + mirtazapine) is a recognised combination for severe or partial-response depression. Mirtazapine is added typically at 7.5\u201315 mg HS. Specialist supervision recommended.<\/p>\n<h3>How long until Mirtaz works?<\/h3>\n<p>Sleep and appetite often improve within 1\u20132 weeks; the mood effect builds over 4\u20136 weeks at 15\u201330 mg.<\/p>\n<h3>How do I stop Mirtaz?<\/h3>\n<p>Taper over 2\u20134 weeks. Withdrawal is generally milder than SSRI\/SNRI withdrawal but rebound insomnia and dysphoria are described.<\/p>\n<h3>Will Mirtaz affect my driving?<\/h3>\n<p>Yes \u2014 the first 1\u20132 weeks of sedation can impair reaction time. Avoid driving until you know your tolerability. After that, most patients drive normally on stable doses.<\/p>\n<h3>Does Mirtaz help anxiety?<\/h3>\n<p>Yes \u2014 the 5-HT2A and 5-HT2C antagonism contributes a meaningful anxiolytic effect, often visible within the first 1\u20132 weeks. Useful when depression and anxiety co-exist.<\/p>\n<h3>Is Mirtaz addictive?<\/h3>\n<p>No \u2014 no euphoria, no compulsive use, no escalating tolerance. Physical dependence is mild and shorter than SSRI dependence.<\/p>\n<h2>Andere medicijnen voor geestelijke gezondheid<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/agoprex\/\">Agoprex (Agomelatine \u2014 melatonerg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/flunil\/\">Flunil (Fluoxetine SSRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/duvanta\/\">Duvanta (Duloxetine SNRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/bupron-xl\/\">Bupron XL (Bupropion XL \u2014 NDRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/lexaheal\/\">Lexaheal (Escitalopram SSRI)<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;font-size:0.9em;\">\n<strong>Medisch disclaimer.<\/strong> Deze pagina is educatief en geen vervanging voor persoonlijk medisch advies. Farmacotherapie voor geestelijke gezondheid dient te worden gestart, gecontroleerd en aangepast onder begeleiding van een gekwalificeerde clinicus. Als u of iemand die u kent in een su\u00efcidale crisis verkeert, neem dan onmiddellijk contact op met de plaatselijke hulpdiensten, of bel de su\u00efcidepreventielijn van uw land (VS\/Canada: 988; VK: Samaritans 116 123; internationale lijst: <a href=\"https:\/\/findahelpline.com\/\" rel=\"nofollow noopener\" target=\"_blank\">findahelpline.com<\/a>).\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Mirtaz (Mirtazapine 7.5\u201345 mg) \u2014 tetracyclic NaSSA for MDD with insomnia, anxiety or weight loss. no sexual dysfunction, strong appetite stimulation.<\/p>","protected":false},"featured_media":59096,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3342,3906],"product_tag":[4626,4487],"class_list":{"0":"post-59095","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-general-health","8":"product_cat-mental-health-and-psychiatric-medications","9":"product_tag-mirtaz","10":"product_tag-mirtazapine","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product\/59095","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/comments?post=59095"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media\/59096"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media?parent=59095"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_brand?post=59095"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_cat?post=59095"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_tag?post=59095"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}