MIRTAZAPINE AND SSRIS
There are a couple of isolated cases of possible serotonin syndrome, when mirtazapine was used with fluoxetine and fluvoxamine, and there is a report of hypomania associated with combined use with sertraline. Restless legs syndrome occurred with fluoxetine and mirtazapine. Fluvoxamine markedly increased plasma levels of mirtazapine in two cases.
Caution is warranted on concurrent use. Monitor for adverse effects (e.g. oedema, sedation) and be aware that CNS excitation may occur. Extra caution might be appropriate with fluvoxamine, since the limited evidence suggests that this might markedly raise mirtazapine levels. However, this needs confirming.
Caution is warranted on concurrent use. Monitor for adverse effects (e.g. oedema, sedation) and be aware that CNS excitation may occur. Extra caution might be appropriate with fluvoxamine, since the limited evidence suggests that this might markedly raise mirtazapine levels. However, this needs confirming.