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Mirtazapine: Difference between revisions
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Mirtazapine is considered to be relatively safe in the event of an [[overdose]],<ref | Mirtazapine is considered to be relatively safe in the event of an [[overdose]],<ref>Taylor, D; Paton, C; Shitij, K (2012). The Maudsley prescribing guidelines in psychiatry (in English). West Sussex: Wiley-Blackwell. ISBN 978-0-470-97948-8.</ref> although it is considered slightly more toxic in overdose than most of the SSRIs (except [[citalopram]]).<ref>{{cite journal | vauthors = White N, Litovitz T, Clancy C | title = Suicidal antidepressant overdoses: a comparative analysis by antidepressant type | journal = Journal of Medical Toxicology | volume = 4 | issue = 4 | pages = 238–50 | date = December 2008 | pmid = 19031375 | pmc = 3550116 | doi = 10.1007/bf03161207 | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550116/pdf/13181_2009_Article_BF03161207.pdf | format = PDF }}</ref> Unlike the TCAs, mirtazapine showed no significant cardiovascular adverse effects at 7 to 22 times the maximum recommended dose.<ref>Review of the results from clinical studies on the efficacy, safety and tolerability of mirtazapine for the treatment of patients with major depression | http://www.jad-journal.com/article/S0165-0327(98)00224-9/abstract</ref> Case reports of overdose with as much as 30 to 50 times the standard dose described the drug as relatively nontoxic, compared to TCAs.<ref name="pmid9807651">{{cite journal | vauthors = Holzbach R, Jahn H, Pajonk FG, Mähne C | title = Suicide attempts with mirtazapine overdose without complications | journal = Biological Psychiatry | volume = 44 | issue = 9 | pages = 925–6 | date = November 1998 | pmid = 9807651 | doi = 10.1016/S0006-3223(98)00081-X }}{{Unreliable medical source|date=October 2011}}</ref><ref name="pmid9861579">{{cite journal | vauthors = Retz W, Maier S, Maris F, Rösler M | title = Non-fatal mirtazapine overdose | journal = International Clinical Psychopharmacology | volume = 13 | issue = 6 | pages = 277–9 | date = November 1998 | pmid = 9861579 | doi = 10.1097/00004850-199811000-00007 }}{{Unreliable medical source|date=October 2011}}</ref> | ||
Twelve reported fatalities have been attributed to mirtazapine overdose.<ref>{{cite journal | vauthors = Nikolaou P, Dona A, Papoutsis I, Spiliopoulou C, Maravelias C | title = Death Due to Mirtazapine Overdose}} in {{cite journal |doi=10.1080/15563650902952273 |title=Abstracts of the XXIX International Congress of the European Association of Poison Centres and Clinical Toxicologists, May 12–15, 2009, Stockholm, Sweden | year = 2009 | journal = Clinical Toxicology | volume = 47 | issue = 5 | pages = 436–510 }}</ref><ref>{{cite book | author = Baselt, RC | title = Disposition of Toxic Drugs and Chemicals in Man | edition = 8th | publisher = Biomedical Publications | location = Foster City, CA | year = 2008 | pages = 1045–7 | isbn = 978-0-9626523-7-0 }}</ref> 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.<ref name="bmj325">{{cite journal | vauthors = Buckley NA, McManus PR | title = Fatal toxicity of serotoninergic and other antidepressant drugs: analysis of United Kingdom mortality data | journal = BMJ | volume = 325 | issue = 7376 | pages = 1332–3 | date = December 2002 | pmid = 12468481 | pmc = 137809 | doi = 10.1136/bmj.325.7376.1332 }}{{Unreliable medical source|date=October 2011}}</ref> | Twelve reported fatalities have been attributed to mirtazapine overdose.<ref>{{cite journal | vauthors = Nikolaou P, Dona A, Papoutsis I, Spiliopoulou C, Maravelias C | title = Death Due to Mirtazapine Overdose}} in {{cite journal |doi=10.1080/15563650902952273 |title=Abstracts of the XXIX International Congress of the European Association of Poison Centres and Clinical Toxicologists, May 12–15, 2009, Stockholm, Sweden | year = 2009 | journal = Clinical Toxicology | volume = 47 | issue = 5 | pages = 436–510 }}</ref><ref>{{cite book | author = Baselt, RC | title = Disposition of Toxic Drugs and Chemicals in Man | edition = 8th | publisher = Biomedical Publications | location = Foster City, CA | year = 2008 | pages = 1045–7 | isbn = 978-0-9626523-7-0 }}</ref> 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.<ref name="bmj325">{{cite journal | vauthors = Buckley NA, McManus PR | title = Fatal toxicity of serotoninergic and other antidepressant drugs: analysis of United Kingdom mortality data | journal = BMJ | volume = 325 | issue = 7376 | pages = 1332–3 | date = December 2002 | pmid = 12468481 | pmc = 137809 | doi = 10.1136/bmj.325.7376.1332 }}{{Unreliable medical source|date=October 2011}}</ref> | ||