Hi everyone, I am really struggling at present with a situation at home (97 year old mum and mentally sick brother) no other family help. I am not sleeping well and dealing with a number of aches and back pain which my doctor is putting down to carers stress as I am constantly in this state. He has prescribed Mirtaziapine and says these do not increase bleed risk unlike some antidepressants. I am on Apixaban and Sotalol. I checked with him about the Sotalol and he says there is no contraindication. I also checked with the pharmacist and he agreed. I have Dr Googled and that says there is a major interaction although relatively rare. Does anyone here take this medication?
Mirtaziapine : Hi everyone, I am really... - Atrial Fibrillati...
Mirtaziapine
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Karendeena
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Hi,
Just a thought - I would have expected a contraindication with the Apixaban rather than the Sotalol. I'm on Sotalol, 40mg in morning at breakfast and 40mg in evening, just before going to bed. Never ever had a warning about it. No problems with it ever.
Apixaban is an anticoagulant and although I'm on Warfarin, an anticoagulant ... I always have warnings about this type of drug. I would check the Mirtaziapine and Apixaban .
In the past my GP (knowing I was on Warfarin ) prescribed me Amtriptyline and when that didn't work she prescribed Gabapentin ......... for pain relief. Both drugs soon gave me Diahorrea. When I read the paper in the packet they were anti-depressants and should never have been given to me while I was on an anticoagulant. Mercifully, no impact on my anticoagulation process.
John
Hi John, thank you. Mirtaziapine is the only anti depressant that doesn't contraindicate with anticoagulants. I have checked this with my doctor and a senior pharmacist who I know very well.
This raises the thought … why are anti depressants prescribed for pain relief. I’m not depressed. - just in pain. I think I’ll have to have a chat to my surgery pharmacist …. which I’m about due to do anyway on other issues. Anyhow, for now at least, CoCodomol 30/500 is doing ’ the job.
yes I have taken it !! I worried when I took it too . But I think it is only when you have a specific heart condition. Do don’t worry. If the pharmacist says it’s ok then it is!! Google can be too off putting sometimes. I think you have to have a heart defect for it to be dangerous !! I hope things improve for you x
Thank you so much ❤️
You're not the first to post about this. The GP and pharmacist, and BNF interactions web site all agree, no problem. Perhaps the source found by Google is wrong. Can you quote the text and enough of the page address that I can check (without actually posting the web address which is not alowed here)?
I think I found it. It's on the drugs dot com page titled "Drug Interactions between mirtazapine and sotalol".
Yes, Mirtazapine has a slight effect on increasing heart rate, but it's not huge. I think it's more of a theoretical interaction, but if you are still concerned, print that page and show it to your GP or pharmacist and ask for advice.
The UK BNF page definitely says no interaction
Thanks Cliff, really appreciated 👍
Thanks a lot, I'll try, not very good with tech. Think it's drug interaction checker, possibly an American source
"Drugs.com" is very up to date and will tell you anything you need to know about medications.
I use drugs dot com uk and it often flags up concerns that the BNF doesn't as Cliff_G says, many of these are theoretical risks .
Thanks 👍
Indeed. Just tested a few and Drugs .com seems to love reporting on mirtazapine and most of the other meds I'm on! I'd personally go by the BNF checker, which btw means British National Formulary, part of NICE, and not anything else!
Tha is again Cliff ❤️❤️
I have been on Mirtazapine for over 2 years. When my PA was diagnosed 5 years ago I was on Sertralene - which I had to change when starting apixaban. They tried silenor but had to many side effects. Finally found Mirtazapine to have the fewest side effects.Take care
Thanks a lot 👍
Hi can you tell my why you shouldn’t take sertraline with apixaban please I’ve been taking the two for about 18 months now and would not like to be storing up more health troubles thank you.
There is an increased likelihood of bleeding when these 2 drugs are combined.
Ok thank you that’s helpful to know 👍🏼
I was told the same. What worries me is that there seems to be no consistency between doctors and the way they weigh up risks and benefits when prescribing drugs
Well I live in Canada and our health system is terrible. We get very little help from specialists. Good Luck
I've been taking these two meds as well, so I was interested in your post, it's so good to get advice here.Best wishes
K.
Am sorry, that’s a lot to cope with. I hope the medication helps
Hospitals use BNF for medicines guidance. I'm a prescribing nurse and was taught to use BNF as my bible
I think with the DOACs - SSRIs and SNRIs are contraindicated certainly with Rivorabaxan, but Benodiazepines and Espiride/sulpiride in addition to Mirtazapine appear to be fine. I have been taking Alprozolam for 17 years, and my doctor wants me to try Espiride.
I take under prescription of a consultant and no ill effects. I am on apixaban and bisoprolol.
I’ve taken the lowest dose for years. Haven’t had a problem with it heart wise but it helped towards weight gain and attempts to shift it. I’m trying to come off it as I’m not sure I need it any more. With docs advice obviously.
No knowledge on the drug side, but I'm wondering if you are getting all the social care support you can get?Given that you seem to be the only/ main carer,what would happen if you became ill yourself,physically as well as starting to become mentally affected?
You are already under strain I feel. I do understand, was in a similar position once.
Sending you best wishes x
Thank you much ❤️ I am heartbroken 💔I have exhausted all avenues and as mum has been deemed to have capacity she can make her own decisions whether good or bad. I just try to help but she just screams and shouts at me, calling me names, she goes crazy to the point she scares me! My doctor says that I must limit my visits and the minute she starts I am to walk out and if she has a go over the phone put it down. It's so very hard. I have an enablement officer coming to see me next week but not sure that will help as they are all running out of options. Everyone says step back and let things develop. I fear I will have a heart attack if I carry on like this. It's been getting worse over the last couple of years and how I have managed since my ablation I'll never know
Oh my dear. I'm so sorry things are like this. I hope that there is something that can be done to help this situation. The thing is,it's OK for others to say that and they mean well,but it's your mum ,and we want to help. It's so upsetting to see a dearly loved person become rather a stranger.
We mourn that loss keenly.
Subconsciously we are also sometimes a little cross with them, illogical of course as it's not their fault and that feeling is horrible too,so we stifle it. Resulting in more internal turmoil.
All I can add is that your Dr's advice is sound hard though it might be to just leave or out the phone down,in fact it is also better for mum for you to end the conversation, as getting into a state can get worsen quickly.
I think you've done marvellously well with all this going on.
Perhaps if you have the energy ,treat yourself as much as you can to nice things at least twice a week to restore your resilience. Doesn't have to be a spa day( ideal though!). Etc just something you do for you.
Your good memories of your mum and you will always be with you,as are mine ❤️
My heart goes out to you just now though.
I send you a virtual big 🫂 hug.
Xxxxx
You need psychotherapeutic support along with your brother and other positive help rather than pills for psychiatric problems.
Big virtual hug!
Thank you so much. I have self referred for talking therapies but there is a very long wait. I have exhausted every avenue you can think of. As mum has been assessed to have capacity there is nothing more I can do as she is refusing help. My doctor says I have to treat her like a child now and not reward her bad behaviour, that means walking away when she starts screaming and shouting at me and/or putting the phone down if she goes at me that way. This is so hard for me as my mum has been my best friend all of my life and would never ever fall out with me, we have travelled the world together and it is breaking my heart in two 💔 I want my lovely mum back 😭
That’s so sad but if you have time, writing about it might help and who knows, there might be a book in it later! And mediation and slow breathing might help too. Good luck!
I hate the bias you get on this site for various drugs like antidepressants, PPIs, sleeping tablets, pain relief like codeine etc as for those it helps it must be so annoying. I spent a year on Mirtazapine and was prescribed 30mg daily to start. I reduced this to 7.5mg and it got me over a very bad patch in my life and is great for sleep and relaxation as indeed are PPIs for gerd etc. You and I are well aware that pschotherapy is very difficult to obtain and in your case will probably not ease your burden by much if at all. You wanted something to help you sleep and your GP has prescribed a very safe and trustworthy medicine for this so go and take it and stop googling. And as an extra I stopped taking it after a year with no problems. If you find it a bit much try cutting it to 7.5mg once at night. let me know how you get on.
Thank you so much, you are so kind. I am really struggling and it's making me not a very nice person 😭
I know by your post so wishing you all the best and some restful nights from now on.
I have taken Mirtazipine on and off for over 4 years to help with anxiety and insomnia primarily. It was prescribed by my GP who assured me that it's not contraindicated with either Rivaroxaban, taken formerly or Apixaban taken currently. I take half the prescribed dose of 15mg and find that 7.5 mg helps me sleep better. Given that, like me, you have carer's stress it may help you through this difficult period.
Do you not feel at all dull-headed the next day? I struggled with that. A friend finds it very helpful, though.
Steve
In all honesty I do have that slight dull headed feeling but the relief of a good night's sleep from time to time is worth that particular side effect. It is, However, also the reason I don't take it consistently, along with my assertion that I wish to take as little medication as possible.
Thank you, I hope so, I am absolutely broken 💔
Hi
The Carer.
You need HELP.
Do you have a FAITH ORG which could unburden the load?
Otherwise as this is a mental strain on your life contact your nearest base hospital and have both patients assessed.
Its not on for other family members not to contribute in some way. Do you have respie relieve? Here in NZ they pick up patients and take them for alternative interaction sessions to meet others and do arts and crafts.
In NZ although you have 3 weeks a year for complete respite, its not enough. I only had mother at 87-90.
You need to take your mind else where.
I used to nominate a friend or faith person to accompany Mum on an outing. I'd get Mum to pay their way.
It's hard. doubly for you.
You are number 1 and need to be healthy. No pills will help your situation.
Do reach out. Folks come out of the woodwork to help.
cheri JOY. 76. (NZ)
Oh cheri you are so kind and understanding, thank you ❤️It's so so difficult and here in the UK the support is not good as the NHS and social care is in crisis 😢
I have tried and tried and cried and cried! Following my ablation last year I was back running around for them only a week later. Mum attacks me verbally and sometimes physically and my brother just feels sorry for himself and sits all day doing nothing. He is able bodied but has Parkinson's and had a stroke which took his left periferal vision, he has now given up. I managed to get social services to assess him and he said he didn't want help while living with mum, that's because his stupid sister (me) is doing everything. It makes it harder because he has his own house he won't go back to and is living with mum which two thirds owned by me. It's impossible and I am at breaking point hence the Mirtaziapine. My doctor just tells me to stay away! I went today and within 5 minutes mum was screaming and shouting at me just because I said the washer wasn't working properly and I had organised an engineer to go tomorrow. I just walked out heartbroken 💔
Hi
Oh dear.
You should get an assessor t assess the whole situation!!!!! Including.
You don't get twice Carer's Support pay I guess only one lot.
You own 2/3rds of house so you can dictate that your brother GO HOME.
Was your Mum in her Will left her 1/3 of house to you???
Mental Health is so important. You need to have happiness.
Is Mum got alzheimers? Surely she should assessed too.
You know, I would get a little dog like my schnauxer JAZ. She is 11 now but wants up for a cuddle in the crook of my arm every morning whilst I wait an hour to allow my Synthroid to go down before breakfast!
She started this in January. Not allowed on chairs, beds, sofa etc.
But if I'm out she can't have this time. It used to be only Sundays. We play paws.
Take care, JOY
I have taken Mirtazipine for several years with Sotalol with no prohlems,
Thank you ❤️ Did you get any side effects? My doctor says it might make me sleepy but he hopes that will help with my sleep problems. I also read it can increase heart rate which concerns me about as my heart rate has already increased post ablation
I haven't noticed any side effects other than helping me to sleep, which is only at night. Sotalol initially reduced my heart rate and there was slight increase from taking Mirtazipine. but it remains just below 60 which seems to suit me. I don't feel sleepy the next day.
My heart rate has increased from low 60s to the 70s since my ablation so I am concerned it will go higher....
My heart feels for you and your situation. 💞My sister lived 5 hours from me and cared for our dad who was exactly as your mum is, really quite aggressive at times, she found it a real struggle and I couldn't do much to help,
I used to visit and help out as often as I could but they lived so far away.
He suffered with altzheimers and was nasty with it, some people suffer in that way but it was horrible for my sister.
The one thing I do know about Mirtazepine is that you will get used to the dull feelings in the mornings, it will take a few weeks to settle down but please don't give up, you really need your rest dealing with both your mum and brother, please do as the Doctor advised and walk away when she shouts or becomes aggressive.
Please do look after yourself.
Sending many best wishes to you.
K.
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