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Mirtazapine and other serotonergic drugs

Treacle

Treacle

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OK, I'm on 30mg of Mirtazapine a day. I have taken MDMA (with reduced effect), Tramadol, and Olanzapine (which I took from a friend, expecting to fall asleep quicker. It didn't seem to affect me). After some reading, I have found that the possibility of Mirtazapine and Tramadol causing serotonin syndrome is possible. Also, Mirtazapine and Olanzapine can cause SS. I also read that SSRIs and Mirtazapine can cause SS. Why does MDMA affect me less than usual? What are the real risks of combining Mirtazapine with Tramadol? None of the combinations I have used have caused me any difficulty. Taking my dose of Mirtazapine causes my pupils to constrict, including after MDMA, which seems odd, as it increases serotonin availability. Does anyone have any answers?
 
Treacle said:
OK, I'm on 30mg of Mirtazapine a day. I have taken MDMA (with reduced effect), Tramadol, and Olanzapine (which I took from a friend, expecting to fall asleep quicker. It didn't seem to affect me). After some reading, I have found that the possibility of Mirtazapine and Tramadol causing serotonin syndrome is possible. Also, Mirtazapine and Olanzapine can cause SS. I also read that SSRIs and Mirtazapine can cause SS. Why does MDMA affect me less than usual?
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If you read up on this, then you should already know the answer. Mirtazapine a tetracyclic antidepressant. The precise mechanism of action of this class of antidepressants is not exactly known, but it increases the amount of norepinephrine and serotonin in the brain. Mirtazapine is a potent antagonist of 5-HT2 and 5-HT3 receptors so it can interfere or interact with the action MDMA also has on 5HT receptors.

Treacle said:
What are the real risks of combining Mirtazapine with Tramadol?
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Mirtazapine adds to the sedating effects of alcohol and other drugs that can cause sedation such as benzodiazepines, narcotic pain medications, the tricyclic class of antidepressants, certain antihypertensive medications, and some antihistamines. The risk of overdose on any of those is increased depending on your tolerance when mixed with Mirtazapine.

Treacle said:
None of the combinations I have used have caused me any difficulty. Taking my dose of Mirtazapine causes my pupils to constrict, including after MDMA, which seems odd, as it increases serotonin availability. Does anyone have any answers?
Click to expand...
I cant explain why your pupils constrict, but there is a long list of side effects that may occur in some people. You might consider this one an unexpected benefit!
 
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I've mixed tramadol, doxepin and mirtazapine together. I normally take doxepin alone, but I had left over pills from my avanza script and I was having some annoying opiate-related insomnia--so I popped 30mgs.

Upon all drugs kicking in, I noticed a significant increase in heart-rate and visual disturbances (seeing 'floaters', double vision etc). I also had some vertigo/dizziness going on. I feel asleep quick and when I awoke I fine. Moral of the story: don't mix serotonergic drugs together. I lived, you might not be so lucky.
 
I used instant desolve remeron orange tabs to kill a 2c-t-4 trip that was going nowhere and annoying. Works better than a benzo, but I dont know how safe it is...
 
Well, it is prescribed for anxiety, and depression, so I'd like to think it has some serotonin activity. Otherwise, it would probably just invoke anxiety.
 
egor said:
I used instant desolve remeron orange tabs to kill a 2c-t-4 trip that was going nowhere and annoying. Works better than a benzo, but I dont know how safe it is...
Click to expand...

Wait- you killed a trip using this antidepressant? Thats both weird, and kinda dangerous seeing as you were on a 2C-T...
 
^well, I guess overpowered it would be a better term, but I was asleep (very well too, given the circumstances;) fast and felt decent the next day too. I didnt "feel" any dangerous signs, but that doesnt mean they arent there...
 
I found mirtazepine put me out the first night I took it- after that, nothing. Except zombie-brain and weight-gain, all that shits makes a madman insane. I wonder how strong the anti-histamine effects are comapred to doxylamine or dipenhyrdramine......Anyone?
 
Its the only anti-depressant that has done anything for me...
I sleep like the dead and feel great the whole next day, I should just buy it by the gram;)
 
I'm certainly seeing the benefits of it. It makes me sleep really well, but it also makes me eat like a pig. My anxiety is certainly reduced, and benzos work much better, even in smaller doses.
 
swilow said:
I found mirtazepine put me out the first night I took it- after that, nothing. Except zombie-brain and weight-gain, all that shits makes a madman insane. I wonder how strong the anti-histamine effects are comapred to doxylamine or dipenhyrdramine......Anyone?
Click to expand...


The antihistaminergic effect is like crazy-strong, I know this from my own experience. Also according to http://www.psychotropical.com/Mirt_medioc_science.shtml , "...it is the most potent anti-histamine currently available on the world market.
 
^Hmm, I have only experienced a HAVE TO SLEEP NOW feeeling from mirtazepine. Usually, I can fight off sleep pretty easily, and have been insomniac for a long time- that stuff made nothing else in the world exist except sleep. I just hated the side-effects and felt that it didn't help my anxiety problem....drug free seems to go better.
 
Mirtazapine is a 5-HT2 and 5-HT3 antagonist, therefore it could theoretically block, or reduce a trip, as most psychedelics act on these receptors.
 
bantaren said:
The antihistaminergic effect is like crazy-strong, I know this from my own experience. Also according to http://www.psychotropical.com/Mirt_medioc_science.shtml , "...it is the most potent anti-histamine currently available on the world market.
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Got to love this quote from the above article:

"What is known, but not known by the people who need to know what is known, is often the most important thing we need to know."


Got to love that!
 
hoho, i actually intended to go offtopic the same direction as you, nabollocks, until i read your post (i suggest we simply change the topic of this thread from now on :) )

i wondered if mirtazapine could be useful for a symptomless opiate removement from your body.
well, 5-ht2+3 antagonism sounds pretty useful for cancelling a psychedelic trip.

but the alpha2-antagonism (which in turn greatly increases NA-release as alpha2 is an autoreceptor) can in my imagination only fiercly exacerbate opioid withdrawal symptoms.

it is at least known that at the dosage of 15mg, the only target that is hit is the H1-receptor, making you sleepy, maybe that's the reason for a successful easening of opiate withdrawals.

alternatively, i could imagine that chronic co-administration of both opioids and mirtazapine are developing contrary tolerances (ie. to low NA-levels and high NA-levels, respectively) which eliminate each other upon removing both substances and thus leading to no significant withdrawal symptomes.
hm hm hm hm, so much questions.....

i'll check some of these papers tomorrow indeed. good night :)
 
i have also found even a half dose (15mg) of mirtazapine to be effective at aborting the annoying tail end of acid and mesc trips, at about the 11 or 12 hour mark. unsure as to the safety of this, but i do not take it regularly, dad is prescribed it for migraine prophylaxis
 
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