Article written by
Dipak HemrajHead of Research and Education
Content reviewed by
Dr. Lewis JasseyMedical Director - Pediatric Medicine
Table of contents
Mirtazapine is a medication prescribed by healthcare providers used to treat depression. It’s what’s known as an “atypical” antidepressant, meaning that healthcare providers prescribe it when more commonly used antidepressants like SSRIs fail to work.
This antidepressant has strong side effects like sedation, and other sedative drugs may increase its effects; as such, it is not recommended to take cannabis with mirtazapine.
What Is Mirtazapine?
Mirtazapine (brand name Remeron) is an antidepressant used to treat depression when a person does not respond to more typical antidepressant drugs like SSRIs. Usually, it is taken in a single 15 mg dose at bedtime, and this can be increased to 45 mg if needed, which will be determined by your doctor.
Uses and How It Works
We don’t know precisely how mirtazapine treats depression, but it may work by increasing the amount of serotonin and norepinephrine in the brain. These are chemicals that affect your mood and, when increased, may help relieve depression.
Potential Risks of Mixing Cannabis and Mirtazapine
Cannabis use alone can have adverse side effects, such as dry mouth, dizziness, fatigue, over- or under-eating, nausea, paranoia, memory loss, and addiction. Cannabis has also been shown to interact with mirtazapine by stopping the metabolism of the antidepressant.
A potentially problematic issue for the concurrent use of the two drugs is that too much serotonin in the brain can cause the potentially fatal serotonin syndrome. The symptoms of this condition can range from mild to severe. Mild symptoms include:
- Rapid heartbeat/high blood pressure
Severe symptoms of serotonin syndrome include:
- Rigid muscles
- Death (in extreme cases)
- Irregular heartbeat
Aside from serotonin syndrome, mirtazapine comes with a boxed warning from the U.S. Food and Drug Administration. This means that the drug comes with potentially serious side effects. Mirtazapine can increase the risk of suicidal thoughts or behavior in children, teens, and young adults. Ultimately, it’s best to avoid mixing cannabis with any drug that carries a boxed warning unless otherwise directed by your doctor.
What To Do If You Need To Use Both Mirtazapine and Marijuana
If you feel you need to take mirtazapine and marijuana, talk to your healthcare provider first. Be aware of the symptoms of serotonin syndrome, and if you have any of the above symptoms, seek emergent medical care.
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The Bottom Line
Due to mirtazapine’s sedative effects and the risk of developing serotonin syndrome, it’s best to avoid mixing marijuana and mirtazapine. And it’s always wise to speak with your doctor before mixing weed with any prescription drug.
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Frequently Asked Questions
What drugs interact with mirtazapine?
Many drugs interact with mirtazapine, including diazepam, tramadol, cimetidine, ketoconazole, seizure and migraine medications, and more.
Can you use cannabis if you’re on SSRIs?
We don’t actually know how SSRIs work on a biochemical level within the brain, so it is challenging to say whether SSRIs interact with cannabis.
Can you use cannabis if you take a tricyclic antidepressant?
It is not recommended to use cannabis if you take a tricyclic antidepressant.