Medical Advice

Mirtazapine vs Amitriptyline: See the Comparison

Mirtazapine vs Amitriptyline

Antidepressant medications are one of the most often prescribed drugs in the United States. The U.S. Food and Drug Administration (FDA) approved the use of antidepressant drugs for people. Mirtazapine vs Amitriptyline both of these drugs are approved by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia, major depressive disorders (MDD), obsessive-compulsive disorder (OCD), anxiety, chronic pain, depression, and many more.

Antidepressant medications are the most effective drugs used for treating various symptoms of patients, such as depression, major depressive disorder (MDD) anxiety, and many more.

In this blog, we will compare Mirtazapine andAmitriptyline medications. Also about their working, uses, dose & dosage strengths, side effects, and precautions. 

Overview of Both Medications

What is Mirtazapine?

Mirtazapine is an antidepressant drug that is used to treat depression, obsessive-compulsive disorder (OCD), anxiety, major depressive disorders (MDD), etc.

Mirtazapine is a generic drug and is available under the brand names such as Remeron and Remeron SolTab. This drug belongs to the group of tetracyclic antidepressants (TeCA).   

What is Amitriptyline?

Amitriptyline is a type of drug that is also known as an antidepressant. A doctor can prescribe this drug for treating the symptoms of depression.

Amitriptyline is a generic drug and is available under brand names such as Elavil, Endep, and Vanatrip but the FDA has discontinued these brand-name drugs. Amitriptyline is still available in the market under its generic name.

This medication belongs to a class of drugs known as tricyclic antidepressants and it is not considered as a controlled substance.

Mechanism of Action of Both Drugs

Working of Amitriptyline

This drug works by increasing the levels of chemicals present in the brain. These chemicals are called serotonin and norepinephrine. The increased level of these chemicals can help in improving mood and decrease the symptoms of depression. The half-life of amitriptyline is around 10 to 28 hours. This drug will stay in the patient’s system for about 2 to 6 days after the last dose.

Working of Mirtazapine

Mirtazapine is a tetracyclic antidepressant. It works by increasing the levels of certain chemicals that are available in the brain, such as serotonin and noradrenaline. This process helps in regulating the mood and emotions of the patients. The half-life of mirtazapine dose is from 20 to 40 hours.

Dose & Dosage of Mirtazapine vs Amitriptyline

Amitriptyline Medication Form and Strengths

It is available in two forms:

  • Tablet form
  • Oral Solution

The strengths of these forms are as follows:

  • Tablet:- 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg strengths are available.
  • Oral Solution Strength:- 10 mg/ml. 

Dosage of Amitriptyline Drug

  • For outpatients
  • The starting dose of 75 mg per day at bedtime, if necessary it can be increased to 150 mg per day.
  • The maintenance dose can be 40 mg to 100 mg orally per day.
  • The maximum dose is 150mg per day.
  • For inpatient
  • The initial dose is 100 mg orally every day.
  • The maintenance dose will be 40 mg to 100 mg orally as a single dose at bedtime.
  • The highest dose is 300 mg per day.
  • For geriatric patients
  • A dose of 10 mg orally thrice a day is recommended and a single dose of 20 mg orally once a day at bedtime. A healthcare expert can adjust the dose if required as per the clinical response.
  • For pediatric patients
  • A 10 mg dose of amitriptyline is advised orally 3 times a day.
  • A doctor can suggest a dose of 20 mg orally once a day at bedtime.

Form and Strengths of Mirtazapine Medication 

  • Form: Oral Immediate-Release and Orally Disintegrating tablets.
  • Immediate-release tablet Strengths: 7.5 mg, 15 mg, 30 mg and 45 mg.
  • Orally disintegrating tablet Strengths: 15 mg, 30 mg, and 45 mg.

Dosages of Mirtazapine Drug

  • For Adults (ages 18 years to 64 years)
  • The typical dose of 15 mg is recommended once per day, before bedtime.
  • The dose can be increased by a doctor every 1–2 weeks. If required dosage can be changed on the basis of your depression symptoms.
  •  A dose of 45 mg is the maximum dose taken once per day.
  • For Senior (65 years and above)
  • Doctors can advise them to a lower dose because the level of the drug can build up too much in their body. This can lead to severe health problems in elderly patients.
  • For Children (0 to 17 years)
  • Younger people of this age group are not advised for the use of this medication but a doctor may decide that mirtazapine is a safe or effective medicine to treat a child’s condition.

Uses

There are various uses of Amitriptyline and Mirtazapine medications. These are listed below:

Uses of Mirtazapine Medication

  • Mirtazapine is used to treat major depressive disorders in adults.
  • This medication is used to treat insomnia in some patients who are also suffering from depression or anxiety disorders.
  • It increases appetite in patients with depression, cancer, or other conditions associated with weight loss.
  • Mirtazapine is also used to treat chronic pain, like fibromyalgia and migraines.
  • For treating cancer pain, such as neuropathic pain and breakthrough pain a doctor can recommend mirtazapine.
  • This drug is used to treat fibromyalgia, a chronic condition in which a patient suffers from muscle pain and fatigue.

Uses of Amitriptyline Drug

  • This drug helps in treating anxiety and depression.
  • Amitriptyline drug can be used for treating pain caused by damage of nerves or back pain.
  • This medication is used off-label for insomnia, migraine prevention, ADHD, bipolar disorder, eating disorders, and psychotic disorders.

Side Effects

Common Side Effects of Both Drugs

  • Nausea
  • Sleepiness
  • Weakness
  • Dizziness
  • Anxiousness
  • Headache
  • Loss of appetite
  • Dry mouth
  • Constipation
  • Weight gain
  • Lightheadedness
  • Dizziness

Serious Side Effects of Both Medicines

  • Change in mood
  • Suicidal thoughts
  • Confusion
  • Agitation
  • Fever
  • Hives
  • Muscle cramps
  • Heart problems
  • Swelling in feet or hands
  • Shaking or tremor
  • Vision problems
  • Irregular heartbeat
  • Seizures

Precautions

  • Avoid drinking alcohol with these drugs, both medications can cause serious side effects.
  • Patients should avoid both of these drugs if they have taken an MAO inhibitor in the last 14 days.
  •  Medicines are always stored at room temperature and keep away from moisture, heat, and light.
  • An overdose of these drugs can be fatal.
  • These medications are prescription-only drugs, so patients should take a prescription from their doctor.

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