Is anyone being prescribedthese tablets?
if so are you aware of any side effects?
With the usual PD medication.


Hi Seve
Mirtazapine is regularly subscribed, to aid sleep and mild depression.
If you feel groggy in the morning, talk to your Doctor and lower the dosage.
It has no interaction with Parkinson’s medications.
No worries
edited by Admin

Hi Seve, I have taken the middle dose of mirtazapine for a number of years and notice no side affects. My sleeping is better and my mood is much improved. I did try and come off them a couple of years ago, came down in dosage and then tried to stop them , but those around me said I needed to go back on them. And so the tablets win again! But decent nights sleep and happy as we can be as I move into my 11th year since diagnosis.

When you want to look up the possible side effects of a drug online look in particular at the section ‘Nervous system’ and keep your eyes open for the term ‘’Extrapyramidal symptoms”. These are drugs that can cause/worsen movement disorders. Below a review and some case reports.

Remeron (mirtazapine) is a tetracyclic antidepressant used to treat depression.
Side effects [include]
Nervous System: frequent: …apathy, depression, hypokinesia, twitching, agitation, anxiety, hyperkinesia, paresthesia;
infrequent: dyskinesia, extrapyramidal syndrome, coordination abnormal, dysarthria, dystonia, hostility, emotional lability
rare: akathisia (psychomotor restlessness), hypotonia, myoclonus, psychotic depression, withdrawal syndrome, serotonin syndrome.

Antidepressants in Parkinson’s disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid Neurología (English Edition) E.Peña, M.Mata, L.López-Manzanares, M.Kurtis M.Eimil , J.C.Martínez-Castrillo , I.Navas , I.J.Posada , C.Prieto, C.Ruíz-Huete, L.Vela, B.Venegas on behalf of the movement disorder study group of the Neurological Association of Madrid Vol.33, Issue 6, July–Aug. 2018, P.395-402

All classes of antidepressant, particularly SSRIs and SNRIs, have been associated with extrapyramidal adverse effects. … The adverse reactions described include akathisia, dystonia, parkinsonism, and dyskinesia.

Mirtazapine-induced restless legs J. Markkula , H. Lauerma Human Psychopharmacology: Clinical and Experimental Vol. 12 Issue 5, P. 497 – 499 Published Online: 4 Dec 1998
Gradual onset of dyskinesia induced by mirtazapine Marek Balaz, Ivan Rektor Vol.58 Issue 4 P.67 2-673 2010
Acute Pisa Syndrome After Administration of a Single Dose of Mirtazapine A.Méndez Guerrero; S. Llamas; F.Murcia; J.Ruíz; Clinical Neuropharmacology. 36(4):133–134, JULY/AUGUST 2013
Hyperkinetic Movement Disorders Induced by Mirtazapine: Unusual Case Report and Clinical Analysis of Reported Cases Won Tae Yoon J Psychia try 2018, 21:2
Mirtazapine induced tremors: A case report. Uvais N A, Sreeraj V S, Shihabudheen P, Mohammed T.P. Indian J Psychol Med 2019;41:190-2

Mirtazapine-Induced Serotonin Syndrome Ubogu, Eroboghene E.; Katirji, Bashar Clinical Neuropharmacology: March-April 2003 – Vol. 26 - Issue 2 - p 54-57
An 85-year-old woman developed sudden confusion and dysarthria progressing to mutism, orobuccal dyskinesias, generalized tremors worse with activity, ataxia, and rigidity with cog wheeling without high-grade fevers or dysautonomia.

Mirtazapine-induced Dystonia in a Patient S van den Bosch , F Bouckaert, J Peuskens Tijdschr Psychiatr. 2006;48(2):153-7.

A 79-year old female patient with Alzheimer’s disease developed acute dystonia twelve hours after taking a single dose of mirtazapine 30 mg. Forty-five hours later the patient’s dystonia began to subside and after sixty hours it had disappeared completely. This side-effect of mirtazapine is hardly mentioned in the literature. So far, little is known about the pathophysiology of acute dystonia and the possible role of mirtazapine. Some hypotheses and recommendations are proposed

Mirtazapine Induced Akathisia: Understanding a Complex Mechanism D.Raveendranathan and G. Rao Swaminath Indian J Psychol Med. 2015 Oct-Dec; 37(4): 474–475.

…After initiation of mirtazapine, family members noticed that she was not sleeping at night and was seen pacing restlessly inside the house. On clarifying, the patient reported feeling anxious and jittery. She felt a sense of uneasiness in her feet and felt like walking constantly. She was unable to sit peacefully for more than a few minutes. A clinical inference of akathisia was made.

The Naranjo probability scale suggested a possible relationship between mirtazapine and this adverse event (score 6). Mirtazapine was stopped and the akathisia improved immediately in a couple of days. Barnes Akathisia Rating Scale score dropped from 6 to 0 within 2 days of stopping mirtazapine.

Sleep disorder & increasing Mirtazapine. Wits end with mum’s Parkinson’s team
Sleep disorder & increasing Mirtazapine. Wits end with mum’s Parkinson’s team Finrod888 Apr 18
…I just want to know - dare I risk increasing her Mirtazapine dose from 30mg to 45mg each night?
…She was prescribed Mirtazapine 30mg to help her get some sleep. She takes Co-Careldopa x 4, Rasagline & Rivastagamine x2. The Mirtazapine gives her about 3 to 4 hours sleep - restless, but disturbed. She then gets up around 2 am & starts pacing,