Major depressive disorder, or MDD, is generally treated by some combination of talk therapy and drug therapy. Mirtazapine is part of a class of drugs known as tetracyclic antidepressants, which are effective in the treatment of MDD for some patients. These drugs work by altering chemicals in the brain that are thought to be responsible for mood regulation. It is not typically safe to combine mirtazapine and alcohol because alcohol also affects those same brain chemicals, but in a different way. Alcohol can also increase the side effects of these medications, especially when patient are first taking the medication.
Drowsiness is one of the most common side effects associated with mirtazapine. Combining mirtazapine with alcohol, even in small amounts, increases the level of drowsiness. This can be particularly dangerous while driving, operating machinery, or performing household tasks such as cooking and ironing. In addition to causing drowsiness, both mirtazapine and alcohol are known to slow down reaction times. The combination of drowsiness and a delayed ability to react to a situation can cause serious consequences or fatalities in certain situations.
In some patients, antidepressant can cause periods of abnormal thinking or irrational thoughts, including thoughts of suicide. Alcohol also affects rational thinking, sometimes leading to behavior that is totally different from sober behavior. Alcohol also lowers drinkers’ inhibitions, which means they may do things they usually wouldn’t do. Taking both mirtazapine and alcohol together can increase the risk of engaging in excessive risk-taking or otherwise inappropriate behavior.
Alcohol is a depressant, and in patients already suffering from depression, it can significantly worsen the condition. Those who drink heavily for a long period of time may be more prone to mood disorders, although it can be unclear as to whether the disorder existed prior to the drinking and led to heavy alcohol consumption or whether the alcohol brought on the condition. While combining mirtazapine with alcohol may not always directly increase a patient’s level of depression, the alcohol does make it more difficult for the antidepressant to do its job.
After several weeks on the antidepressant, side effects typically tend to become milder and patients have a better idea of how the medication affects them. At this point, it may be safe to combine mirtazapine and alcohol on rare occasions and in moderation, as long as the patient doesn’t have any other health conditions that require abstaining from alcohol. For example, drinking one or two servings of alcohol, such as a glass of wine or champagne, will not typically cause significant negative effects. Patients should discuss this with their doctor first, however, as every case is different.