Drug interactions
Escitalopram + Mirtazapine
Severity: Moderate
Escitalopram and Mirtazapine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
The combination is used in practice for resistant depression, but both drugs have serotonergic activity and some QT liability. Serotonin syndrome and QT prolongation are possible, though uncommon at usual doses.
What this interaction means in plain words
Escitalopram and Mirtazapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Escitalopram belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and modest additive QT prolongation.
What to do
Start with low doses and increase gradually, monitoring for serotonin toxicity symptoms. Obtain an ECG if there are other QT risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Other interactions of Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Frequently asked questions
Can I take Escitalopram with Mirtazapine?
MediHelp rates the interaction as moderate. Escitalopram and Mirtazapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. The combination is used in practice for resistant depression, but both drugs have serotonergic activity and some QT liability. Serotonin syndrome and QT prolongation are possible, though uncommon at usual doses.
How serious is the interaction between Escitalopram and Mirtazapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and increase gradually, monitoring for serotonin toxicity symptoms. Obtain an ECG if there are other QT risk factors.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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