Drug interactions
Lisdexamfetamine + Mirtazapine
Severity: Moderate
Lisdexamfetamine 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
Amphetamines have serotonergic activity and mirtazapine is a serotonergic antidepressant, so combined use carries a theoretical risk of serotonin syndrome. Opposing effects on sedation and alertness may also occur, and amphetamines can worsen anxiety or insomnia.
What this interaction means in plain words
Lisdexamfetamine 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.
Lisdexamfetamine belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Amphetamine-induced monoamine release adds to mirtazapine's serotonergic and noradrenergic effects, giving possible additive serotonergic toxicity.
What to do
Monitor for agitation, tremor, hyperthermia, tachycardia and blood pressure changes when starting or increasing doses. Stop lisdexamfetamine and treat if serotonin syndrome is suspected.
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 Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Other interactions of Lisdexamfetamine
- Isocarboxazid + Lisdexamfetamine Contraindicated
- Linezolid + Lisdexamfetamine Contraindicated
- Lisdexamfetamine + Phenelzine Contraindicated
- Lisdexamfetamine + Procarbazine Contraindicated
- Lisdexamfetamine + Rasagiline Contraindicated
- Lisdexamfetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Lisdexamfetamine with Mirtazapine?
MediHelp rates the interaction as moderate. Lisdexamfetamine 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. Amphetamines have serotonergic activity and mirtazapine is a serotonergic antidepressant, so combined use carries a theoretical risk of serotonin syndrome. Opposing effects on sedation and alertness may also occur, and amphetamines can worsen anxiety or insomnia.
How serious is the interaction between Lisdexamfetamine 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: Monitor for agitation, tremor, hyperthermia, tachycardia and blood pressure changes when starting or increasing doses. Stop lisdexamfetamine and treat if serotonin syndrome is suspected.
What other medicines interact with Mirtazapine?
MediHelp also lists interactions of Mirtazapine with, for example, Isocarboxazid, Phenelzine, Pimozide. The full list is on the Mirtazapine page.
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