Mirtazapine

(Date: September 2020. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Mirtazapine is mainly used to treat depression and mood disorders.

What are the benefits of taking mirtazapine in pregnancy?

Mirtazapine can improve mood and feelings of wellbeing. It is very important that mental health problems are appropriately treated to ensure a woman is well during pregnancy and while looking after her baby.

Are there any risks of taking mirtazapine during pregnancy?

There is no evidence that use of mirtazapine in pregnancy causes birth defects, preterm birth, or low infant birth weight. While the evidence for other pregnancy outcomes is also reassuring, only small numbers of women have been studied and ongoing data collection is therefore ideally required.

Are there any alternatives to mirtazapine?

Possibly. Other medicines can be used to treat depression and mood disorders. Some mental health problems can also be treated with talking therapies instead of medicines. However, this does not work for everyone and some people may prefer to take a medicine. If a woman’s condition is well-controlled with mirtazapine, it may be best to stay on it rather than try something new and risk a relapse.

Ideally, women planning a pregnancy should speak to their GP or specialist to determine whether mirtazapine is still the best option for them. Similarly, women who have an unplanned pregnancy while taking mirtazapine should be reviewed at the earliest opportunity by their GP or specialist.

What if I prefer not to take medicines during pregnancy?

It is very important that mental health problems are well-controlled during pregnancy. Discontinuing antidepressant medication can cause symptoms to return, and stopping abruptly can cause withdrawal symptoms. Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Do not stop mirtazapine without speaking to your GP or specialist.

Will my baby need extra monitoring?

All pregnant women in the UK should be offered a detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following mirtazapine use in pregnancy.

Are there any risks to my baby if the father has taken mirtazapine?

We would not expect any increased risk to your baby if the father took mirtazapine before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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