Combinations - cocaine and mirtazapine

[morrisonf]

SWIM is currently on an antidepressant called Remeron (or Mirtazapine), as well as Xanax. Curious if SWIY has heard of anyone on this cocktail and what experiences SWIY may share. SWIM has experienced neck/throat tightness and is a little concerned.

[Micklemouse]

Although rare, Mirtazepine can indeed cause an acute dystonic reaction, which could account for the tightness in the neck - have SWiY had any stiffness in the shoulders or wrists, tightening of the jaw, or feelings of agitation & restlessness separate to any "normal" anxiety (akathisia)? These would also indicate dystonia or Extra Pyramidal Side Effects. These unwanted effects are more common amongst the older (& occasionally newer) antipsychotics, but have also been documented amongst the newer antidepressants. I'd definitely suggest taking to SWiY doctor about this.

http://www.antidepressantsfacts.com/...irtazapine.htm

[Alicia]

Originally Posted by Micklemouse

Although rare, Miratazepine can indeed cause an acute dystonic reaction, which could account for the tightness in the neck - have SWiY had any stiffness in the shoulders or wrists, tightening of the jaw, or feelings of agitation & restlessness separate to any "normal" anxiety (akathisia)? These would also indicate dystonia or Extra Pyramidal Side Effects. These unwanted effects are more common amongst the older (& occasionally newer) antipsychotics, but have also been documented amongst the newer antidepressants. I'd definitely suggest taking to SWiY doctor about this.

http://www.antidepressantsfacts.com/...irtazapine.htm

Miratazepine i thought was a benzo .. must just look familiar.

[Jatelka]

see here A...

http://www.drugs-forum.com/forum/sho...21&postcount=3

[Micklemouse]

Nope, it's a novel antidepressant that specifically stimulates serotonin & adrenaline while blocking 2 particular serotonin receptors (as opposed to other SSRI's which apparently can alter other neurotransmitters as a side effect of blocking serotonin reuptake). It has quite a sedating edge, & is generally used as a nighttime med, which may be where SWiA's confusion may lie. That & the fact that it seems to have a limited period of efficacy for many users.

MorrisonF - where does cocaine fit into this? So far this would be better suited in Various drugs not covered by other forums.

[morrisonf]

SWIM reports Cocaine fits into this equation as symptoms appear shortly after insuffallating rather high purity (80-90%) Cocaine. Feeling of neck tightness is most predominant, though tingling in extremeties are expected with binge (daily for a few days) usage. SWIM reports symptoms are completely dependent upon Cocaine ingestion.

[Micklemouse]

Is SWim taking mirtazepine as a sleep aid or antidepressant? Either way (but especially if diagnosed with depression), it might be an idea to leave the coke alone if these symptoms persist - it won't do the depression any good if that is what the Mirtazepine is prescribed for, may heighten the chances of a full blown dystonic reaction due to dopamine blockade. Remember that if you play with one neurotransmitter, you play with them all - one theory (the Prozac Backlash) posits that the serotonin enhancing antidepressants have a tendency to de-regulate the D2 (dopamine) receptors responsible for fine muscle tone & movement, leading to dystonia & other Parkinson's-like symptoms more commonly found in antipsychotics. Add a dopaminergic like cocaine (which increases some dopamine but decreases D2, as well as affecting serotonin & adrenaline) & the chances increase again

The Awakened Giant’s Wrath

Fortnightly review: Acute dystonia induced by drug treatment ...

Cocaine as a risk factor for neuroleptic-induced acute dystonia.