Clonazepam and Mirtazapine for Anxiety: All You Need to Know

Stress, anxiety, depression and obsessive compulsive disorder (OCD) are very common problems nowadays. People these days are having trouble with these problems. There are a number of antidepressant medications available and Clonazepam and Mirtazapine are two of them.

So, how can Clonazepam and Mirtazepam be treated for anxiety?

Both Clonazepam and Mirtazepam are antidepressant medications. Mitrazepam increases noradrenaline and serotonin, a mood-enhancing chemical and thus you start to feel better. Besides, Benzodiazepine, the major ingredient of Clonazepam reduces the abnormal electrical activity of our brain and thus you feel fresh.

Before you know about these medications, you need to know about anxiety disorders, their types and symptoms. In this article, I will be discussing the ins and outs of these medications; so without further delay, let’s dive right in.

Initially, your doctor will prescribe you 0.5 mg to 1 mg a day in divided doses. Doctors may increase or decrease the dose level depending on the reactions. If you are having social anxiety disorder your doctor most likely will prescribe fewer doses. 

What Is an Anxiety Disorder?

It’s completely fine if you have anxiety occasionally but things become worse when you are facing it every day. When you have endless anxiety and things start to interfere with your daily lifestyle, you might have an anxiety disorder.

Here are symptoms indicating you have an anxiety disorder:

  • Frequently feeling nervous and irritable
  • Concentrating and focusing difficulties
  • Sleeping disorder 
  • A number of physical symptoms like, increasing heart rate, shaking and trembling and breathing rapidly
  • Experiencing nausea and vomiting
anxiety-disorder

You are having anxiety disorder if you have the following situations:

  • You are facing symptoms for more than six months
  • Your symptoms are severe and interfere your day to day life, in fact having significant distress in social functioning
  • The symptoms must not be caused by a physical condition

When you are having an anxiety disorder, you will find that you have a persistent worry in everyday situations and you may also experience intense fear or anxiety (panic attack) which may lead to you feeling as though you are having a heart attack.

Different Types of Anxiety Disorders

There are various types of anxiety disorders and they are differentiated into various specific disorders. 

Have a look at the classification below to understand your type of anxiety disorder. The treatment is slightly different for each type of anxiety disorder.

Generalized Anxiety disorder:

Panic Disorder:

  • Recurring episodes of severe anxiety, panic, or terror that peak in a matter of minutes
  • Linked to bodily signs like trembling, breathlessness, sweating, nausea, and heart palpitations
  • Sometimes you may face severe symptoms like feeling that you are having a heart attack or about to die.
  • Developing fear of having a future heart attack

Agoraphobia:

  • Intense fear of being trapped, helpless and embarrassed
  • Avoiding places where you may feel trapped or helpless
  • In some cases feeling so embarrassed to leave home
agoraphobia

Anxiety disorder caused by a medical condition:

An underlying medical problem, such as an overactive thyroid, may cause this kind of worry. In most cases, you would experience both the symptoms of worry and the underlying medical problem.

Specific Phobias:

  • Being anxious about getting exposed to certain situations
  • Avoiding specific triggers
  • May experience panic attacks in response to your trigger

Social Anxiety Disorder:

  • Extreme fear or anxiety in social interactions
  • Being self-conscious with others company
  • Avoiding social situations
  • A constant fear of being judged negatively by others

Childhood Anxiety Disorder:

This includes specific disorders like selective mutism and separation anxiety. Most of them face trouble in making friends. This problem is mostly present in childhood and may seldom continue into adulthood. In most cases, this problem interferes with school or other social functioning.

Causes of Anxiety Disorder

Still, the exact causes of anxieties are unknown but there are some common causes of creating anxiety. Some of them are genetic while others are developed from the environment.

In some cases, genetics play a vital role in developing anxiety disorders. You have a slight chance of having anxiety if any of your blood relatives have an anxiety disorder. 

Studies say that imbalance in neurotransmitters in your brain may develop anxiety disorders. People having low serotonin activity and elevated noradrenergic system activity may have a high chance of developing anxiety.

The factors responsible for developing anxiety include:

  • Trauma
  • Excessive or persistent life stressors
  • Stress because of ill health
  • Drugs and alcohol consumption
  • Due to some personal issues
  • Some mental health disorders like depression

Treatment of Anxiety Disorder

The treatment of anxiety disorder requires antidepressant medication in conjugation with psychotherapy like cognitive behavior therapy. Lifestyle modification, yoga, meditation and mindfulness practice might be effective practices to deal with anxiety disorders. 

Clonazepam and Mirtazapine are two effective medications you may try. These two are basically antidepressant medications. If you are prescribed any of these two then you might wonder how they deal with anxiety, how long they take to work and what you need to consider while taking them.

What is Mirtazapine?

Mirtazapine, a class of medication called tetracyclic antidepressants, basically has an active ingredient, Remeron. It is an antidepressant used to treat anxiety; to be precise, it treats generalized anxiety disorders.

There is a type of chemical, Neurotransmitter used to send signals from one neuron to another. Serotonin and Noradrenaline are two Neurotransmitters responsible for anxiety disorders. Research found that people having low Serotonin activity and elevated noradrenergic system activity have higher chances of developing anxiety disorders.

How to Take Mirtazapine?

Both tablet and soluble forms (dispersible tablets) are available for Mirtazapine. You may start with 15 mg and then increase the dose level to 30 mg. You can take up to 45 mg depending upon your level of anxiety.

It’s better to take Mirtazapine in the evening for better results as it has sedating effects.

mirtazapine

However, its sedating effect will help you to have a good night’s sleep and it may take four to six weeks to show better results.

Side Effects of Mirtazapine

Like other medications, Mirtazapine also has some side effects. These includes:

  • Weight gain
  • Dry mouth
  • Faint feeling
  • Constipation
  • Sleepiness and drowsiness
  • Increased appetite

Most of them will diminish as your body starts to cope with Mirtazapine. There are some severe side effects of Mirtazapine; though they are very uncommon, you should contact your doctor if you have any symptoms stated below.

Serotonin Syndrome:

Serotonin syndrome, an unusual yet possibly fatal illness marked by uncontrollable shivering, unsteadiness, muscle spasms, and altered degrees of consciousness can become severe at times. You may experience this side effect as Mirtazapine increases serotonin levels.

Low White Blood Cell Count:

You might not understand directly that your WBC is lowering but you may experience flu-like syndromes; like chills, fever and sores in the mouth or throat.

Low Blood Salt levels:

Mirtazapine drops the salt level of your blood and sometimes can lead to headaches, confusion, feeling unsteady, weaknesses and decreased level of consciousness. 

Foods to Avoid with Mirtazapine

There are no certain foods to avoid with Mirtazapine. But it is recommended to avoid alcohol while taking Mirtazapine. As you are taking Mirtazapine to heal anxiety and sleeping disorders, try to avoid Caffeine and Caffeine like foods and drinks. These include:

  • Tea 
  • Coffee
  • Chocolate
  • softdrinks

Chances are these foods and drinks may increase the risk of sleep apnea.

Mirtazapine Food Interactions

Normally, Mirtazapine does not interact with foods or drinks. You can go on with your normal diet plan; no need to adjust anything. But Caffeine and Caffeine like foods and drinks decreases your sedation or 

When to Stop Taking Mirtazapine?

Mirtazapine is not suitable for everyone and we recommend you not to take it if you have underlying conditions:

  • Low blood pressure
  • Epilepsy or seizures
  • Glaucoma (raised pressure in your eyes)
  • Pregnancy

You also need to keep an eye on diabetes as Mirtazapine can at times make it more difficult to control your blood sugar levels. Also, you need to stop taking alcohol as Mirtazapine has a sedating effect.

If you find improvement in anxiety in 4 to 6 weeks your doctor will most likely suggest you to continue for twelve weeks to complete the course. It’s better not to stop consuming Mirtazapine in cold turkey. Consult with your doctor before you stop taking it.

How Clonazepam is Administered?

Both orally disintegrating tablet and tablet forms are available; for tablets, have it with water and for disintegrating tablets, put it under your tongue and let it dissolve automatically.

clonazepam

You can have it one to three times a day and with or without meals. Benzodiazepine, the major ingredient of Clonazepam reduces the abnormal electrical activity of our brain and we feel fresh and chill.

Dosage Guidelines for Clonazepam

Initially, your doctor will prescribe you 0.5 mg to 1 mg a day in divided doses. Doctors may increase or decrease the dose level depending on the reactions. If you are having social anxiety disorder your doctor most likely will prescribe fewer doses. 

When Not to Take Clonazepam?

It’s recommended not to take Clonazepam if you have underlying conditions:

  • Having significant kidney or liver diseases
  • Age under 18
  • Being pregnant or breastfeeding
  • Have been diagnosed with acute narrow-angle glaucoma
  • Have been diagnosed with hepatic porphyria

In some cases, Clonazepam might increase the symptoms of anxiety. If you face this problem then contact your doctor immediately.

Medication Interactions

Like other medications, Clonazepam also has some medical interactions. This might become moderate to severe at times. 

The following prescription agents are not safe in conjugation with Clonazepam:

  • Antianxiety agents
  • Narcotics
  • Phenothiazines
  • Antipsychotic agents
  • Barbiturates and non-barbiturate hypnotics

Medications that can increase the level of effects of Clonazepam includes

  • Nizoral (ketoconazole)
  • Serzone (nefazodone)
  • Tagamet (cimetidine)
  • Luvox (fluvoxamine)

Medications that can decrease the level of effects of Clonazepam include:

  • Dilantin (phenytoin)
  • Tegretol (carbamazepine)
  • Luminal (phenobarbital)

Clonazepam Side Effects

Like other medications, clonazepam also has some side effects. These includes:

  • Blurred vision
  • Issues with coordination
  • Frequent urination
  • Respiratory or sinus issues
  • Pain in joints and muscles
  • Unsteadiness
  • Increased saliva production
  • Changes in sexual performance

Apart from that, there are some severe side effects of Clonazepam. These includes:

  • Trouble breathing
  • Rashes
  • Hives
  • Loss of consciousness
  • Extreme sleepiness
  • Swelling of throat, face and eyes.
  • Unresponsiveness

If you found any of the symptoms above mentioned, consult with your healthcare provider right away.

FAQs

Question: Can Clonazepam and Mirtazapine be taken together?

Answer: No, Clonazepam often causes severe respiratory and cardiac side effects like low blood pressure, respiratory failure and cardiac arrest. Besides, it often interacts with other medications. Mirtazapine, on the other hand, is an antidepressant medication which may increase the risk of cardiac failure. So, taking Clonazepam with Mirtazapine may cause problems.

Question: What can you not take with Clonazepam?

Answer: Normally we take Clonazepam for better sleep and as an antidepressant. So, It’s better to avoid Caffeine or Caffeine like foods and beverages like tea, coffee, chocolates and colas. Foods containing Caffeine may hamper your sleep.

Question: What antidepressant works well with Mirtazapine?

Answer: Paroxetine shows better results in combination with Mirtazapine. Paroxetine with Mirtazapine improves the symptoms of both anxiety and sleep disorder drastically. 

Question: What medications should not be taken with Mirtazapine?

Answer: A number of medications interact with Mirtazapine. It is recommended to avoid medications including: Dronedarone, Fluconazole, Furazolidone, Iproniazid, Isocarboxazid and Linezolid.

Question: How soon does Mirtazapine start treating anxiety?

Answer: You will start seeing an improvement in the very first week. Normally, it takes four to six weeks to give the desired result. Actually, Mirtazapine will take a week to build up in your body and then it starts to show results eventually.

Question:  How may I reduce extreme anxiety?

Answer: You may try the following steps to reduce severe anxiety:

  • Share your feelings with your near ones, friends, family, health professional or counselors.
  • Try calming breathing exercises.
  • Try exercises like yoga, running and swimming to keep yourself relaxed.

Question: Can Mirtazapine deal with anxiety?

Answer:  Mirtazapine, an antidepressant medication, works pretty well to deal with anxiety. It is normally prescribed for patients having depression, obsessive compulsive disorder (OCD) and anxiety. It increases noradrenaline and serotonin, a mood-enhancing chemical and thus you start to feel better. 

Bottom Line:

So, are Clonazepam and Mirtazapine useful to reduce anxiety disorders and depression?

We provided the answer, yes. Psychotherapy, mindfulness practice yoga and meditation along with these medications might help a lot to treat anxiety disorders.

Besides, there are some side effects as well. Make sure to contact your healthcare provider if you find any severe conditions.

Dr. Afifa Amer

Dr. Afifa Amer

My name is Afifa Amer and I have done Doctor of Pharmacy. I am a registered retail pharmacist. I believe we should not stick to one specific job, so writing and educating others has always been my passion. I love to share content that improves health, fitness and well being. When I am not typing or dealing with prescriptions, I like to travel and read books.

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