Medicinsk godkendt artikel
Mirtazapine is used as a preventive treatment for tension headaches
Mirtazapine has been developed to treat depression, but it has later been shown to also have an effect on chronic tension headaches. When the medicine is prescribed to you, it is not to achieve an antidepressant effect, but because mirtazapine can hopefully improve your headache.
Mirtazapine increases the concentration of painkillers in the central nervous system and provides a more relaxed night's sleep, which is probably the reason for the preventive effect against headaches.
Mirtazapine does not remove the headache. A realistic treatment goal is a 30% reduction in headache. However, there is a big difference from person to person in how well it works.
The most frequent side effects are fatigue, dry mouth and weight gain. Alcohol can amplify the dulling effect. Mirtazapine does not have any effect on metabolism, but may increase appetite. You can therefore counteract the weight gain by eating as usual and regularly controlling weight.
Alcohol can amplify the dulling effect.
You need to be careful when driving when starting treatment.
Before starting treatment with mirtazapine, you must have an electrocardiogram (ECG) taken.
Usually start by taking 15 mg 1-2 hours before bedtime for a week. Then 30 mg before bedtime.
If there is a good effect and not too bothersome side effects, this dose is taken for 6 to 12 months, after which the dose, in consultation with the doctor, can be escalated. However, some patients need to take mirtazapine for a longer period of time. If there is no effect after 1-2 months, it can be concluded that mirtazapine does not work on you and you can step down to 15 mg for a week and then stop taking the medication altogether.
