Abstract
We report the case of a 43-year-old female with depression and posttraumatic stress disorder who made a suicide attempt with an overdose of mirtazapine (4,5 g) and alcohol. On admission she had already vomited and was somnolent but orientated and exhibited ataxia. The serum level of mirtazapine could not be measured in our institution. One of the German centres for intoxication advised the monitoring of the patient for 12 hours.
The patient herself did not complain of any other adverse effects beside feeling tired; mild ataxia persisted for half a day.
The electroencephalography showed slow α-waves but was judged as normal and the cardiovascular parameters were normal. The blood cell count and the serum parameters were normal with the exception of urea that peaked at 8.3 μmol/L.
The patient made a full physical recovery and was treated with fluoxetine and lorazepam afterwards.
Only a few cases of mirtazapine overdoses have been reported and the patients seemed to suffer no serious medical consequences [1–5]. In this case the patient was somnolent and ataxic only for a few hours. The known potential side-effect of seizures was not manifest.
Mirtazapine does not seem to have a high risk of toxic effects in overdose.