Mirtazepine monitoring for psychiatrists
Mirtazapine (Mirror Determination)
0.50 ml serum, without separating gel (black cap)
This test, known as a mirror determination or drug level test for mirtazapine (with synonym Remergil), is used in psychiatry to measure the concentration of mirtazapine in the blood. Mirtazapine is an antidepressant used to treat depressive disorders. The concentration of the drug in the blood, also called the plasma concentration, can help determine whether the dosage of the drug is effective and safe for the patient.
Synonyms: Remergil
Categories: Antidepressants, Drug levels
Blood draw immediately before next drug intake
therapeutic 30 - 80 µg/l
toxic > 160 µg/l
Metabolite/Mirtazapine ratio 0.2 - 1.2
Method LCMS: Liquid chromatography-mass spectrometry
Note
Also determines the metabolite Desmethylmirtazapine
Therapy monitoring and observation of Mirtazapine
The main applications of this test for psychiatrists are:
Therapy Monitoring: By monitoring the concentration of mirtazapine in the blood, psychiatrists can determine whether the current dose is effective in treating the patient's depressive symptoms. If the concentration falls within the therapeutic range (30 - 80 µg/l), this suggests that the dose is probably effective. A concentration outside this range may indicate a need to adjust the dose.
Prevention of toxicity: If the concentration of mirtazapine in the blood exceeds the toxic level (> 160 µg/l), this may indicate a risk of adverse effects or toxicity. Psychiatrists may then reduce the dose to reduce the risk of adverse effects.
Determination of medication compliance: The test can also help assess whether patients are taking their medication as prescribed. If the concentration of mirtazapine is lower than expected, it may indicate a problem with medication compliance.
Personalization of treatment: The pharmacokinetics of mirtazapine can vary between individuals due to genetic differences, interactions with other medications, and age- or health-related factors. By measuring mirtazapine levels, psychiatrists can tailor treatment more closely to individual patient needs and circumstances.
Interpretation of side effects: In patients who experience side effects, measuring mirtazapine levels may be useful to assess whether these side effects are related to excessive concentrations of the drug.
In summary, the mirtazapine level test provides valuable information that psychiatrists can use to optimize treatment of depression, minimize side effects and improve overall care for their patients.
