Fluvoxamine Augmentation Increases Serum Mirtazapine Concentrations Three- to Fourfold

  title={Fluvoxamine Augmentation Increases Serum Mirtazapine Concentrations Three- to Fourfold},
  author={Sami Anttila and Ilpo Rasanen and Esa V J Leinonen},
  journal={Annals of Pharmacotherapy},
  pages={1221 - 1223}
OBJECTIVE: To report two cases of interaction between fluvoxamine and mirtazapine. CASE SUMMARY: A 17-year-old boy was treated with mirtazapine 30 mg/d. The addition of fluvoxamine 100 mg/d to the regimen caused a threefold increase in the mirtazapine concentration. This interaction was associated with increased anxiety. A second patient, a 43-year-old woman, was treated with mirtazapine 15 mg/d. There was a fourfold increase in her mirtazapine concentration and simultaneous mood improvements… 

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The variability of mirtazapine plasma concentrations in clinical routine is caused to a relevant degree by CYP2D6, and should be taken into account when therapeutic drug monitoring is carried out to check treatment adherence or when a special clinical situation, such as co-morbidity and add-on medication, demands careful dosing of this drug.

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