Taking Mirtazapine When You Have Glaucoma

In our latest question and answer, the pharmacist discusses whether or not mirtazapine can be taken in those who have been diagnosed with glaucoma.

Feb 12, 2018

andi asked

The drug information as well as internet sources warn of taking Mirtazapine (lowest dose) for (94 yr old) person having glaucoma. However the prescriber (a psychiatrist) knew of this preexisting condition. How serious a concern is this...should it definitely not be taken then?

Answer

Caution is advised for those who are taking Remeron (mirtazapine) and have been diagnosed with glaucoma, particularly narrow-angle glaucoma. Mirtazapine can precipitate a closed-angle glaucoma attack in certain individuals. Such attacks are considered a medical emergency because the increased intra-ocular pressure caused by mirtazapine can occur rapidly and may result in negative effects on your vision.

Having Glaucoma And Taking Mirtazapine

Narrow angle glaucoma, also known as acute angle glaucoma, occurs when the drainage canal (aka "angle") of the eye is very narrow and reduces fluid outflow from the eye. Being diagnosed with narrow angle glaucoma puts you at a higher risk of a closed-angle glaucoma attack, an ocular emergency. Symptoms of a closed-angle glaucoma attack include:

  • Blurred vision
  • Eye pain
  • Headache
  • Nausea
  • Vomiting
  • Reddening of the eye

Mirtazapine has mydriatic (i.e. pupil dilating) effects which could precipitate a closed-angle glaucoma attack in susceptible individuals, although it is rare. If you have been diagnosed with open-angle glaucoma, your risk is less than those diagnosed with narrow-angle, but the risk is still there.

If you are concerned regarding the use of mirtazapine having been diagnosed with glaucoma, please speak with your doctor regarding the potential risks and benefits of therapy.

Ready for a more personal experience with your meds?