Seeking emergency medical care for anti-depressant side-effect?

[Ecdysis]

So, I got put on Mirtazapine at the end of January for pretty severe depression.

15 mg initially, which helped with sleep and did mildly ease my depression.

When I went up to 30 mg around March/ April I developed a pretty weird, bad rash all over my body which was clearly a side-effect and I figured that I'd probably have to discontinue the med, but actually after about a fortnight it seems my body adjusted to the med cos the rash cleared up.

A week ago my Dr upped the dose to 45 mg and I can finally feel a proper anti-depressant effect, which is reeeeeally good.

However, a new side-effect has turned up - a muscle in my face has started twitching - not majorly, but enough to be low-grade annoying for the past few days. It's a muscle above my left eyelid, just under my eyebrow.

I didn't think too much of it, it is obviously a side-effect but I figured maybe my body would adjust again and in a week or two this will have cleared up.

But today, just out of curiosity I googled "mirtazapine side effect muscle twitching" and all the main websites say "go and seek emergency care".

This seems a pretty extreme measure for a muscle near my eyebrow gently twitching more or less constantly (but it comes and goes).

The only reason I can think of why emergency medical care might be appropriate is that the med might make "all" my muscles potentially twitch - which would the potentially include my heart muscles.

It's late Saturday afternoon here and I'm trying to process this and whether to go and head off to the local hospital because a muscle in my face is gently twitching...?


Edit to add: Ohhh.... it seems that muscle twitching is a concern cos it can be a sign of "serotonin syndrome" (ie. serotonin overdose). That would make sense seeing it's an anti-depressant. I've got a list of the symptoms of that now, so I'm just going to monitor myself for those symptoms and if the twitches get worse or additional symptoms arise, then I'll go and seek medical care...

Serotonin Syndrom symptoms are:

Confusion
Agitation or restlessness
Dilated pupils
Headache
Changes in blood pressure and/or temperature
Nausea
Vomiting
Diarrhea
Rapid heart rate
High blood pressure
Tremor
Loss of muscle control or twitching muscles
Muscle rigidity
Shivering or goosebumps
Heavy sweating

 

[LuckiLee]

A call to your pharmacist could give you more information if you can't get through to your doctor.

 

[Friday]

This seems a pretty extreme measure for a muscle near my eyebrow gently twitching more or less constantly (but it comes and goes).

Nope. It’s a giant flashing warning sign, that means to go to the ER / A&E immediately, to avoid a potentially lethal reaction. Like a depakote rash, or blowing one pupil, or sticking your tongue out straight & having it stick out the corner of your mouth… there are a metric shitton of weird but only annoying symptoms… that are warning signs of dying, in the very near future.

Please, please, go seek emergency medical support.

 

[Ecdysis]

I've left a message with my p-doc to ask him what I should do.

 

[Ecdysis]

P-doc said it's fine and to just keep monitoring symptoms for this:

it seems that muscle twitching is a concern cos it can be a sign of "serotonin syndrome" (ie. serotonin overdose). That would make sense seeing it's an anti-depressant. I've got a list of the symptoms of that now, so I'm just going to monitor myself for those symptoms and if the twitches get worse or additional symptoms arise, then I'll go and seek medical care...