Mirtazapine use in open angle glaucoma

[annoyedpsychiatrist]

I know in closed angle glaucoma this is more of a concern, but i have a patient using eye drops for open angle glaucoma. But she would be a good candidate for remeron (shes on a mess of medications but one core issue is not sleeping and somewhat reduced appetite). Any good data on this?

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[aim-agm]

I know in closed angle glaucoma this is more of a concern, but i have a patient using eye drops for open angle glaucoma. But she would be a good candidate for remeron (shes on a mess of medications but one core issue is not sleeping and somewhat reduced appetite). Any good data on this?

I couldn't find any literature on mirtazapine and glaucoma specifically, but since alpha-2 agonists are used in treatment of glaucoma, why not just use a different antihistamine that isn't an alpha-2 antagonist? Better yet, why not use an alpha-2 agonist for sleep?

 

[docksan]

I know in closed angle glaucoma this is more of a concern, but i have a patient using eye drops for open angle glaucoma. But she would be a good candidate for remeron (shes on a mess of medications but one core issue is not sleeping and somewhat reduced appetite). Any good data on this?

Not sure about the data but theoretically Remeron doesn't really become adrenergic until around 30-45mg. Why not just Trazodone?

 

[annoyedpsychiatrist]

Not sure about the data but theoretically Remeron doesn't really become adrenergic until around 30-45mg. Why not just Trazodone?

tried it before and she didnt tolerate it well