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Atypical antidepressant (NaSSA)

Mirtazapine and surgery: what to do before and after

Surgery raises specific medication-management questions, and getting the answer right matters because both unintended drug interactions during anaesthesia and abrupt discontinuation of important chronic therapies carry risk. Whether Mirtazapine (Mirtazapine) needs to be stopped before surgery, continued through, or paused for a defined window depends on Mirtazapine and the type of procedure.

Before-surgery decision

For most chronic medications including many Atypical antidepressant (NaSSA) agents, the surgical team or anaesthetist makes the stop-or-continue decision during pre-op assessment. Considerations include bleeding risk, anaesthesia interactions, the urgency of the underlying condition and the type of procedure. According to most guidelines, surprises are avoided by listing all medications including Mirtazapine at 7.5mg, 15mg, 30mg, 45mg on the pre-op form.

After surgery

Post-operative resumption of Mirtazapine depends on the surgical course, the medication's impact on recovery (e.g. wound healing, gastric tolerance, mobility) and any new prescriptions added after surgery. Mirtazapine antagonises presynaptic α2-adrenergic autoreceptors and heteroreceptors, increasing noradrenaline and serotonin release. Resuming on schedule is usually the goal as soon as oral intake and clinical stability allow.

Frequently asked questions

Do I need to stop Mirtazapine before surgery?

It depends on Mirtazapine and the procedure. The pre-op assessment is where this is decided, ideally a week or more before surgery. Bring the full medication list including Mirtazapine at 7.5mg, 15mg, 30mg, 45mg so the team can advise.

When can I restart Mirtazapine after surgery?

Resumption timing depends on the procedure, the recovery course and any interactions with new postoperative medications. Many patients restart Mirtazapine on the day of discharge or earlier; some need a longer pause. The surgical team or prescriber confirms the timing.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.