if you are taking gabitril and add remeron are you increasing threashold for seizurers

Dear Howard,
Remeron (mirtazapine), in its own right, can lower seizure threshold.  The manufacturer advises caution when used in epileptics.  It suggests using low doses and to titrate slowly.  Theoretically, the use of Remeron with Gabitril could increase the risk of seizures, and the combination is ill-advised (although not completely contra-indicated).  A physician may opt for the combination provided low doses of each are used, dose increases are conservative, and the patient is monitored carefully.

I hope this helps.


All Answers

Answers by Expert:

Ask Experts


Gisella Campanelli


I am able to answer questions relating to pharmaceuticals, therapeutic regimes and primary health care. This includes offering advice on drug indications, dosages, and disease state management. I can also identify side effects, drug interactions and contra-indications, and offer recommendations on ways to mitigate these. I can diagnose minor illnesses and suggest appropriate over-the-counter remedies and/or preventive healthcare tips. I can recognize cardinal symptoms which would otherwise require referral to a medical practitioner.


I am a registered pharmacist in Australia, and I have practiced in a hospital pharmacy for over thirteen years. My clinical specializations lie within the areas of psychiatry and general medicine (including gastroenterology, respiratory, endocrinology, neurology, infectious diseases, gerontology, dermatology). I self-managed the training program for pharmacy interns in preparation for their final registration exams, and I have worked for the Pharmacy Board of Australia as an examiner and exam writer.

I hold a Bachelor of Pharmacy from the Victorian College of Pharmacy, Monash University, and I am board-registered to practice within Australia. I also hold a Master's degree in an unrelated field (art conservation).

©2017 All rights reserved.