• Instruct patient to take mirtazapine as directed. Take missed doses as soon as remembered; if almost time for next dose, skip missed dose and return to regular schedule. If single bedtime dose regimen is used, do not take missed dose in morning, but consult health care professional. Do not discontinue abruptly; gradual dose reduction may be required.

• May cause drowsiness and dizziness. Caution patient to avoid driving and other activities requiring alertness until response to drug is known.

• Encourage patient and family to be alert for emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia, hypomania, mania, worsening of depression and suicidal ideation, especially during early antidepressant therapy. Assess symptoms on a day-to-day basis as changes may be abrupt. If these symptoms occur, notify health care professional.

• Caution patient to change positions slowly to minimize orthostatic hypotension.

• Advise patient to avoid alcohol or other CNS depressant drugs during and for at least 3–7 days after therapy has been discontinued.

• Instruct patient to notify health care professional of signs and symptoms of serotonin syndrome (mental status changes: agitation, hallucinations, coma; autonomic instability: tachycardia, labile BP, hyperthermia; neuromuscular aberrations: hyperreflexia, incoordination; and/or gastrointestinal symptoms: nausea, vomiting, diarrhea) occur.

• Advise patient to notify health care professional if dry mouth, urinary retention, or constipation occurs. Frequent rinses, good oral hygiene, and sugarless candy or gum may diminish dry mouth. An increase in fluid intake, fiber, and exercise may prevent constipation.

• Inform patient of need to monitor dietary intake. Increase in appetite may lead to undesired weight gain.

• Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially St. John's Wort.

• Advise patient to notify health care professional of medication regimen before treatment or surgery.

• Therapy for depression may be prolonged. Emphasize the importance of follow-up exam to monitor effectiveness and side effects.