Brief Answer:

I would explain as follows:

Detailed Answer:

Hello,

Your actual clinical symptomatology needs to be carefully investigated and several potential causes should be sought and excluded.

Fist as you are taking Mirtazapine which is an antidepressant drug (affecting also serotonin release by increasing its available presence) a suspicion is raised regarding possible serotonin syndrome (characterized by confusion, agitation, increased heart rate and trends of high blood pressure, nausea, muscle rigidity and diarrhea, etc.).

The risk for such serious complications is elevated in case renal or hepatic dysfunctions are present. Coming to this point, you should discuss with your prescribing doctor on the current complaints and the possibility of checking liver and renal function tests.

In case of a renal or liver dysfunction Mirtazapine daily dose reduction is required.

Another option may be a primary digestive disorder most probably irritable bowel syndrome. This condition needs to be supported by symptomatic and temporary treatment (anti-vomiting, anti- diarrheals, etc.)

A third alternative may be an acute inflammatory/infectious digestive disorder which needs to be explored by several tests as follows:

- complete blood count,
- ESR & PCR,
- stool microbiologica lculture,
- AST & ALT,
- Bilirubin,
- Lipase, etc.

You should discuss with your attending doctor no above-mentioned issues.

Hope I have answered your query.

Take care

Regards,
Dr Ilir Sharka, Cardiologist

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