Moderate
Alprazolam × Mirtazapine
Benzodiazepines. Short-to-medium-acting anxiolytics×Other antidepressants (NaSSA)
Mechanism
Additive sedation and fall risk in older patients. No direct pharmacokinetic interaction.
Symptoms
Deep sedation, drowsiness, ataxia. Older patients: fall and fracture risk. Symptoms appear in the first 1–2 weeks.
Management
Widely used in anxious-depressive disorders. Alprazolam is given for a short course (4–6 weeks) with gradual taper after mirtazapine's effect stabilises. In older patients: minimum alprazolam dose; monitor cognition.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.