You are correct.
Sertraline and mirtazapine.
It is still not optimal, and it is still trying to treat a side effect of one with the other.
In fact, the idea is somewhat erroneous in general as mirtazapine causes constipation in 13% of patients, so trying to exploit this will not necessarily work. In fact, it cause diarrhea in 9% of patients, so I find the whole plan erroneous.
Moreover, the combination has a rare risk of causing seritonin syndrome which is life threatening.
I would rather switch the sertraline, one way or another.
Rely on a single agent if possible, and there are many many choices.
This needs to be handled based on his exam, and a good psychiatrist should be able to tailor one or 2 meds to him, or add
a different med tot he seroquel.
OK. If you have further questions or details, use reply to expert.
Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.