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Mirtazapine is the generic form of the brand-name antidepressant Remeron, which is used to treat depression and other ailments.
In some patients, depression may be associated with abnormal levels of neurotransmitters, the brain chemicals that nerve cells use to communicate with each other.
Remeron (mirtazapine), which belongs to a class of drugs known as tetracyclic antidepressants, can treat depression by moderating the levels of neurotransmitters in the brain.
Antidepressants such as mirtazapine are also prescribed “off-label” to treat other conditions, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other anxiety disorders.
The drug has also been prescribed as an appetite stimulant.
(One of its most common side effects is weight gain.) Mirtazapine was approved by the Food and Drug Administration (FDA) for use as an antidepressant in 1996.
Its patent expired in 2004 and generic versions are now available.
Mirtazapine Warnings Like many antidepressants, the FDA requires that mirtazapine carry a black-box warning because of an increased risk of suicide.
Before you start using mirtazapine, tell your doctor about your family’s medical history, including any psychiatric disorders or history of suicide attempts.
If you are using mirtazapine, tell your doctor immediately if you notice worsening depression or other psychiatric conditions, or any unusual behavior changes, especially if you’re younger than 25.
This includes possible suicidal thoughts, new or worsening anxiety, or panic attacks.
You should also tell your doctor if you have trouble sleeping, become easily irritated, or start taking impulsive actions.
Be especially watchful for these symptoms when this medication is started or when the dose is changed.
Your doctor also needs to be aware if you have liver or kidney disease, seizures of any kind, high cholesterol, heart disease, or if you have ever had a heart attack or stroke.
Mirtazapine and Sleep Some doctors prescribe mirtazapine or other antidepressants to treat sleep disorders such as insomnia.
An August 2012 report in the Annals of Clinical Psychiatry noted that mirtazapine had proven sleep-promoting effects, and that use of the drug should “be balanced with mirtazapine’s ability to cause sedation-related side effects.” Talk with your doctor about use of mirtazapine or other drugs to address sleep disorders.
Mirtazapine ‘High’ and Abuse Anecdotal reports indicate that some people have used mirtazapine to “get high,” largely due to its sedative effects.
Recreational use of this drug can result in severe side effects and death, especially when combined with alcohol or other drugs.
Take mirtazapine only as directed by your doctor, and keep this and all other drugs away from children, teenagers, and anyone for whom the drug has not been prescribed.
Mirtazapine Withdrawal Don’t stop the use of mirtazapine without first discussing it with your doctor.
If mirtazapine is discontinued abruptly, you could experience withdrawal symptoms such as dizziness, headache, nausea, and changes in mood.
You may experience withdrawal symptoms even if you miss just a few doses, so it’s recommended that your dose of mirtazapine be reduced gradually when therapy is discontinued.
Pregnancy and Mirtazapine There have been no significant studies of mirtazapine use by pregnant women, and it’s not known if mirtazapine can be passed through a mother’s breast milk to a breastfeeding baby.
Several studies have linked the use of antidepressants during pregnancy with a higher overall risk of stillbirth and newborn death.
Other, newer studies show that risk may not be warranted.
If you are pregnant or breastfeeding, you and your doctor should determine if the benefits of using mirtazapine outweigh the potential risks.
Mirtazapine for Cats and Dogs Veterinarians may prescribe mirtazapine as an appetite stimulant, especially for cats and dogs that have a stomach condition, nausea, or other causes of a lack of appetite.
Drowsiness is the most common side effect of mirtazapine in pets.
Give this drug to your cat or dog only as directed by your veterinarian, and tell your vet about any other drugs your pet might be taking.
BasicDescription Back to Top Mirtazapine Side Effects Common Side Effects of Mirtazapine Mirtazapine may cause side effects.
Tell your doctor if any of these symptoms are severe or do not go away in a short amount of time after starting mirtazapine: Drowsiness Dizziness Anxiousness Confusion Constipation Nausea Vomiting Increase in weight Increase in appetite Dry mouth Muscle stiffness Serious Side Effects of Mirtazapine Some side effects of mirtazapine can be serious.
If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: Flu-like symptoms, high fever, chills, sore throat, mouth sores, or other signs of infection Chest pain Fast heartbeat Seizures You should also get immediate emergency help if you have any signs of an allergic reaction, including skin rash or hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
Back to Top Mirtazapine Interactions Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by mirtazapine.
Tell your doctor if you regularly use any of these medicines.
There are several other drugs that can interact with mirtazapine.
Tell your doctor if you are using: Antibiotics such as Biaxin (clarithromycin) or E-Mycin (erythromycin) Antifungals such as Nizoral (ketoconazole) Anti-retroviral medicines for HIV infection Any blood thinner such as Coumadin (warfarin) Eskalith (lithium) Heart or blood pressure medication Isoniazid (used for treating tuberculosis) Medicines for migraine headaches Other antidepressants such as Prozac (fluoxetine) or Zoloft (sertraline) Seizure medications Tagamet (cimetidine) Ultram (tramadol) This is only a partial list.
Other drugs may interact with mirtazapine.
Tell your doctor about all of the medications you use, including any over-the-counter drugs, vitamins, and herbal products.
Alcohol and Mirtazapine If you drink alcohol while taking mirtazapine, the combination could have an enhanced sedating effect.
Mirtazapine may make you dizzy or drowsy.
You should not drink alcohol or drive after taking mirtazapine.
Your doctor should be especially aware if you have been prescribed OxyContin (oxycodone), Valium (diazepam), Xanax (alprazolam), or similar drugs.
Smoking while taking mirtazapine could also cause an adverse reaction.
If you continue to smoke, your doctor may want to adjust your dose of mirtazapine.
Mirtazapine may impair your thinking or reactions.
Be careful if you do anything that requires you to be alert.
Back to Top Mirtazapine Dosage Mirtazapine comes in a tablet form.
The recommended starting dose for mirtazapine is 15 milligrams (mg) per day.
It should be taken in the evening, preferably before you go to sleep.
If you do not respond to your initial 15 mg dose, your doctor could increase your prescription up to a maximum of 45 mg per day.
Mirtazapine usually works in your system for 20 to 40 hours.
It may take one or two weeks for your body to get used to the dosage prescribed by your doctor.
Mirtazapine Overdose If an overdose is suspected, contact a poison control center or emergency room immediately.
You can contact a poison control center at 800-222-1222.
Symptoms of a mirtazapine overdose may include: Very fast or irregular heartbeat Severe dizziness Fainting Confusion Missed Dose of Mirtazapine If you miss taking your regular dose of mirtazapine, take is as soon as you remember it.
However, if it is almost time for the next dose, skip the missed dose and continue your regular schedule.
Never take a double dose to make up for a missed one.
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