Mirtazapine (Remeron)


Overview: Mirtazapine, known by the brand name Remeron, is an antidepressant of the Atypical class. Mirtazapine is mainly used to treat depression, though has been found to be useful in treating Anxiety and related disorders. Mirtazapine has helped many people recover from their mental health problems – and is a good alternative for when patients fail to respond to SSRI or SNRI antidepressants. Mirtazapine is one of the newest antidepressants, having been patented around twenty years ago. Mirtazapine is only available on prescription.




Key Facts: Mirtazapine will normally take around 4-6 weeks to take full effect. Minor improvements might be visible after around a week. There are some side effects to Mirtazapine, and some cautions too. Mirtazapine should be used without interruption – you shouldn’t suddenly stop taking the medicine. The medication should help jump start your mood, and slowly make you feel like your old self again.


How do they work?: Unfortunately, it isn’t entirely known how antidepressants work. Atypical antidepressants work by changing the levels of some neurotransmitters such as dopamine, serotonin and norepinephrine. These neurotransmitters are linked to mood and emotion. How the exact process works and links together isn’t entirely known, but antidepressants have a proven track record of working.


Dosage: The normal dosage of Mirtazapine is 15mg per day. The tablet is generally taken just before you go to sleep. Mirtazapine can cause drowsiness, so it is recommended not to take the tablet in the morning. A dosage can be increased if no response is gained – with a maximum daily dose of 45mg. It can take some time to find the correct dose. Mirtazapine can be taken with or without food, as it doesn’t upset the stomach. A typical treatment course of Mirtazapine is nine months, though a longer treatment is common.


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Side Effects

With each box of Mirtazapine, there will be an information leaflet enclosed. This will provide an exhaustive list of side effects. Side effects from Mirtazapine should only last a few days, though can cause issues. It is natural to experience some side effects as your body gets used to the medication.


Common side effects of Mirtazapine include drowsiness, constipation, dry mouth, sleepiness, increased appetitie and weight gain. Unlike all other classes of antidepressants, Mirtazapine does not cause sexual dysfunction, and very rarely causes suicidal ideation.


Serious side effects include suicidal thinking, seizures, chest pain and psychosis. An overdose should be avoided, as it can cause the potentially fatal Serotonin Syndrome, nervous system breakdown and cardiovascular problems. You should contact your doctor if any of these serious side effects take place.




You should always read the information leaflet that comes with your medication as it will include important information. You should tell your doctor if you are taking any other medication. It is important that you don’t use the herbal remedy St. Johns wort. Always ask your doctor if you are unsure on combining medicines. Do not combine MAOI antidepressants with Mirtazapine. Any medication that has sleepiness as a side effect should be avoided.


You can combine SSRIs and SNRIs with Mirtazapine, with many people attaining remission with a combination.


Mirtazapine often causes weight gain – and therefore individuals with high cholesterol levels should be cautious when considering Mirtazapine.


People with epilepsy shouldn’t take Mirtazapine due to the increased risk of seizures.


Drowsiness is a profound issue with Mirtazapine, and the first few days of treatment should be adopted in a cautious manner.


Alcohol acts as a depressant, therefore it is recommended that anyone taking an antidepressant stays away from drinking alcohol. Combining Mirtazapine with recreational drugs is also not recommended.


Mirtazapine is not recommended in pregnancy or the breastfeeding stage. Antidepressants are generally considered unsafe to use in pregnancy.


Mirtazapine is not normally prescribed to anyone under the age of 18. Instead, some form of psychotherapy is recommended. Younger people have been shown to be more vulnerable to suicidal thoughts when using antidepressants. In the case that an antidepressant needs to be prescribed, Fluoxetine will instead generally be prescribed.


Other Atypical Antidepressants: