Mirtazapine (
Remeron®) is a prescription medicine used for the treatment of
depression (also known as major depression or clinical depression).
Mirtazapine is manufactured by Organon USA. It is sold under the brand name Remeron. Generic mirtazapine is made by several manufacturers.
How Does Mirtazapine Work?
It is not entirely clear how mirtazapine works, since no other medications work exactly like it.
The drug blocks several different kinds of receptors, including serotonin, norepinephrine, histamine, alpha, and muscarinic receptors.
It is thought that the
antidepressant effects of this drug are due to its actions on serotonin and norepinephrine. These are chemicals used to send messages in between nerves. However, if serotonin or norepinephrine levels become unbalanced, it can cause a variety of conditions, including depression. Mirtazapine's actions on other types of receptors may cause some of its side effects, such as drowsiness or low
blood pressure.
Certain receptors decrease the levels of serotonin and norepinephrine released by the nerves. Mirtazapine blocks these inhibitory receptors, causing more to be released. This may help to relieve the
symptoms of depression.
Studies have shown mirtazapine to be effective in treating
depression in adults. People who took the drug showed more improvement in their symptoms when compared to people not taking it. Also, long-term studies have shown that fewer people taking the drug have a relapse (their depression comes back) than people not taking it.
General considerations for when and how to take mirtazapine include the following:
- The medication comes in tablet form. It is taken by mouth once a day, usually at bedtime, because it often causes drowsiness.
- For people who have trouble swallowing tablets, mirtazapine also comes in an orally disintegrating tablet (Remeron SolTab®). These tablets will rapidly dissolve on your tongue, with no need to drink water.
- Do not cut the disintegrating tablets. Also, to avoid crushing them, do not try to push them through the foil blister. Peel back the foil to remove the tablet.
- Mirtazapine should be taken at the same time each day to maintain an even level in your blood.
- For the medication to work properly, it must be taken as prescribed. Mirtazapine will not work if you stop taking it.
The dose of mirtazapine your healthcare provider recommends will vary, depending on a number of factors, including:
- Your age
- Other medical conditions you may have
- Other medications you are currently taking.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Side Effects of Mirtazapine
As with any medicine, side effects are possible with mirtazapine. However, not everyone who takes it will experience side effects. In fact, most people tolerate the medication quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
The most common side effects include:
(Click Side Effects of Mirtazapine to learn more, including potentially serious side effects you should report to your healthcare provider.)
You can also read about specific side effects in the following eMedTV articles:
What Should I Tell My Healthcare Provider Before Taking Mirtazapine?
Talk with your healthcare provider prior to taking this drug if you have:
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Depression, even in its most severe form, is highly treatable. As with many illnesses, getting treatment early is more effective and reduces the chance of recurrence.
The most common forms of treatment for depression are medication (
antidepressants) and psychotherapy ("talk therapy"). In cases of severe depression, some healthcare providers may recommend electroconvulsive therapy (ECT). Some people may also try complementary or alternative treatments for depression
(see Natural Remedies for Depression).
Mirtazapine is generally quite effective in treating depression. It is also generally well tolerated. However, side effects can occur, or the medicine may not work as well as needed. In these cases, your healthcare provider may recommend an alternative. Examples of substitute medications include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- Tricyclic antidepressants
- Monoamine oxidase inhibitors (MAOIs).
What If I Take an Overdose?
People who take too much mirtazapine may have overdose symptoms that could include:
- Disorientation
- Drowsiness
- Memory problems
- A rapid heart rate (tachycardia)
- Loss of life (especially if mirtazapine is taken with other medications).
If you happen to take too much, seek immediate medical attention.
How Should Mirtazapine Be Stored?
Mirtazapine should be stored at room temperature, away from moisture and heat, in an airtight container. The orally disintegrating tablets should be kept in their original blister packaging until just before use.
Keep this and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your mirtazapine as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Mirtazapine tablets are available in the following strengths:
- Mirtazapine 15 mg
- Mirtazapine 30 mg
- Mirtazapine 45 mg.
The orally disintegrating tablets are available in the following strengths:
- Mirtazapine SolTab 15 mg
- Mirtazapine SolTab 30 mg
- Mirtazapine SolTab 45 mg.
Both brand-name and generic mirtazapine tablets and SolTabs are currently available
(see Generic Remeron for more information).
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