Mirtazapine

Mirtazapine, commonly sold under the brand name Remeron, is an antidepressant used to treat depression in adults. It’s a type of medication called a noradrenergic and specific serotonergic antidepressant (NaSSA), which helps restore the balance of neurotransmitters—chemical messengers in your brain that affects your mood.’

This antidepressant increases the neurotransmitters serotonin and noradrenaline. Boosting the levels of these mood-enhancing, natural chemicals in your brain can ease symptoms of depression, help you feel calm, and give you a better sense of well-being.

At Brightside, our psychiatric providers specialize in personalizing treatment for each person. We give you personal attention and expert advice you can count on—we explain all your options and use our expertise to find the medication that’s right for you. We make sure you understand how medications work and what to expect so that your treatment is worry-free.

Mirtazapine is prescribed to adults experiencing depression and other conditions, including:

• Anxiety disorders
• Insomnia
• Nausea
• Post-traumatic stress disorder (PTSD)
• Weight loss

Mirtazapine is used to treat depression, but the benefits you experience will depend on your diagnosis and symptoms. If you’ve tried another antidepressant and it didn’t relieve your symptoms, or it caused side effects, mirtazapine can offer an excellent alternative. It’s also a good choice for people experiencing depression and anxiety or difficulty sleeping.

At Brightside, we use mirtazapine to help with symptoms such as:

• Agitation and restlessness
• Decreased appetite
• Difficulty concentrating
• Feeling sad, hopeless, empty, or worthless
• Irritability
• Loss of interest in your usual activities
• Sleeping or eating more or less than usual
• Self-harm or thoughts of suicide
• Tiredness and lack of energy
• Trouble concentrating

Other symptoms mirtazapine can help treat are:

• Insomnia
• Nausea
• Weight loss

You and your Brightside provider will discuss all your symptoms to decide if mirtazapine is right for you. You can be confident your provider understands the subtleties of various antidepressants, and they will explain which medications can offer you the best results.

Medications don’t have the same effect on everyone—each person is different. Your age, sex, health history, and genetic makeup impact how a particular medication works for you. Your response to medications can also be affected by other medications you’re taking.

At Brightside, we consider all aspects of your health and lifestyle to design a treatment plan that meets your unique needs. We use our expertise to find the medications and therapies we believe will work best for you. Whether that means adjusting your dosage or trying a different medication, we take the time to ensure you get the best results as quickly as possible.

Typically, providers begin you on a low dose of mirtazapine and then gradually increase it over several weeks. Some people notice improvements in sleep, energy, and appetite within the first few weeks, but it can take up to six or eight weeks to feel improvement in your mood or experience the full benefits.

If you don’t notice an improvement right away, it doesn’t mean the medication isn’t working. Sometimes it takes a little longer for some people to feel the effects, so you must give it enough time to work.

We understand you want to feel better right away, but it may take some time. We’re here to support you and ease your concerns so don’t hesitate to talk to your provider—we offer telehealth services and provider consultations that can be scheduled within 48 hours.

Studies have shown that antidepressants, such as mirtazapine, relieve symptoms of depression about 40-60% of the time and additional treatments (such as therapy and lifestyle improvements) on top of medication often lead to the best outcomes. To get the best results with medication, it’s important to consistently measure progress during treatment. This is known as Measurement Based Care, and it’s the approach we use at Brightside. It’s common to adjust the dose and/or medication when starting antidepressants until you find just the right fit.

Studies show mirtazapine is safe and effective in treating depression and may have milder side effects than other antidepressants. A study comparing side effects of different antidepressants found that mirtazapine had a lower incidence of heart problems and other side effects.

At Brightside, our providers are knowledgeable about the benefits and drawbacks of particular antidepressants. We use our expertise to discover a treatment plan that will give you the best results—so you can feel better as quickly as possible.

The most important thing to know about taking antidepressants like mirtazapine is to take them as your provider prescribes—even if you feel better. You may feel like you don’t need it any longer, but the medication is part of why you feel so much better.

Before making any changes or stopping your medication, please talk to your provider first. If you and your provider decide it’s time to stop taking the medication, your provider will develop a plan to reduce your dosage gradually to keep you feeling your best.

Mirtazapine is safe to take for an extended time as long as it’s taken as directed. You and your provider will decide together what’s right for you—you may take it for several months or longer, depending on your needs.

We understand you may be concerned that taking mirtazapine or another antidepressant will change who you are—it won’t. The goal of antidepressants isn’t to change your personality but to help you feel like your very best self. We prescribe mirtazapine to relieve symptoms that are getting in the way of your happiness and well-being.

Your provider may prescribe mirtazapine if they believe it’s right for you. But remember to be patient. It may take some time for the medication to take full effect and reduce your symptoms. We’re here to answer your questions and support you on your journey to feeling better.

Mirtazapine is a safe medication, and just like with any medication, you may experience side effects from mirtazapine. At Brightside, our goal is to help you find an antidepressant that lets you feel better with the fewest side effects—or no side effects at all.

The most common side effects of mirtazapine include:

• Abnormal dreams
• Elevated cholesterol/triglyceride levels
• Constipation
• Dry mouth
• Feeling dizzy
• Increased appetite
• Sleepiness

Most symptoms are temporary and go away as your body adjusts. If they don’t go away, talk to your provider. It may be as simple as changing your dosage. 

Serious side effects of mirtazapine may include: 

• Agitation
• Excessive energy, happiness, or irritability
• Extreme difficulty sleeping
• Flu-like symptoms, such as fever, chills, sweating, or other signs of infection
• Loss of coordination
• Nausea, vomiting, or diarrhea
• Racing or irregular heartbeat
• Unusual thoughts

If you experience any of these or other troubling symptoms, talk to your provider right away.

At Brightside, your health and safety are our highest priorities. We make sure you get individual attention and guidance to make sure you feel your best.

If you’re feeling better and considering stopping mirtazapine, talk to your doctor first. If you suddenly stop taking it, it may cause unwanted side effects, dizziness, headaches, irritability, nausea, or nightmares.

When you and your doctor decide it’s time to stop taking mirtazapine, they’ll tell you how to do it in a way that ensures you continue to feel great. Your Brightside provider will help you reduce the dose gradually to give your body time to adjust.

If you’re pregnant, planning to become pregnant, or breastfeeding, let your provider know. We want to be sure that any medications you take are safe for you and your baby.

It’s unclear how mirtazapine may affect your unborn baby, and it may pass into breast milk. It’s essential to discuss all the risks and benefits of the medication with your provider so that you can make an informed decision. Your provider will talk to you about all your options to relieve your symptoms as safely as possible.

Mirtazapine isn’t addictive, but it may cause side effects if you stop taking it abruptly. If you and your doctor decide it’s time to stop taking it, they’ll explain how to reduce your dosage to prevent any withdrawal side effects.

You can view the FDA black box warning for mirtazapine here. If you have questions about whether the black box warning for mirtazapine applies to you, please talk to your provider.