Mirtazapine is a newer medicine belonging to the group called tetracyclic antidepressants. Also, known as cyclic antidepressants, the original antidepressants were developed in the 1950s. Although effective and a much better alternative than electroshock, they have been replaced by medications that have fewer side effects. The benefit of the medicine Mirtazapine and the other medications in the cyclic family is that they relieve extreme depression when other treatments haven’t worked. They do so by bringing chemicals in the brain back into balance. It helps relieve symptoms that go along with depression-like loss of appetite, issues with sleeping and lack of interest in usually enjoyable past times.
While the medicine Mirtazapine was approved by the FDA as an antidepressant in 1996, the patent expired in 2004 so generic brands are available now. It’s available under various brand names and different forms. One of the better-known brands administered for depression is Remeron.
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What is Remeron?
Remeron (Mirtazapine) eases depression by positively impacting the chemical communication within brain cells. It’s an atypical antidepressant that carries specific serotonergic activity, reversing changes in the brain chemistry and nerve cells in the nervous system that originally caused the depression. Serotonin and reuptake levels increase which can prevent suicidal thoughts, increase the desire to enjoy things in life and eventually allow you to gain back your life. Mirtazapine is often used in substance abuse rehab as it helps addicts maintain abstinence from alcohol, cocaine, and opiate drugs.
Other Uses for Mirtazapine
While the medicine Mirtazapine is primarily used to treat depression, it can also be prescribed “off label” for other medical problems. It’s been shown to help treat:
- Post-traumatic stress disorder
- Obsessive-compulsive disorder
- Bipolar disorder
- Other anxiety-related disorders
- For those with issues gaining weight, Mirtazapine can be prescribed for its appetite stimulant properties.
How Long Remeron Takes To Improve Depression
On average, it takes about four weeks of taking Remeron daily before you start noticing an improvement in your appetite, sleep, and energy levels. There may be a slight improvement in the first 1-2 weeks but its full benefits will take some time. The feeling of depression along with the lack of interest in things can take up to 8 weeks to improve.
Considerations Before Taking Remeron
While there is a benefit to taking Remeron for depression, there are also some things to consider before taking it. If you’re using MAO inhibitors already for depression or have been within the past two weeks, you should not use medicine like Mirtazapine. The interaction between the two drugs is potentially dangerous.
Ensure you let your doctor know about these conditions before taking Remeron:
- Liver or kidney problems
- You’ve had manic depression issues
- Have experienced seizures in the past
- Low blood pressure
- Heart disease
- High cholesterol
- History of heart attacks or strokes
Remeron can have adverse effects and cause the same problems you are trying to improve. If you’re under 25, you are particularly at risk of experiencing worsened depression, greater mood symptoms and further suicidal attempts or thoughts when taking antidepressants.
Remeron Side Effects
Mirtazapine side effects should be reported to your doctor and most often, your doctor will want to monitor the effects when you first begin taking it. The most serious side effect is agranulocytosis, an acute condition involving lowered white blood cell count. It’s extremely rare (1 in 1,000) and can be reversed when medication is stopped.
If you experience any of the following, seek out medical assistance immediately:
Signs of allergic reactions include:
- A skin rash or hives
- Difficulty in breathing
- Swelling of the face, tongue, or throat
Possible side effects:
- Behavioral changes
- Anxious feelings
- Panic attacks
- Trouble sleeping
- Hostile or aggressive
- Depression worsens
- Suicidal thoughts increase
- Unusual risk-taking tendencies
- Rapid emotional highs and lows
- Chills or fever
Due to a severe reaction from the nervous system, you may experience:
- Rigid muscles
- High fever
- Uneven heartbeats
The most common Remeron side effects include:
- Weight gain
- A change in vision
- Dry mouth
- Weight gain
- Increased appetite
Mirtazapine Medicine Withdrawal
Even once you start to feel better, you shouldn’t take yourself off Remeron. Your doctor or other healthcare providers should determine the length of treatment. If you miss doses, it can increase your risk of relapse. An abrupt end to Remeron causes withdrawal symptoms that can include dizziness, vomiting, headaches, and nausea. You may also be extremely emotional and in some cases, people have become suicidal.
There are a few factors that will determine how severe your withdrawal symptoms are and how long they’ll last. This includes how long you took Remeron and how quickly you tapered off before stopping the medication completely. If you took it for a year, your brain does rely on it somewhat to function normally. If this is the case, it may take longer to readjust.
Your doctor will instruct you on tapering off the doses gradually. This allows the body and mind to slowly adjust to changes in the dose. If you’ve been using Remeron for a long time, your doctor will recommend you taper at a rate of 10% every month.
Remeron and Interaction with Other Drugs
Another Mirtazapine side effect is that it has dangerous reactions when taken with other medications. You should consult with your doctor about taking Remeron with sleeping pills, muscle relaxants, or anxiety/depression medications. Let your doctor know if you are taking the following medications as they often have adverse effects when taken with Remeron:
- Valium (diazepam)
- St. John’s wort
- Mood or thought disorder medication like lithium
- Migraine medication
- Seizure medication
There are other drugs that may potentially interact with Mirtazapine so ensure you tell your health care provider what medications you’re taking.
Is Mirtazapine Addictive?
While Mirtazapine is not addictive, it may cause withdrawal if you suddenly stop taking it or miss a few doses consecutively. The side effects can make you feel confused, disoriented and cause anxiety. You may have trouble sleeping and feel sick as though you were experiencing true drug withdrawal.
Remeron dependence wouldn’t be put in the same category as opiate addiction but addictive traits can occur. If you’re using it for a long period of time, your brain can become dependent on it and sometimes requires assistance when discontinuing use.
Remeron dependence may not be as heard of as say, Heroin opiate addiction. However, this addiction seems to be just as commonly occurring, yields just as troublesome side effects as other drug addictions, and often requires Remeron addiction help to overcome. This medication is usually prescribed for depression, anxiousness, or insomnia.
There have been reports that people use Mirtazapine to get high as it has sedative effects. There is a risk of severe side effects and death when used recreationally. This is especially the case if it’s combined with other drugs or alcohol.
The body high of Mirtazapine is said to be pleasurable, warm and creates a tingling sensation. At high doses, it’s euphoric but comes with a strange throbbing or aching feeling. Being extremely sedating, it can create a lethargic state which can cause you to feel like you haven’t slept in days. It can be difficult to walk as your motor skills are affected, making you feel like you’re walking on a trampoline.
When you get your initial dose of Remeron tablets, it will likely be 15-mg per day, once a day. It should be taken before bed. In general, an effective dose for treating major depression is 15-mg to 45-mg per day.
If you don’t respond to the 15-mg dose, your doctor will likely choose to increase your daily dose up to 45 mg so you can get the positive benefits of the treatment. The dose can be increased every 7-14 days up to 45 mg Remeron lasts in the body for 20-40 hours.
Remeron (Mirtazapine) Reviews
Situational depression and racing thoughts created insomnia in the form of waking up and not being able to fall back asleep at two or three a.m. which led to a downward spiral in my overall mood due to lack of sleep. After starting with 15 milligrams and experiencing lethargy the following day I have now dialed back the dose to 3.75 milligrams before bed. It works like a charm but I definitely look forward to my coffee first thing in the morning. a bit of sedation, lack of motivation until I engage in something physical then I feel great. Going on three years almost and no I don’t like being dependent on any drug, this one has been a key in enabling me to have a good night’s sleep. Invaluable to overall mood and outlook on life!
For Depression: “I have recently started Mirtazepine and read everything about it before I started taking it. I was very skeptical as I have heard a lot of things, bad things about this medication, I have to say my experience is a good one, I started on 15mgs and my first night I slept like a log but I took it a few hours before I usually go to bed, just as well as it didn’t work instantly on me, but when it did I slept really well, had some weird dreams but nothing that I couldn’t handle, I had the shakes for a while after taking Mirtazapine but what I didn’t get is the vigorous appetite that a lot of people have experienced, It really seemed to help my depression and feel better than I have done for many years, actually want to get out of bed now.”
Remeron Important Information
There is a level of responsibility for your health and well-being when taking any anti-depressant. You should see your doctor regularly so they can detect your progress on the medication. As Remeron can bring on suicidal thoughts, it’s a good idea to inform your family member or other caregivers. Let them know to stay alert about rapid mood changes. If this occurs, you should see your doctor immediately.
Make sure to keep Remeron away from anyone aged 18 or younger as it’s not approved for children.
Know that it can take a few weeks before you notice improvement and continue taking the medication as directed. If you’re not noticing a difference after one month of treatment, let your doctor know.
You shouldn’t drink alcohol when taking Remeron as it can increase the nervous system side effects like dizziness, concentration, and thinking.
Remeron can potentially impair your thinking or motor reflexes. The major side effect is it’s sedation qualities. If you have to drive or manage other activities where alertness is essential, it’s important to be cautious.
Remeron side effects that many consider a downfall is that there is weight gain and often can cause cholesterol to rise. A concerning Mirtazapine side effect also includes a higher risk of suicidal behavior and thoughts. It’s also more difficult to manage your life as Remeron is more sedating than other antidepressants. While there are instances where Mirtazapine medicine is used in drug and alcohol rehab, it can also be the cause of a challenging withdrawal.
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