Jeffrey Panko NP Psychiatry · Patient education
Mirtazapine
Remeron / RemeronSolTab / Generic formulations
A guide for adults taking mirtazapine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Standard and orally disintegrating tablets have different handling instructions. Treatment is usually once daily in the evening.
What it is used for
Mirtazapine treats depression. Its effects on sleep and appetite may be useful when those symptoms are part of depression, while unwanted sedation or weight gain may limit treatment.
How it works
It blocks alpha-2 receptors and selected serotonin receptors, influencing norepinephrine and serotonin signaling. Histamine blockade contributes to sleepiness and appetite changes.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Take at the prescribed evening time, with or without food.
- For dissolving tablets, use dry hands, peel the packaging, and let the tablet dissolve on the tongue.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Consult with your provider before reducing or stopping.
When to get help
Emergency symptoms. Get emergency care for a seizure, severe allergic reaction, or sudden eye pain with vision changes. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome and needs urgent assessment.
Prompt medical advice. Contact your provider promptly for fever, sore throat, mouth sores, marked sedation, unusual agitation, or a reduced need for sleep with high energy.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness or morning grogginess
- Increased appetite and weight gain
- Dry mouth or constipation
- Dizziness
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.
Track weight and appetite; cholesterol or triglycerides may need checking. Report infection signs, which rarely reflect a low white blood-cell count.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss any history of mania or bipolar disorder, seizures, heart disease, glaucoma, and kidney or liver problems.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
MAOI antidepressants require a medication-specific waiting period before or after this treatment. Linezolid and IV methylene blue also need special precautions. Consult with your provider before any switch.
Other medicines that increase serotonin can raise the risk of serotonin syndrome. Alcohol and sedating medicines may worsen dizziness or impairment.
Everyday tips
A regular dose time and refill reminder can help prevent missed doses.
Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.
Your questions answered
Does increasing the dose always reduce sleepiness?
No. Sedation does not follow a dependable dose rule for everyone. Do not raise the dose to treat grogginess.
What about sexual side effects?
They may be less troublesome than with some antidepressants, but can still occur. Discuss changes with your provider.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.