Generic Name: Mirtazapine
Brand Names: Remeron, Remeron Soltab
Drug Class: Tricyclic Antidepressant (TCA), Atypical Antidepressant, Anxiolytic, Antiemetic
Similar Class Drugs: Imipramine, Amitriptyline
Available Dosage forms: Oral tablet, liquid
What is Mirtazapine?
Mirtazapine is an atypical antidepressant used to treat major depression in adults with insomnia or weight loss as the predominant symptom.1 It inhibits alpha-2-adrenergic receptors and thus upregulates the concentration of neurotransmitters (serotonin, norepinephrine) in synaptic clefts.
Serotonin has mood regulatory effects, while norepinephrine enhances metabolism and activity by stimulating the sympathetic nervous system. Both mechanisms lead to a reduction in depressive symptoms and encourage weight gain. Mirtazapine antagonizes the activity of histamine and serotonergic receptors.2 Action on histamine receptors produces sedative and calming effects.1
The non-FDA approved uses of Mirtazapine:
– Generalized anxiety disorder
– Obsessive-Compulsive disorder
– Panic disorder
– Substance abuse
– Post-traumatic stress disorder (PTSD)
– Migraine
– Sexual disorders
– Sleep issues
How to use Mirtazapine?
Prescription Mirtazapine is available as tablets and solution form. Tablets are taken orally with water and swallowed whole. You can take the tablet with or without food. Follow your doctor’s directions to receive full benefit from the medication.
The medicine might take a few weeks to show its maximum effects. Do not try giving up medication without your doctor’s approval. Leaving treatment midway could result in side effects like headaches, seizures, or worsening of depressive symptoms.
What are the side effects of Mirtazapine?
Some usual side effects of Mirtazapine include:
– Dry mouth
– Dizziness
– GI upset
– Headache
The most common adverse effects reported with Mirtazapine:2
– Increased appetite
– Weight gain
– Somnolence
The risk of suicidal inclination, especially in young adults, should be considered when prescribing antidepressants.
It should be used with caution in:
– Pregnant and breastfeeding women
– Geriatric patients older than 65
Who should not use Mirtazapine?
– Children
– Adults with impaired kidney function
– Hypersensitivity
– Interaction with (MAOIs) and other drugs
– Linezolid and methylene blue therapy
References
- Jilani TN, Gibbons JR, Faizy RM, et al. Mirtazapine. [Updated 2021 Mar 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519059/
- Alam A, Voronovich Z, Carley JA. A review of therapeutic uses of Mirtazapine in psychiatric and medical conditions. Prim Care Companion CNS Disord. 2013;15(5): PCC.13r01525. doi:10.4088/PCC.13r01525
