Indications 

Remeron, an antidepressant medication, exerts its therapeutic effects via mechanisms that are not entirely clear.  

Remeron may enhance the communication among nerve cells in the central nervous system and/or reestablish chemical homeostasis within the brain. 

Remeron is a prescription drug primarily indicated for the treatment of Major Depressive Disorder (MDD) in adults. The safety and efficacy of Remeron for the management of MDD in pediatric patients have not been established. 

Uses and Dosage 

Prior to initiating the use of mirtazapine, carefully review the Medication Guide supplied by the pharmacist. Any questions concerning the medication should be directed to the physician or pharmacist. 

Take this medication orally, either with or without food, as prescribed by the physician, usually once daily at bedtime. The dosage is dependent on the individual’s medical condition and response to treatment. 

For optimal results, administer this medication routinely at the same time each day. It may take between 1 and 4 weeks to observe an amelioration of symptoms. Essential not to exceed the prescribed dose or frequency. 

Continue the use of this medication even if symptom improvement is apparent. Discontinuation of this drug should not be attempted without consulting the physician, as some conditions may deteriorate upon abrupt cessation of the medication. It may be necessary to gradually reduce the dosage to discontinue use. 

Side Effects 

Allergic Reactions

In the event of an allergic reaction to Remeron or a severe skin reaction, seek emergency medical help. Signs of an allergic reaction include: 

• Hives 
• Joint pain 
• Fever 
• Difficult breathing 
• Swelling in the face or throat 

Severe Side Effects

Report any new or worsening symptoms to your physician, such as: 

• Mood or behavior changes 
• Anxiety 
• Panic attacks 
• Trouble sleeping 
• Feeling impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or having thoughts about suicide or hurting oneself 

Call your doctor immediately if you experience: 

• Racing thoughts 
• Decreased need for sleep 
• Unusual risk-taking behavior 
• Feelings of extreme happiness or sadness 
• Being more talkative than usual 
• Blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights 
• A light-headed feeling, like you might pass out 
• Severe rash, blisters, or swelling on the palms of your hands or the soles of your feet 
• A seizure 
• Low white blood cell counts:
  • Fever
  • Chills
  • Sore throat
  • Cough
  • Sores in your mouth or nose
  • Flu-like symptoms
  • Trouble breathing 
• Low sodium level:
  • Headache
  • Confusion
  • Slurred speech
  • Severe weakness
  • Vomiting
  • Loss of coordination
  • Feeling unsteady 

Seek medical attention immediately if you have symptoms of serotonin syndrome, such as: 

• Agitation 
• Hallucinations 
• Fever 
• Sweating 
• Shivering 
• Fast heart rate 
• Muscle stiffness 
• Twitching 
• Loss of coordination 
• Nausea 
• Vomiting 
• Diarrhea 

Common Side Effects  

• Drowsiness 
• Dizziness 
• Increased appetite 
• Weight gain 

Caution 

Before taking mirtazapine, inform your healthcare provider if you have any allergies or if you are allergic to any of the inactive ingredients present in the medication. You should inform your pharmacist about any other allergies you may have. 

Disclose your medical history to your doctor or pharmacist, particularly if you have a history of psychiatric disorders, suicide attempts, liver or kidney disease, seizures, high cholesterol or triglyceride levels, heart disease, stroke, dehydration, low blood pressure, or glaucoma. 

Mirtazapine may cause QT prolongation, which is a condition that affects the heart rhythm and can cause serious symptoms, such as irregular heartbeat or fainting. Therefore, inform your healthcare provider about all the medications you are taking and any medical conditions you have that may increase the risk of QT prolongation. 

The use of alcohol or marijuana (cannabis) can increase the risk of dizziness or drowsiness caused by mirtazapine. Avoid driving or operating machinery until you know how this medication affects you. 

If you are an older adult, you may be more sensitive to the side effects of mirtazapine, including drowsiness and QT prolongation.