Remeron is the brand name for mirtazapine, an atypical antidepressant medication. It is one of the drugs under the class of Tetracyclic, Alpha 2 agonists. It is approved by the US Food and Drug Administration for depression treatment in adults. The drug modulates the brain chemicals, norepinephrine and serotonin, that influence mood, cognition, and other body functions. In this article, let’s review the basic facts about this medicine, including its uses, dosage options, side effects, and more.
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What Is Remeron Used for?
The FDA has approved Remeron for treating major depressive disorder (MDD) in adults. According to the current psychiatric manual, the DSM V, MDD or clinical depression refers to two or more weeks of persistently depressed mood, accompanied by loss of interest or pleasure in daily activities and other symptoms, leading to impairment of a person’s functioning. The other symptoms of major depression include low energy, sleep disturbances (insomnia), psychomotor agitation, feelings of worthlessness, difficulty concentrating, and suicidal ideations.
Although uncommon, mirtazapine can be used to manage other mental health disorders, including social anxiety, general anxiety, and panic disorder. However, caution is needed when treating mood problems, as the drug’s potential to exacerbate manic episodes is significant.
Remeron Dosage for Depression
The Remeron medication comes in doses of 15, 30, and 45-milligram tablets and dissolvable pills. Notably, generic mirtazapine is also available in 7.5 mg tablets. For adults, the recommended Remeron dosage for depression is as follows:
- Start dose: Initially, you should take 15 mg of Remeron once daily. To minimize symptoms, take the drug a few minutes before bedtime, with or without food.
- Maintenance dose: Your doctor may increase the daily dose of Remeron every week or fortnight until the desired effects are achieved. Nevertheless, the dosage of Remeron must not exceed 45 mg per day.
- Special consideration: For the elderly, those aged 65 years and above, lower doses are prescribed to prevent toxicity due to the decline in kidney functions and drug clearance.
What Should You Know About Remeron for Depression?
When treating depression, your doctor can prescribe Remeron medication alone or in combination with other antidepressants.
Without instructions from your doctor, do not stop taking Remeron even if you feel better. You may be recommended to take this medicine for several more weeks, depending on your status, even when the symptoms have begun disappearing.
Abrupt stoppage of Remeron treatment can result in severe withdrawal symptoms like headache, irritability, vomiting, dizziness, and unusual skin sensations. On the other hand, missing doses puts you at high risk of symptom relapse.
Consult a prescriber to know what medication and its dosage will be the most suitable for you.
Side Effects of Remeron
Like other antidepressants, Remeron has several side effects, but some are more common than others. If you are taking this drug, you are more likely to experience:
- Dry mouth
- Increased appetite and weight gain
- Hypersomnolence (sleepiness)
- Constipation
- Dizziness
While these undesired effects often disappear after a few days, some might persist, necessitating clinical intervention. When they worsen and become intolerable, call your doctor.
Uncommon But Severe Side Effects of Remeron
Some side effects associated with Remeron use are rare, but they can be life-threatening if they occur. These include agranulocytosis, serotonin syndrome, Steven-Johnson syndrome, and anaphylactic reaction. With agranulocytosis, your white cell counts are reduced, impairing your body’s ability to fight infections.
Contact emergency services immediately if you develop any sign of Remeron’s fatal side effects, including hives, difficulty breathing, skin rash, or body swelling after taking the drug.
Caution When Taking Remeron for Bipolar Depression
Treating depression that occurs as part of bipolar mood disorder with Remeron poses a significant risk of switching the depressive episodes to mania. Symptoms indicating this switch include irritable mood, decreased need for sleep, distractibility, pressured speech, and excessive energy. Individuals with mania are prone to engaging in high-risk activities, including sexual indiscretion and buying sprees. Monitoring is essential for those taking Remeron for bipolar disorder along with antimanic drugs.
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Drug Interactions and Contraindications
When co-administered, different drugs interact with Remeron to potentiate its side effects or reduce its activity. For instance, phenytoin enhances the psychoactive effects of Remeron, leading to increased dizziness and drowsiness. Other drugs that can interact with mirtazapine include Zoloft, Effexor, and fentanyl.
Hypersensitivity to Remeron is an absolute contraindication for the drug’s use. Again, individuals taking this medicine should not use other antidepressants belonging to the class of monoamine oxidase inhibitors (MAOIs). Examples of MAOI drugs include selegiline, isocarboxazid, and phenelzine. Using Remeron together with those medications can cause fatal reactions like seizures, muscle rigidity, and coma. After halting Remeron, you should wait for at least two weeks before using MAOIs.
Before starting Remeron use, you should disclose your complete medical history to the doctor.
In Summary
Remeron is a prescribed drug approved for treating major depression. Even after starting to feel better, do not stop taking this medicine unless informed by a doctor. In case of any severe or life-threatening side effects associated with Remeron use, contact the doctor or emergency services immediately.
