Remeron has a boxed warning, the most serious type of warning from the Food and Drug Administration (FDA). Remeron’s active ingredient mirtazapine has a risk of suicidal thoughts and behaviors in young adults. Remember to discuss the risks with your healthcare provider.
Let’s start this article with some mindblowing statistics. Anxiety disorders affect
Sometimes, therapy is chosen as first-line help, while for some patients, medication is more suitable. There are different medications prescribed for anxiety, and one of them is Remeron (mirtazapine), an antidepressant treatment. It helps improve a patient’s mood and calms anxiety symptoms. In this post, let’s learn more about this medicine.
Highlights
- Remeron or mirtazapine is an antidepressant prescribed to relieve symptoms of depression and anxiety.
- Although mirtazapine is only FDA-approved for treating major depressive disorder (MDD), it is also used off-label to treat anxiety-related insomnia.
- Mirtazapine also has benefits for underweight patients with anxiety, as it is an appetite stimulant.
What Is Mirtazapine?
Mirtazapine, the generic name for the original brand name Remeron, belongs to the atypical
Although it is FDA-approved for the treatment of
Other conditions that doctors may prescribe mirtazapine for are insomnia, tension headaches, hot flashes, and migraines.
Major depression and anxiety go hand in hand:
- Up to 8 out of 10 untreated patients with a first episode of MDD have
anxiety symptoms [4*] - 2 out of 10 patients with MDD might have a
co-existing anxiety disorder [5*]
Mirtazapine Side Effects
We’ll discuss this up front, because some of the potential side effects of mirtazapine, although they are unacceptable to most individuals, actually benefit specific people with anxiety; so it’s important to know what these effects are.
The Most Common Side Effects of Mirtazapine
Patients are at increased risk of experiencing side effects when they start mirtazapine, settling down as their body adjusts to the medication. So, your healthcare provider will probably begin treatment with a low dose and gradually increase it as your body adapts. The
- Increased appetite (17%)
- Weight gain (12%)
- Sleepiness and sedating effect (54%)
- Dizziness (7%)
- Dry mouth (25%)
- Constipation (13%)
Most people don’t want to feel drowsy and gain weight. However, an underweight individual with no appetite and insomnia will find this helpful.
Warnings and Serious Side Effects
There are a
- Low white blood cell count. Fever, chills, sore throat, mouth or nose sores, flu-like symptoms, and infections.
- Serotonin syndrome. Fast heartbeat, flushing, shakes, seizures, dizziness, confusion, aggressiveness, sweating, high body temperature, nausea, vomiting, diarrhea, unusual thoughts, and seeing or hearing things that are not real.
- Suicidal and self-harming thoughts. Particularly in young adults.
- Any severe rash.
- Increased eye pressure. Red, painful eyes or blurred vision.
- Acute pancreatitis. Severe stomach pain and vomiting.
- Increased cholesterol.
Other Precautions
Unfortunately, mirtazapine may not be a good choice for everyone. If a person has any of the following health issues, they should not take mirtazapine:
- Heart problems: It can cause abnormal rhythms.
- Epilepsy: Although rare, it might raise seizure risk.
- Glaucoma: Eye pressure may increase.
- Allergy: People with a history of severe reactions to the medication should not use mirtazapine.
- Diabetes: Raised blood sugar is a rare side effect.
- History of pancreatitis.
Drug Interactions
Interactions between Remeron and other medications may reduce the effectiveness of either of them, change how long it takes for the medicine to start working, or increase the risk of side effects.
Mirtazapine cannot be taken with monoamine oxidase inhibitors (MAOIs), such as isocarboxazid, phenelzine, or tranylcypromine. It can only be started 14 days after stopping MAOIs.
Another life-threatening reaction,
Medications that might clash with mirtazapine include:
- Anticoagulants, such as warfarin
- Buspar
- Lithium
- Abilify (Aripiprazole)
- Selective serotonin reuptake inhibitors (SSRIs), including Celexa, Lexapro, Luvox, Prozac, Paxil, and Zoloft.
- Selective serotonin and norepinephrine reuptake inhibitors (SNRIs), including Cymbalta, Effexor, and Pristiq.
- Tricyclic antidepressants
- St. John’s Wort
- Valium
Patients should also avoid alcohol when taking mirtazapine, as it can increase the drowsiness effects of this medication.
This is not a complete list of interactions with Remeron. Patients should always consult their healthcare provider to familiarize themselves with all the possible drug interactions.
Remeron Overdose and Withdrawal Symptoms
Stopping taking Remeron for anxiety suddenly can cause withdrawal symptoms. If patients feel better, they should consult their doctor about tapering off mirtazapine to avoid this.
Using Remeron for Anxiety: The Facts You Need to Know
Mirtazapine does help with anxiety, but doctors don’t typically prescribe it as a first-line therapy for anxiety because of the common side effects listed above.
If these agents are not effective, healthcare providers may consider remeron for sleep and anxiety, especially in patients who are
Typical Mirtazapine Dosage for Anxiety
Mirtazapine is available in the form of:
- 15 mg, 30 mg, or 45 mg dispersible tablets
- 7.5mg 15 mg, 30 mg, or 45 mg tablets
Because mirtazapine is not registered for anxiety, doctors
Dosage for MDD: A starting dose of 15 mg of mirtazapine each day before bedtime for two weeks is standard before reassessing the person’s depression and anxiety symptoms; for uncontrolled symptoms, the dose is increased.
The dose is increased slowly by 15 mg every two weeks until symptoms are controlled, to a maximum dose of 45 mg daily.
For example:
- Week 1 and 2一15 mg before sleeping
- Week 3 and 4一30 mg before sleeping
- From week 5 onwards一45 mg before sleeping
The examples of mirtazapine dosages are provided for informational purposes only. Please consult your physician about an individualized treatment plan and never exceed the prescribed dosage.
Effectiveness of Mirtazapine for Anxiety
The expected timeline for seeing improvements on Remeron (mirtazapine) will vary from patient to patient, as no two cases of anxiety or depression are the same.
How Long Does It Take for Mirtazapine to Work for Anxiety?
While many people report feeling better soon after beginning treatment, the full benefits of the medication may not become apparent for up to six weeks.
How Long Does Mirtazapine Take to Work for Panic Attacks?
Remeron for panic attacks is not helpful as a treatment because it takes weeks to feel an effect; an anxiety attack needs medication that works in minutes. But, it is used off-label sometimes to treat panic disorder.
Comparing Mirtazapine With Other Anxiety Treatments
It is always recommended that the starting treatment for anxiety is an SSRI or SNRI. However, Remeron may be more effective in treating insomnia and anxiety than other antidepressants because of its sedating effect.
Sometimes, mirtazapine is
Another benefit of mirtazapine is that it is
It is also a safer second-line anxiety treatment option, compared to benzodiazepines, as it is not addictive.
Patient Experiences
Summing It Up
Remeron or mirtazapine is an antidepressant prescription medication that is prescribed to relieve symptoms of anxiety and depression. The FDA approved it for treating major depressive disorder (MDD), but it may also help if anxiety prevents a patient from getting a good night’s sleep.
To know whether Remeron is appropriate for you, contact MEDvidi and book an appointment today.
FAQs
Is mirtazapine a good choice for anxiety?
Is 7.5 mg of mirtazapine enough for anxiety?
It is unlikely that 7.5 mg of mirtazapine is enough; the off-label mirtazapine dose for anxiety would be the same as for its registered condition, major depressive disorder. Consult your healthcare provider to choose the most suitable dosage.
What is the best combination with mirtazapine for anxiety?
How quickly does Remeron work for anxiety?
Remeron usually works for anxiety and sleep within a few weeks because of its side effect of drowsiness; however, the full benefits of the medication may not become apparent for up to six weeks.
Is mirtazapine better than an SSRI for anxiety?
Mirtazapine might be better than an SSRI for anxiety in some patients, especially those with insomnia who are underweight.
Does mirtazapine make anxiety worse at first?
Mirtazapine frequently (
