Mirtazapine (Remeron)

Mirtazapine (Remeron), another newer antidepressant, enhances both norepinephrine and serotonin activity. It works through a a mechanism different from that of venlafaxine. Mirtazapine may be effective for both mildly depressed patients and for more severely depressed patients. It may be particularly helpful for depressed patients who are very anxious or nervous.

Doses of Mirtazapine

The dose range for mirtazapine is 15 to 45 mg per day.

Side Effects of Mirtazapine

The side effects of mirtazapine are:

Tiredness
Dry mouth
Increased appetite
Weight gain
Constipation
Sleepiness
Dizziness

Caution: Consult your doctor if you develop signs of an infection (such as fever). This could indicate a rare fall in the white cell count, a rare but dangerous side effect. Can also cause increased blood levels of cholesterol and triglycerides.

Mirtazapine is not likely to cause stomach upset, insomnia, nervousness, and sexual problems commonly seen with the SSRIs.

Drug Interactions for Mirtazapine

Because mirtazapine is relatively new, very little information about drug interactions is available. 

Mirtazapine must not be combined with the MAOI antidepressants because of the risk of the serotonin syndrome (hyperpyrexic crisis).

Because it can be quite sedating, mirtazapine will enhance the effects of other sedative drugs. These include alcohol, major and minor tranquilizers, sleeping pills, some antihistamines, barbiturates, sleeping pills, many other antidepressants, and the anti-anxiety drug busiprone (BuSpar).

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