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US Brand Name:
Remeron
A link here will take you to the official website for the drug.
Other Brand Names: Avanza, Axit (Australia)
Mirtabene (Austria)
Remergon (Belgium)
Norset (France)
Remergil (Germany)
Mirtaz (India, Sri Lanka)
Rexer (Spain)
Zispin SolTab (United Kingdom, Ireland)
Generic Name: mirtazapine
Other Forms: You might be able to get it in pill form. These days the disintegrating tablet is the main way Remeron is dispensed.
What is Remeron: Remeron is an
Antidepressant, specifically a tetracyclic antidepressant.
Read up on these sections if you
haven't done so already, because they cover a lot of information about multiple
medications that I'm not going to repeat on many pages. I'm just autistic
that way about not repeating myself.
What is the FDA Approved Use of Remeron: Remeron is officially approved to treat major depressive disorder.
What are some of Remeron'sOff-Label Uses: Additionally Remeron is prescribed unofficially to treat:
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Remeron's pros and cons: Pros: If serotonin and/or norepinephrine are the answer for you, Remeron will pull you out of the deepest, blackest depression like no other medication will. Cons: You will literally eat sugar straight out of the bag to satisfy your cravings for sweets and carbohydrates. Remeron's Typical Side Effects: Most of the anticholinergic effects common with psychiatric medications (e.g. constipation, confusion, loss of coordination, memory loss) are infrequent with Remeron. Instead you get intense hunger for the wrong foods, and with that comes weight gain, dry mouth and constipation caused by what you eat and not Remeron itself. Then you want to sleep a lot. It's like you may as well be smoking pot when you take Remeron. For tips on how to cope with these side effects, please see our side effects page. Remeron's Not So Common Side Effects: Edema, dizziness, low blood pressure, increased thirst
to go with the munchies, 'flu-like symptoms. Remeron's Freaky Rare Side Effects: Going deaf and various flavors of herpes. Yeah, right, Remeron gave someone an STD. Remeron also carries a warning for agranulyocytosis, the severe reduction in white cell count, along with fever, infection and all that fun stuff. That hit Mouse like a ton of bricks. She was stuck in a motel in Fairfield for a week after one dose of Remeron. You aren't going to get these. I promise. For all side effects, see the PI sheets below. Interesting Stuff Your Doctor Probably Won't Tell You: Remeron appears to be subject to a really quick poop-out, like after just a month or so. Works great, then quits on you. Remeron will make you more drunk. So while liquor as no effect upon Remeron, the opposite is not true. Be extra careful if you mix booze and Remeron. |
Remeron's Dosage and How to Take Remeron: The initial dose of Remeron is 15mg. If no improvement is felt within two weeks, that may be increased to 30mg. If you're still not feeling better a month after that, you can go up to 45mg and officially that's it, although there are reports of some psychiatrists experimenting with doses up to 90mg. There are no other published dosage options for Remeron at this time, it's just weird that way. 15, 30 or 45mg. Some of the more enlightened doctors are starting their patients at 7.5mg and titrating them in 7.5mg increments, and I'm all for that method. If I were you, and I got along with meds that messed with my serotonin, I'd insist on that. 7.5mg to start, up to 15mg after a week or two if no improvement, then 22.5mg after a month and so forth up to 45mg. I think the 90mg craziness is in response to Remeron poop-out, which is just exposing people to side effects for no good reason.
Days to Reach a Steady State: Five days.
How Long Remeron Takes to Work: Remeron works within two weeks.
Remeron's Half-Life: 20-40 hours. The average is 26 hours for guys and 37 hours for girls. Girls always take longer.
Average Time for Remeron to Clear Out of Your System: Remeron is out of a guy's system in about five days while it's out of a girl's in about seven days. to step down by 7.5-15mg a day, while a girl needs seven days to do that.
How to Stop Taking Remeron: Your doctor should be recommending that
you reduce your dosage by 7.5 - 15mg a day every week if you need to stop taking
it, if not more slowly than that. Based on the 20-40 hour half-life.
For more information, please see the page on how to
safely stop taking these crazy meds.
If you've worked your way up to a particular dosage, it's usually best to spend this
many days at the next lowest dosage before going down the next lowest dosage before that
and so forth. This is the least sucky way to avoid problems when stopping any psychiatric
medication. Presuming you have the option of slowly tapering off them.
How Remeron Works In Your Brain: Remeron enhances the activity around the receptors for serotonin and norepinephrine, so unlike the SSRIs and SNRIs, Remeron stimulates your brain to release more of the serotonin and norepinephrine it has. It also antagonizes the H1 histamine receptor (i.e. it's one hell of a central nervous system antihistamine, sort of like super Benadryl), which is a big reason why you get so tired and so hungry. At 15mg it will also make you very sleepy, yet at 30 and 45mg the sleepiness sometimes isn't so much of an issue. My guess is that at the higher dosages the extra norepinephrine regulates your sleep, trumping the sedation that often accompanies messing around with serotonin and histamine. Then again, sometimes not. Remeron has been studied for sleep disorders, not just making you sleep more but improving the quality of your sleep. It ranks up with trazodone as the official antidepressant of Sleepy-bye Land. Serotonin and norepinephrine are two of the big three neurotransmitters responsible for depression, along with dopamine. My wild-ass guess / rule of thumb is that imbalances of one or more of the three are responsible for 80% of the depression issues. It's all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.
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Comments: At any dosage it will make you crave doughnuts. Seriously. You will want to invest in
Krispy Kreme stock
(or maybe something along similar lines that isn't tanking); as Remeron's
antagonism of the H1 receptor and stimulation of your serotonin
production gives you the munchies for
carbohydrates and sugars like you were 16 and smoking the best pot ever in the parking lot
of a strip mall with a 24-hour doughnut shop beckoning you with glazed and jelly-filled
ecstasy. People dipping spoons into a bag of sugar and eating it as is - not unheard of
when on Remeron. This stuff is nothing more than legal marijuana, and if I knew crap about
biochemistry I could probably prove that crazy statement. From a purely
molecular-chemical perspective THC and mirtazapine are nothing alike.
But there's just something about how the two drugs work that is really
close. And people who have self-medicated with pot respond really
well to meds that really push the norepinephrine, and hard.
Strattera,
reboxetine, Cymbalta, and the more
potent TCAs. And Remeron. The production of extra serotonin and norepinephrine, and not just soaking neurons in what neurotransmitters are available, is sometimes the best solution to recalcitrant depression. When it works it makes people feel really good. I mean really good. Remeron is the closest thing to a happy pill on the market. Until you get all bummed out about how much weight you've put on and how little you do because you're sleeping all the time. Remeron is not for mild to moderate depression, it's for people who are seriously depressed, who are willing to put up with the weight gain and the sleeping because those side effects suck much less than the dark pit of depressive despair one finds oneself in. Just don't mix Remeron with Zyprexa as your choice of antipsychotic and antidepressant. One woman was recently prescribed that combination as an inpatient in a Canadian hospital. She reported on the bipolar support forum on about.com how she ballooned up in weight, from 103 pounds to 162 pounds, in about six weeks, and carrying that on a 5' 1" frame. She gained a pound and a half a day, eating hospital food!
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Have questions about Remeron? Want to read about experiences other people have had with Remeron? Check out our Remeron Board.
Manufacturer: Organon
Sample US Cost:About $100 for 30 tablets of whatever size you want: 15mg, 30mg or 45mg.
As of 11/11/2003. Full retail for the uninsured. Go ahead and gloat, citizens of civilized countries and all of you with full medical coverage.
Sample Canadian Cost: $54 for 30 30mg tablets.
As of 11/11/2003. In US dollars, for re-importation to the US. Does not include any shipping charges.
Remedy Find Rating for Depression
Remedy Find Rating for Sleep Disorders
Check for Drug-Drug Interactions
Full US Patient/Prescribing/Physician Information Sheet
UK PI Sheet for Zispin SolTab (What they give patients)
UK SPC Sheet for Zispin SolTab (What doctors are supposed to read)
South African
Remeron PI Sheet
Please see the section on how to read these sheets. Don't freak out about every potential side effect. Look at the odds of
something having happened during the clinical trials.
Wikipedia's mirtazapine article
The Overlords of the 12 Zernox Galaxies have compelled me through messages in the Sunday Chronicle to beg you for funds to help squash the Arachnoid uprising. So if this site has been of use and/or amusement to you, we'd be grateful if you could donate some cash.
Visit the Support Page for how you can help if you don't have any money laying around. This includes reviewing Crazy Meds for Amazon.com and/or
There's also our Mental Mall, to purchase some books or t-shirts.
Crazy Meds Home Crazy Meds Talk About Antidepressants About SSRIs About Anticonvulsants / Mood Stabilizers About Atypical Antipsychotics About Benzodiazepines About Stimulants Finding a Doctor Sites with More Information Support Group Sites About Crazy Meds Crazy Meds: The Blog
Take care, and keep taking your crazy meds!
Jerod
If you still have unanswered questions about this or other medications,
including which one is, or combination of meds are the best for you, your best
bet is to ask on Crazy
Meds Talk. Better yet, if you want to let the world know how they
worked out for you and want to help out others in their quest for the correct
meds, join the party.
If you want to discuss your issues, I suggest checking out one of
the various
support groups online.
Otherwise, if you're letting me know about how much you like or hate the site,
or need to let me know about medication effects in private, then just drop
a note to jerod23 at gmail dot com Honestly, I usually don't have a
lot of time to answer e-mail these days. The snide autoresponse
message that may or may not hit your mailbox is going to tell you the same
thing.
Another problem is that you may not get a response even if I wanted to send you
one. You see, so many dickweeds with malicious intents and too much time
on their hands have appropriated the crazymeds.org domain name to use for their
spam, viruses and the like. Subsequently some lazy-ass e-mail protection
software authors just go by the domain name, and not the IP address. So
I've been blacklisted because of the actions of others. Or the software
just doesn't like the domain name because of the "crazy" and/or "meds." Or
your question about a particular medication will set off spam flags. So
the e-mail just wouldn't go through regardless. Sorry.
Dead tree references:
Mosby's 2004 Drug Guide David Nissen PharmD, Editor.© 2004. An imprint of Elsevier. The edition we're using isn't listed on Amazon.
Physicians' Desk Reference Edition 59 Min Ko and Greg Tallis, Drug Information Specialists, et al. © 2005. Published by Thomson PDR.
Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton
Essential Psychopharmacology Stephen M. Stahl, M.D., Ph. D. © 2000. Published by Cambridge University Press
Essential Psychopharmacology of Depression and Bipolar Disorder Stephen M. Stahl, M.D., Ph. D. © 2001. Published by Cambridge University Press
A Primer of Drug Action Robert M. Julien, M.D., Ph. D. © 2001. We use the Ninth Edition. Sometimes that comes up on an Amazon search, usually it doesn't. Published by Worth Publishers
End of books used for this article.
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Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.
Created Friday, November 07,2003
Last updated Saturday, May 15, 2010
Copyright © 2003 - 2007 Jerod Poore. All rights reserved.
Almost all of the material on this site is copyright © 2002, 2003, 2004, 2005, 2006 and 2007 Jerod Poore. Except, of course, the PI sheets, those are the property of the drug companies who developed the drugs the sheets are about. And any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That's usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that's OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I'm cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won't necessarily happen to you. Nobody on this site is a doctor, therapist, or a pharmacist. We don't portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don't be a cyberchondriac, thinking you have every disease you see a website about, or that you'll get every side effect from every medication. Self-prescribing is just as dangerous. All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site. Know your sources! As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it. No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away. If you didn't get a PI sheet, demand one. Loudly. Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they're paid advertisements, or they're something you should read to make an informed decision about a particular med. Sometimes they're more than one of those things. But what's on those sites is their business, not ours. Very little information about visitors to this site is collected or saved. And from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.
"Everything is true, nothing is permitted." - Jerod Poore
