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Remeron (Mirtazapine) is an antidepressant. It is thought to positively affect communication between nerve cells in the central nervous system and/or restore chemical balance in the brain.

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Remeron is a new-generation antidepressant that is characterized by the absence of "withdrawal" syndrome and copes well with anxiety depressions.

Remeron is an antidepressant that weakly increases the activity of serotonin and norepinephrine neurons. Some drugs deal with depression better or worse, but this drug is quite strong in its niche. It is prescribed when a person has negative emotions, he is moping, he is irritated by the world around him. The strength of the effect is determined by the individual tolerability of the drug. Mirtazapine belongs to the fifth (average) category of tolerance, i.e. not the worst, but not the best. Although there are States when it fits perfectly, and there are such depressions in which it is categorically impossible to prescribe it. We'll figure it out.


Any medications can give so-called non-curative side effects. In depression, substances are used that sometimes affect neurons that are not necessary for treatment at all, these are not their curative, side effects. Remeron, in parallel with its clinical purpose (to enhance the synthesis of serotonin and norepinephrine), inhibits histamine neurons, and this effect is completely unnecessary for the treatment of depression, which requires the activation of serotonin, norepinephrine and dopamine neurons. Side effects associated with inhibition of histamine nerve cells are most often manifested by drowsiness, increased fatigue, and increased appetite, which leads to an increase in body weight.

Many psychotherapists, because of this feature, prescribe the drug for any depressed States, when patients have no appetite or are tormented by insomnia. But the direct purpose of the drug is to save a person from:

  • moping;
  • irritability;
  • feelings of guilt;
  • anxiety;
  • alarms.

Psychotherapists recommend using mirtazapine only in the treatment of depressive episodes of mild or moderate severity because it is of average effectiveness. If patients have sleep disorders, decreased appetite, and body weight, then the side effects of the drug become therapeutic and will benefit.


The original drug is called Remeron, it is added to various generics, although it is an antidepressant that selectively affects the production of serotonin and norepinephrine. Because of this, various emotional, behavioral, and motivational effects appear.

However, there is no effect on cognitive functions. Practically do not change:

  • cognitive mechanisms;
  • structure and forms of thinking;
  • formation of associative links;
  • thought processes;
  • memory;
  • attention;
  • imagination.


After taking Remeron, a powerful sedative and hypnotic effect quickly set in, so the drug is usually taken at night, an hour before bedtime. If it is taken during the day, then due to the sedative effect, thinking, memory, and attention will be inhibited. Sometimes such residual manifestations occur during the day, even in cases when mirtazapine is correctly taken at night. Another slight slowdown in all cognitive and mental processes due to the powerful sedative effect of mirtazapine occurs with prolonged use.


In General, remeron is considered an anti-anxiety antidepressant. But in practice, it happens that this effect is not observed, or the opposite effect occurs.

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In combination with benzodiazepine tranquilizers, this does not happen, because they further enhance the sedative, calming effect, which occurs quite quickly. But with monotherapy, it happens that the state of the emotional sphere does not change for the better.

Mirtazapine activates the synthesis of norepinephrine, so it gives some cheerfulness, increases tone. But sometimes it happens that calmness is replaced by emotional fluctuations, irritability, and in some people even anger. In people with high emotional lability, with a bipolar or borderline personality disorder, this will be shown, with a high degree of probability. No wonder norepinephrine is called the predator hormone.

That is, in such people with an average conditional anxiety-depressive neurosis, it happens that the positive antidepressant effect, which is first realized in a state of increased tone and cheerfulness, quickly passes. And in the future, instead of it, all sorts of unexpected manifestations of hypertonus come, because of which mirtazapine has to be abandoned.

Behavior CHANGE

As for the influence on the behavioral side, in most cases, there are no large motivational and value changes on the behavioral side. Food and sexual behavior also do not change. Remeron does not affect sexual behavior as strongly as serotonin antidepressants, such as selective serotonin reuptake inhibitors. This means that the substance does not affect social activity either. Although under its influence, a person becomes much more sociable.


Many people note that this is a good drug with a sufficient antidepressant effect, characterized by a small number of side effects. It has a good anti-anxiety effect, and in most cases, it is prescribed for anxiety depressions (men with psychosis or psychosis in women). It works very well in cases where there are suicidal thoughts or intentions. The drug does not harm the heart and is generally well-tolerated.

The substance works even better when combined with depression, anxiety, sleep disorders, and lack of appetite. In such cases, the effect is noticeable already at a dosage of 15 mg. Persistent improvement occurs in about 2 weeks.


If we are talking about mild and moderate depression, then Remeron is highly effective. But not in all cases. If the disease is severe or accompanied by fatigue, fatigue, lethargy, drowsiness, then Remeron is not suitable for monotherapy or complex therapy.

Mirtazapine cannot be used to treat absolutely any depression in any patient. It is necessary to take into account the sedative and hypnotic effects of the drug, as well as the tendency of most people taking it to gain bodyweight. If you do not take into account these nuances, you can make a lot of mistakes and worsen the undesirable consequences for the patient.


The strength of Remeron is sufficient for effective monotherapy, but psychotherapists successfully combine it with other drugs. Sometimes it is combined with serotonin reuptake inhibitors for strengthening, with which it is not quite well combined due to different mechanisms of action.

Incongruity may occur due to personal intolerance. Most often, it is manifested by increased sleepiness. The second negative result of intolerance is weight gain. In such cases, you should not expect the stabilization of the state, it will not occur. You need to change the antidepressant, and not try to smooth out its side effects with other medications.

Also, the increase in body weight is because the production of antidiuretic hormone is disrupted in the metabolic process, which results in water retention in the body.


This is a new generation of antidepressants, an important advantage of which is that it has a weak withdrawal syndrome, and this is very important.

After a long period of taking first-generation antidepressants and abruptly stopping the use of tablets, most patients begin to "break", almost like drug addicts.

Remeron is a new-generation drug that has almost no such withdrawal syndrome. This is evidenced by many real users. If you stop the course of administration not abruptly, but gradually, then the body will calmly, without stress, adjust to a new way and will do without medication.

Another undoubted advantage – a week after daily use of tablets at night, sleep is completely normalized, the person gets rid of insomnia. And this is in the absence of sleepiness in the daytime. If it is, it is light and passes in 1-2 weeks at most. In any case, such a "cast-iron" head, as from classic sleeping pills, from mirtazapine never happens.

This drug has, in addition to the actual antidepressant effect, which develops over 1.5-3 weeks, also a sedative, calming effect. Which again is a plus for drugs of this plan, because you do not need to prescribe additional sedatives.

As psychiatrists say, sedation is never unnecessary. Of course, when a person lies flat, can't get up, sleeps all the time for days, then it is unnecessary to calm him even more. But it is often observed that depression is combined with anxiety, agitation (motor anxiety due to fears and anxiety). And then psychotherapists are forced to prescribe antidepressants and use tranquilizers or sedatives of any other group. For example, light daytime neuroleptics.

When taking Remeron, if there is an anxiety depression or agitation, additional prescription of sedatives is not required.


Remeron is a modern antidepressant that affects not only the serotonin exchange system but also norepinephrine, i.e. it affects the two main mediators responsible for the state of the emotional sphere. This drug has fairly good tolerance, side effects are minimal.

The antidepressant effect develops gradually, over 1.5-3 weeks. A persistent calming effect occurs in the same interval.

In General, people respond well to it, it quickly adjusts sleep and appetite, the activity of people increases, i.e. there is a good antidepressant effect in the working dosage of 15-45 mg. Psychotherapists focus on the ability of this drug to quickly remove suicidal thoughts and intentions.

Even though many people call Remeron the most harmless antidepressant, it also needs to be handled carefully, before taking it, you should consult your doctor, although you can buy Remeron without a prescription.

And once again, we remind you: if depression is accompanied by weakness, drowsiness, fatigue, and Heartbreak, then Mirtazapine is not suitable in this case.

This content has been written and checked for quality and accuracy by Dr. Frederic Kass
Updated on: 13/06/2020


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