Drugs Q & A

How Does Mirtazapine Make You Feel?

Mirtazapine is a fast-acting novel antidepressant with a dual-mode of action. It is a noradrenergic and specific serotonergic antidepressant (NaSSA) that acts by antagonizing the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors as well as by blocking 5-HT2 and 5-HT3 receptor which enhances the release of norepinephrine and 5-HT1A-mediated serotonergic transmission and fast tract effects.

Mirtazapine is used to treat depression. It comes as an oral immediate-release tablet or an orally disintegrating (dissolving) tablet. Mirtazapine is available as the brand-name drugs Remeron (immediate-release tablet) and Remeron Soltab (orally disintegrating tablet). Both forms are also available as generic drugs. Generic drugs usually cost less than brand-name versions. In some cases, they may not be available in every strength or form as brand-name drugs.

Mirtazapine may be used as part of a combination therapy. This means you may need to take it with other medications.

How should I take mirtazapine?

Take mirtazapine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take the medicine at the same time each day, usually at bedtime.

Take the regular tablet form of mirtazapine with water.

You may take mirtazapine with or without food.

Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet on your tongue and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves.

It may take a few weeks for your symptoms to improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

Do not stop using mirtazapine suddenly, or you could have unpleasant symptoms (such as dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or electric shock feelings). Ask your doctor how to safely stop using this medicine.

How does mirtazapine make you feel?

When you take mirtazapine, you will feel hungrier and sleepy, this can cause you to eat more and gain weight. The sleepy effect of mirtazapine can affect your concentration and focus. This side effect may be more intense if combined with alcohol or other medications that cause drowsiness, such as anxiety and sleeping medications. Avoid activities that require you to be alert, like driving or operating machinery, until you know how this medication affects you.

Mirtazapine generally works faster than other antidepressants, especially for insomnia and anxiety. Many people feel some improvement shortly after starting the medication, but it can take up to 6 weeks before you feel the full benefits.

However, it is important to note that mirtazapine is not a sleeping pill and is not FDA-approved to treat insomnia, other sleeping conditions, or anxiety.

Is mirtazapine like Xanax?

No. You might experience some of the same side effects while taking Xanax or mirtazapine, but the two medications belong to different medication classes. mirtazapine is an antidepressant, while Xanax is a benzodiazepine. They work on different chemicals in your brain to change your mood.

How Long Does It Take For Mirtazapine To Work?

Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Is mirtazapine safe to take while pregnant?

It’s unknown if mirtazapine will harm your unborn baby. Let your provider know if you’re pregnant or planning on becoming pregnant before starting this medication. There is a National Pregnancy Registry for Psychiatric Medications to monitor the safety of certain medications during pregnancy. If you are currently pregnant and taking mirtazapine, it is encouraged that you enroll in the registry.

What are the side effects of Mirtazapine?

Mirtazapine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

•        anxiousness

•        confusion

•        constipation

•        dizziness

•        drowsiness

•        dry mouth

•        increased weight and appetite

•        nausea

•        vomiting

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

•        chest pain

•        fast heartbeat

•        flu-like symptoms, fever, chills, sore throat, mouth sores, or other signs of infection

•        seizures

Mirtazapine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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