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Remeron (mirtazapine)

Indications

Remeron is indicated for the treatment of major depressive disorder.

Dosage and Administration

• Take Remeron exactly as directed by your healthcare provider. The typical starting dose is 15 mg once daily, usually in the evening. Your healthcare provider may adjust the dose every 1 to 2 weeks based on your response to treatment. The maximum recommended dose is 45 mg once daily.
• Take the medication at the same time each day to ensure its effectiveness. It may take 1 to 4 weeks to notice an improvement in symptoms.
• Use the medication regularly to obtain the most benefit from it. If a dose is missed, take it as soon as you remember unless it’s close to the next scheduled dose.
• Keep your healthcare provider informed about your condition.
• Do not increase the dose or take it more often than prescribed.
• Do not stop taking the medication without consulting your healthcare provider.
• Do not take two doses at once if you miss a dose.
• Do not abruptly stop the medication without your healthcare provider’s advice.

Mechanism of Action

Mirtazapine works by increasing the levels of neurotransmitters, specifically norepinephrine and serotonin, in the brain. These neurotransmitters help regulate mood and emotional responses. By enhancing their activity, mirtazapine helps alleviate symptoms of depression.

Contraindications

• Known hypersensitivity to Mirtazapine or any of its ingredients.
• Using along with monoamine oxidase inhibitors (MAOIs).

Side Effects

Common Side Effects:

• Drowsiness
• Dizziness
• Increased appetite
• Weight gain

Serious Side Effects:

• Symptoms of serotonin syndrome (agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea).
• Swelling of the hands/feet
• Shaking (tremor)
• Confusion
• Fast/irregular heartbeat
• Severe dizziness
• Fainting
• Eye pain/swelling/redness
• Widened pupils
• Vision changes (seeing rainbows around lights at night, blurred vision)
• Suicidal thoughts and behaviors, especially in children and young adults taking antidepressants

Precautions

• Remeron may cause drowsiness, dizziness, and increased appetite, which can affect your judgment, thinking, and motor skills.
• Be cautious when driving or operating machinery until you know how Remeron affects you.
• Avoid alcohol, as it can increase the sedative effects of Remeron.
• Watch for signs of mania or hypomania and report these to your healthcare provider immediately.
• Do not stop taking Remeron suddenly; it is recommended to gradually reduce the dose to avoid adverse reactions.
• Make sure to screen for personal or family history of bipolar disorder, mania, or hypomania before starting Remeron.
• Wait at least 14 days between stopping an MAOI and starting Remeron, and vice versa.
• Remember that Remeron is not approved for use in children.
• Keep all your appointments with your healthcare provider and report any new or worsening symptoms.
• Maintain a list of all medications you are taking and share it with your healthcare provider.

Storage Instructions

• Store at 25°C (77°F).
• Keep the medication in its original container, tightly closed, and out of reach of children.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020415s023s024.pdf