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Handouts · Medications

Mirtazapine (Remeron)

An antidepressant that helps sleep and appetite. Often chosen when poor sleep, low appetite, or weight loss are part of the picture.

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What It Is

Mirtazapine boosts mood while also improving sleep and appetite. It works differently from SSRIs and has few sexual side effects.

It is often used when depression comes with insomnia or weight loss.

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How to Take It

Take at bedtime — it is sedating and helps you sleep.

Interesting quirk: lower doses can be MORE sedating than higher ones. Take with or without food. If daytime grogginess is a problem, tell us.

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Black Box Warning

Like all antidepressants, it carries a small risk of increased suicidal thoughts in people under 25, mainly early in treatment. Watch closely and call if things worsen.

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Common (Usually Mild) Side Effects

  • Drowsiness and next-morning grogginess.
  • Increased appetite and weight gain.
  • Dry mouth, dizziness.
  • Vivid dreams.

Serious — Call Us or Seek Care

  • Signs of low white blood cells (rare): fever, sore throat, mouth sores, or infection that won’t clear.
  • Serotonin syndrome if combined with other serotonin drugs.
  • Big jumps in cholesterol or triglycerides.
  • New agitation or a “high”/racing mood.
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Alcohol & Interactions

Avoid alcohol — it adds strongly to the drowsiness.

Use caution with other sedatives and serotonin drugs.

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Monitoring

We may track your weight and check cholesterol/triglycerides over time.

A blood count (CBC) is done if you develop signs of infection.

This is general information, not a substitute for your prescriber's advice. Never start, stop, or change a dose on your own — some of these medicines need a slow, supervised taper. Bring this sheet to your appointments and ask questions.