Remeron (mirtazapine)

[Drew]

Mirtazapine is an antidepressant introduced by Organon International in 1994 used for the treatment of moderate to severe depression. Mirtazapine has a tetracyclic chemical structure and is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA). Mirtazapine and maprotiline are the only tetracyclic antidepressants that have been approved by the U.S. Food and Drug Administration to treat depression.

More Info:
http://en.wikipedia.org/wiki/Remeron

Askapatient.com Ratings:
http://www.askapatient.com/viewrating.asp?drug=20415

RevolutionHealth.com Ratings:
http://www.revolutionhealth.com/drug...rating/remeron

[Drew]

(Copied over from old review system)

Posted by jim_morrison

Social Anxiety Background
Social Phobia/GAD/Depression/Insomnia

Treatment Experience
I've taken this medication for about 5 months, at doses ranging from 15 to 60 mg. Prior to taking this I had fairly severe insomnia.

Pros
-If you have severe insomnia this drug will help you sleep like no other med.
-Does not cause sexual dysfunction.
-Does not have any anticholinergic side effects.

Cons -
-Even after taking this medication for several months, I still find that it leaves me very groggy and lethargic during the daytime, Which I beleive is due to the powerful antihistamine properties of this drug, aswell as it's long half life.
- The associated weight gain is somewhat anoying.
- I Didn't find this drug to be particularly useful for Social phobia.
-Initially helped my depression but in the long run made it worse due to constantly being tired/lethargic.

[Drew]

(Copied over from old review system)

Posted by rustybob

Social Anxiety Background
Had social anxiety pretty much forever from growing up in a racist town. Definitely not the textbook social anxiety case, as I did have friends, played team sports, worked since I was 10 years old, did sales jobs, etc etc. I never realized I had it until I finally decided to fix my sleep problems.

My whole life I've been unable to get more than 1.5 hours straight of sleep (unless I was sick). So even though I got 8 hours I still felt like crap. This is what initially got me into trying to figure out what's wrong with me. Once I seen the list of symptoms for seratonin deficiency I knew that was my problem. My whole life have suffered from a lack of energy and motivation.

Other Treatments
Ativan (although this was initially prescribed for sleep)
Valium (not obtained through a doctor, worked great though)
Zoloft (Awful)
Wellbutrin (Still using, working great with Remeron)
5-HTP (Helped mood slightly, sleep was just as bad due to crazy nightmares)

Treatment Experience
Asked my doctor to prescribe me Remeron after Zoloft failed miserably. This seemed like the ideal drug for me, since it would help both my social anxiety and sleep issues without sexual side effects. It has worked better than I could've expected, with basically all of Remeron's side effects being couteracted by Wellbutrin.

Within the first night of taking it, I went from 1.5 hours straight of sleep to 3 hours. Within 4 weeks I was up to 6 straight hours. Right now I can get a full 8 hours of sleep, and I feel amazing because of that.

For social anxiety, the changes started about a week in, with the full effect reached about 7 weeks in. It hasn't "cured" my social anxiety, but it got me 90% of the way towards overcoming it. Now that I'm about 6 months in I'm probably 98% of the way towards overcoming it.

The most amazing thing with Remeron for me is that for most of my life I pretty much had a complete inability to feel. Within 2 weeks of taking Remeron that started to change. Now I can feel happy, be upset, be angry, get pleasure from doing positive things, etc. Combined with Wellbutrin to give me energy and motivation, I'm about as close to normal as I've ever been.

Side effects are basically non-existant for me. The Wellbutrin has stopped some of the munchies, and gives me the energy to live an active lifestyle. Also, instead of eating junk food when it gives me the munchies, I always have fruit laying around the house to eat instead. As such, I've lost weight since being on both drugs.

My dose is 45mg that I take in the morning. At 15 and 30mg it did leave me tired and groggy.

[Drew]

(Copied over from old review system)

Posted by thisisfraser

Treatment Experience
I personally can't say enough good for this medication. It has a very nice sedative effect and makes going to bed very very easy.

Before I started taking this I could never get to sleep and if I did it was only for a couple hours. I've used this now for the last 6 months and can say that I am sleeping much better now than I ever was before. Also has done wonders to help bring my general anxiety and depression down. Plus the beauty of it is that I feel human when I wake up in the morning instead of like a zombie when I was taking Effexor.

[Drew]

(Copied over from old review system)

Posted by UltraShy

Treatment Experience
I only tried Remeron as a sleep aid years ago, taking 15 mg since this is supposed to be an odd drug where the side effects, including drowsiness, are most intense at lower doses.

Like most drugs, it didn't sedate me in the least.

[Drew]

(Copied over from old review system)

Posted by MaidMarian

Social Anxiety Background
Moderate to severe SA.

Other Treatments
?

Treatment Experience
I took this medication for a while because of anxiety/depression with major sleep difficulties. It made falling asleep, and staying asleep, really easy. I don't remember if it had a positive effect on my anxiety/depression. However, I did gain a great deal of weight when I was taking it, which wasn't good, so eventually I had to go off of it.

[Drew]

(Copied over from old review system)

Posted by Aerfen

Social Anxiety Background
Severe Generalised Social Phobia

Treatment Experience
Remeron was the first antidepressant I took. It made me so drowsy! My head felt like it weighed a twice as much as the rest of me and I quite literally had to crawl around because of this. It was absurd. However, the sleep was nice as I tend to be an insomniac! This drug did absolutely nothing for my anxiety or depression, and I made it to the maximum dosage. Definitely did not gel with my brain chemistry.

[LaRibbon]

For me:
At 15 mg it isn't helping with anxiety or depression.
At 30 mg it's actually making my anxiety worse.

As far as I can tell it's only good for sleep.

[jim_morrison]

Originally Posted by LaRibbon

For me:
At 15 mg it isn't helping with anxiety or depression.
At 30 mg it's actually making my anxiety worse.

As far as I can tell it's only good for sleep.

LaRibbon; Mirtazapine is basically a potent sedative, and a mild noradrenaline, serotonin, and dopamine releaser (responsible for the antidepressant effects). So on it's own it is essentially just good for sleep.

IMO it's efficacy as an antidepressant usually seems to be more prominent in cases where it's added to SNRI's (look up california rocket fuel on google etc) because they potentiate the antidepressant effect of eachother.

[yogaflame]

Originally Posted by jim_morrison

LaRibbon; Mirtazapine is basically a potent sedative, and a mild noradrenaline, serotonin, and dopamine releaser (responsible for the antidepressant effects). So on it's own it is essentially just good for sleep.

IMO it's efficacy as an antidepressant usually seems to be more prominent in cases where it's added to SNRI's (look up california rocket fuel on google etc) because they potentiate the antidepressant effect of eachother.

I don't know if this is the right place to say this, but thanks a lot for your posts, it has really been helpful to me. I'm currently taking Mirtazapine as well, but it has probably only given me about 5% relief from my symptoms. I was wary about taking Mirtazapine with Effexor from the get go, because I feared Effexor would cause negative sexual side effects, but it seems you did not experience that with Effexor. Do you think taking Mirtazapine with Effexor would keep the sexual side effects at bay like people report with Welbutrin?

Also, since this is supposed to be a review thread, I can safely say that Mirtazapine did not do jack for my social anxiety. I had a presentation last week and I was absoluetly terrified and had to get yet another F. However, I've recently begun taking 30 mg and night and I feel a little calmer and more relaxed about an hour after taking it, very similar to what .5 mg of Xanax feels like to me.

[jim_morrison]

Originally Posted by yogaflame

I don't know if this is the right place to say this, but thanks a lot for your posts, it has really been helpful to me. I'm currently taking Mirtazapine as well, but it has probably only given me about 5% relief from my symptoms. I was wary about taking Mirtazapine with Effexor from the get go, because I feared Effexor would cause negative sexual side effects, but it seems you did not experience that with Effexor. Do you think taking Mirtazapine with Effexor would keep the sexual side effects at bay like people report with Welbutrin?

Thanks, Yeah common finding seems to be that in the range of 225-300 mg Effexor doesn't have any sexual side effects, as it's noradrenergic and weakly dopaminergic effects are said to be more prominent in that dose range, but if for some reason it did cause some then yeah Mirtazapine would most likely reverse them through it's antagonism of the 5HT2-A and 5HT2-C receptors, since indirect agonism of theses receptors induced by SRI's is thought the be the main mediator of their sexual dysfunction.
In short, I would say that if you were taking for example 225 mg of Effexor and 30 mg of Mirtazapine then the risk of sexual dysfunction would be practically zero.

[LaRibbon]

Social Anxiety Background
SA since 16, depression since 10.

Treatment Experience
I've been on it for a 2 months perhaps more, and it's EXTREMELY excellent for sleep. I don't know why it's not prescribed more for sleep disorders actually. I haven't experienced any change in depression / anxiety though. After trying 30mg, I had to go back to 15mg, as the higher dose seems to be more stimulating and actually made me more anxious and i didn't sleep as well. The down side is weight gain, but it's not much, and can be avoided / lost again with some will power.

[MandyC]

did nothing...then again, i stopped taking it after the first month, because i was extremely worried about its potential to cause weight gain.