Social Anxiety Forum - View Single Post - What does mirtazapine (Remeron) feel like once you're used to the sedation?
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post #9 of (permalink) Old 04-17-2012, 11:00 PM
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The daytime grogginess never went away for me over a prolonged period of taking 45mg/day.

As this blogger points out, two scales which are commonly used in depression research/drug trials count reduced appetite and sleeplessness as symptoms of depression, so mirtazapine by fixing these symptoms directly may give a falsely higher score of improvement.

Mirtazapine is an unusual drug, with a pharmacological profile very different to that of most antidepressants. Notably, it's a powerful hypnotic - it makes you sleep - and it increases appetite. Patients on mirtazapine in the present study put on over 2kg in 6 weeks.

Why does this matter? Because the two scales used to rate depression in this study, the Hamilton Scale and the Montgomery-Asberg Scale, both count reduced appetite and sleeplessness as symptoms of depression. If you're on mirtazapine, you're unlikely to have either problem - you'll be more worried about the exact opposite, insatiable hunger and drowsiness. So mirtazapine could reduce your total score on these scales even if it didn't change your mood.
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