Mirtazapine (Remeron) for Depression: How Does It Work?

Mirtazapine (Remeron)

Mirtazapine, also known by the brand name Remeron, is a medication used to treat depression. It is a tetracyclic antidepressant, which means that it belongs to a class of medications that are specifically designed to treat depression. Mirtazapine works by further increasing the amount of serotonin and norepinephrine in the brain. This helps to improve mood and relieve depressive symptoms. In this blog post, we will discuss everything you need to know about mirtazapine!

What Is Mirtazapine?

what is Mirtazapine (Remeron)

Mirtazapine is a tetracyclic antidepressant that is specifically used to treat depression. It was first introduced in the United States in 1996. Mirtazapine is structurally similar to other antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

How Does It Work?

Mirtazapine works by increasing the amount of serotonin and norepinephrine in the brain. Serotonin is a neurotransmitter that plays a role in mood regulation. Norepinephrine is another neurotransmitter that is responsible for alertness and energy levels. By increasing the levels of these neurotransmitters, mirtazapine helps to improve mood and relieve depression symptoms.

Mirtazapine is unique from other antidepressants in that it has a dual mechanism of action. It works by both increasing the levels of serotonin and norepinephrine, as well as by blocking the reuptake of these neurotransmitters. This means that mirtazapine not only helps to improve mood but also helps to prevent relapse into depression.


As an anti-depressant medication, Remeron mainly treats clinically diagnosed Major Depressive Disorder (MDD). This happens by positively affecting the communication between the nerve cells of the central nervous system, which further restores the chemical balance in the brain.

Since depression is also a subsequent symptom of bipolar disorder, it may also be effective as a treatment for a bipolar diagnosis.


Mirtazapine (Remeron) dosage

The starting dose of mirtazapine is usually 15 mg. The average maintenance dose can range anywhere from 15-45 mg in a day. However, the maximum dose allowed in a single day is 45mg.


The instruction sheet that comes with the prescription should be read thoroughly before the consumption of the medicine.

Some general intake instructions include:

  • Taking the medicine at the same time every day
  • Consuming it with plain water
  • No compulsion to intake the medication meals
  • Making sure to swallow the tablet instead of chewing

Side Effects

The most common side effects of mirtazapine include

  • Dry mouth
  • Drowsiness
  • Weight gain
  • Constipation
  • Dizziness
  • Headache
  • Nausea
  • Decreased appetite

Rare but serious side effects of mirtazapine include:

If you experience any of these rare yet serious side effects, you should contact your doctor immediately.

A highly dangerous reaction to this medication may cause what is typically known as serotonin syndrome. This happens when the body produces too much serotonin, causing overstimulation of the brain to cause various physical (diarrhea, shivering, fever) and mental (seizures, insomnia, restlessness) side effects.


Like every other medication, Remeron may also have life-altering side effects for some people. If you are someone who is prone to the severity of side effects or are unsure of undergoing medical treatment, you may consider alternative treatments. These may include natural changes, therapeutic intervention, as well as a different set of medications.

Natural alternate tips include:

  • Exercise
  • Increased intake of vitamin D and B3, omega fatty acids, zinc, and magnesium
  • Avoidance of toxic exposures
  • Improving the quality of sleep
  • Regulating blood pressure

Some therapies that can be taken into consideration are:

Other medical alternatives for Remeron include

General warnings

Mirtazapine (Remeron) effects

Although your doctor will run you through all the precautions and adversities of medication while prescribing your medical treatment, there are some things you should take into consideration before approaching the medical route of treatment.

  • Pregnant/breastfeeding women must cross verify the medication from their doctors as some anti-depressants have substances that may further harm the baby.
  • Inform your doctor about any other medication or herbs you are additionally intaking.
  • Do not withdraw the intake of these pills without a doctor’s advice.
  • Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Mirtazapine is not approved for use in children.
  • Consuming alcohol may further worsen some of the side effects.
  • Impairment of certain reactions is common
  • Inform your doctor about any previously existing health conditions like liver/kidney/heart disease, BP issues, low cholesterol, strokes, or glaucoma, among others.
  • In case you miss a dose, do not take two doses at the same time.


Mirtazapine is a medication used to treat depression. It works by increasing the levels of serotonin and norepinephrine in the brain, which helps to improve mood and relieve depressive symptoms. Mirtazapine is unique from other antidepressants since it has a dual mechanism of action. It is also extremely important to consult with a licensed professional for an official diagnosis and prescription of the medication. It is also essential to be aware of the side effects, general warnings, and overall impact of the medication before making a decision.

A Word From Therapy Mantra

Your mental health — Your psychological, emotional, and social well-being — has an impact on every aspect of your life. Positive mental health essentially allows you to effectively deal with life’s everyday challenges.

At TherapyMantra, we have a team of therapists who provide affordable online therapy to assist you with issues such as depression, anxiety, stress, workplace Issues, addiction, relationship, OCD, LGBTQ, and PTSD. You can book a free therapy or download our free Android or iOS app.