The antidepressant drug Remeron (generic name mirtazapine) has been approved for use in the treatment of depression, but can also be beneficial for patients with certain anxiety disorders, in particular Generalized Anxiety Disorder. Many drugs that were originally developed to treat depression have been found to be useful in treating anxiety. This is permitted by the Food and Drug Administration (FDA) as long as the drug company is not advising doctors and other prescribers in off-label use.
Many commonly prescribed antidepressants belong to a class called selective serotonin reuptake inhibitors, or SSRIs. Patients who do not respond to SSRIs may benefit from treatment by drugs from another class, such as Remeron, which belongs to a class called noradrenergic and selective serotonergic antidepressant, or NaSSAs.
While SSRIs work mainly on the levels of the neurotransmitter serotonin, NaSSAs like Remeron work on both serotonin and norepinephrine. Norepinephrine is also referred to as noradenalin. Serotonin is thought to be responsible for elevation of mood, while norepinephrine is responsible for arousal and reward.
By working on both of these components in a patient's brain chemistry, it is possible to correct a wider range of psychological symptoms. Because Remeron has more than one mechanism of action, it is sometimes referred to as a "designer antidepressant."
Benefits of Remeron
When Remeron is used in treating an anxious patient, it can have a very positive effect within the first week of treatment. Some patients may experience significant symptom relief after taking the very first dose, which is a noticeable improvement over certain SSRIs and other medications that require several weeks of treatment before a therapeutic level of the drug can build up in the blood stream. Remeron is beneficial for anxiety patients for several reasons:
- Symptom relief is experienced soon after treatment has begun.
- Induced drowsiness can help patients with insomnia.
- There is lower incidence of sexual dysfunction than is found with other antidepressants.
- It does not cause the same acute heart problems caused by other antidepressants.
Side Effects of Remeron
There are some negative side effects associated with Remeron, but many patients who have found success taking the drug report that these side effects are preferable to the side effects of other drugs they have tried, or their untreated symptoms.
- Weight gain
- Blurred vision
- May raise cholesterol and triglyceride levels
- Dry mouth
Lower dose pills (15 mg or less) tend to have more of a sedating effect than higher dosages of the medication (30 mg or more). Because many anxiety patients suffer from insomnia or other sleep disorders, they may find more relief from a lower dosage of Remeron. For patients who do not have insomnia, a higher dosage may be more appropriate, to prevent excessive drowsiness.
Remeron is available in its generic form, mirtazapene. The pills are scored, so prescribers may write an initial prescription for the 15 mg pills, and have the patient split the pills in half for a starting dosage of 7.5 mg, to increase to 15 mg after the first week of treatment.
This article is not a substitute for medical advice. Please consult with your physician. For more information about Remeron, see information from its manufacturer Organon or from the University of Maryland Medical Center.
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