Mirtazapine

Mental health

Also known as Remeron

Mirtazapine is an antidepressant that works differently from SSRIs — it boosts serotonin and norepinephrine through its own pathway, and it's noticeably sedating. Doctors often choose it for people whose depression comes with insomnia or poor appetite, because it tends to help with both. Like other antidepressants, it takes two to six weeks to fully work. The drowsiness and increased appetite are usually strongest at the start.

How to take it

When

Once a day at bedtime — it will likely make you sleepy, so let it work for you.

Food

With or without food. Heads up: it often increases appetite, and some weight gain is common.

Avoid

Alcohol and other sedating medicines — the combined drowsiness can be dangerous. Skip St. John's wort too.

Good to know

Watch for new or worsening depression or suicidal thoughts, especially under 25 — tell someone and call your doctor right away. Don't drive until you know how sleepy it makes you.

Missed a dose?

Take it when you remember, unless it's close to your next scheduled dose — then just skip it. Never take a double dose.

Common side effects

Drowsiness, especially the first week or two
Bigger appetite and some weight gain
Dry mouth
Dizziness when standing up — rise slowly
Constipation

Call a doctor if

Fever, sore throat, or mouth sores that come out of nowhere — rarely this drug lowers infection-fighting white blood cells; call your doctor right away and get seen quickly
Swelling of your face, lips, tongue, or throat — this is an emergency, call for help immediately
Fever with agitation, racing heart, or muscle twitching — possible serotonin syndrome, get help now
Thoughts of hurting yourself — tell someone right away and call your doctor or a crisis line immediately

Educational only. This summary is drawn from public FDA labeling and MedlinePlus and simplified for readability. Your prescription label and your pharmacist always come first — doses and instructions vary from person to person.