Remeron (Mirtazapine)

Remeron is one brand name for mirtazapine, an antidepressant and alpha-2 antagonist. It is a tetracyclic antidepressant and is different from selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs). This drug blocks specific alpha-2 receptors that subsequently increase norepinephrine and serotonin neurons in the brain. It also blocks a specific histamine receptor.

Why is this drug prescribed?
Remeron is FDA-labeled in adults for major depressive disorder. There is also some evidence that favors the usage for anxiety, dysthymia, obsessive-compulsive disorder, and panic disorder in adults.

Remeron is used to treat major depression. When taken to relieve depression, its effects are usually felt within one to four weeks. The usual adult dose is between 15 and 45 mg/day.

Remeron is being used experimentally to treat children with ADHD, autism, and Asperger Syndrome, but its effectiveness for these diagnoses is not clearly established.
At lower doses, Remeron has been associated with increased hypnotic effects and thus has been used for insomnia.

How much of this drug is typically used?
Tablet: 15 mg, 30 mg, 45 mg
Tablet, orally disintegrating: 15 mg, 30 mg, 45 mg

Buy Remeron

Reasons to buy Remeron:

• Effective at relieving some depression symptoms.
• Starts to work more quickly than most antidepressants.
• Can help you fall asleep if you have trouble sleeping.
• Can also help relieve anxiety.
• Good option if you are underweight or frail, because it can help you gain weight.
• Available as a generic.

Warnings and Precautions
There is no information on Remeron specific to children; all studies have been done with adults.

Rarely, Remeron causes flu-like symptoms such as a sore throat, chills or fever, mouth sores, or any other signs of infection which may indicate a serious blood problem. Such symptoms should be immediately brought to the attention of a doctor.

Remeron may cause drowsiness or difficulty thinking clearly. Patients should not drive or operate heavy machinery until it is known that Remeron does not seriously interfere with concentration and alertness.

For Pregnant or Nursing Mothers: Remeron has not been studied in pregnant women. Studies using very high doses in animals have caused fetal death. Remeron has not been shown to cause birth defects. It is not known whether Remeron passes into breast milk, and nursing mothers should be cautious.

Contraindications
Remeron should Not be used for people with the following conditions:

• An allergy or sensitivity to Remeron or similar drugs like Ludiomil and Desyrel.
• Phenylketonuria (PKU) - one form of Remeron tablets, the oral disintegrating tablets, contain aspartame which can worsen PKU.

Precautions
Remeron may be used with caution in people with the following conditions:

• A history of seizures - Remeron has rarely been known to cause seizures.
• Dehydration or low blood pressure - Remeron may cause a dangerous reduction in blood pressure.
• Kidney or liver disease - Remeron dose may need to be lowered because of the reduced rate of its elimination from the blood.
• Mania or a history of mania - Remeron, like all antidepressants, may cause mania to recur and should be used ccarefully in bipolar disorder.

Adverse Reactions
Remeron may cause the following reactions:

• Drowsiness
• Dizziness
• Weight gain
• Increased appetite
• Back pain
• Tremors
• Weakness
• Dry mouth
• Constipation
• "Flu-like" symptoms (report to a doctor)
• Increased sensitivity to sunlight / rash
• Increased cholesterol or triglyceride levels in the blood
• Confusion
• Frequent urination
• Nausea
• Abnormal dreams and/or thinking
• Swelling of ankles or hands
• Fluid retention
• Difficult breathing
• Muscle pain
• Sleepiness
• Increased liver enzymes
• Dizziness
• Dream disorder

Rarely:

• Decreased white blood cell counts
• Seizures (rare)
• Worsening depression
• Mania (0.2%)
• Suicidality (rare)

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Remeron include:

• Alcohol or other depressants (including cold medicine) and Tricyclic antidepressants (TCAs) - these may increase the sedative effects such as drowsiness and impaired motor skills.
• MAO (mono-oxidine) Inhibitors - MAOIs have toxic iteractions with many drugs, including Remeron. Any MAOI should be discontinued for at least 14 days before taking Remeron.

Research Studies and Use in Child Psychiatry
Safety and efficacy of this drug have not been established in children and adolescents. A multi-center open label study did show benefit of mirtazipine in the treatment of adolescents with major depression 12-18 years old. The medication carries a special warning, as with other antidepressants, of increased suicidal thinking and behavior in children, adolescents and young adults.