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Remeron Addiction: Signs And Symptoms Of Mirtazapine Abuse

Last Updated: November 24, 2021

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Mirtazapine, under the brand name Remeron, is a medication that is used for the treatment of major depressive disorder. Aside from this, the Remeron medication also comes with different off-label uses such as treatment of anxiety and pain disorders. So how does Remeron work, as in 2019, around 6.3 million prescriptions of Remeron were issued in the United States. With these statistics, it is important to know that if a patient taking this medication misused or abused it, their health might be at risk.

What Is Remeron?

Mirtazapine is a drug primarily used to treat depression. In terms of the Remeron drug class, this medication belongs to the tetracyclic antidepressant drugs or TeCAs. In addition to treating depression, doctors also prescribe Mirtazapine for insomnia, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). However, these are not FDA-approved uses. Furthermore, according to the FDA, Mirtazapine is not a controlled substance but is only meant to be used in patients over 18 years old.

Generic Remeron

Remeron, the Mirtazapine brand name drug, is manufactured by Merck and Organon, Inc., USA. In 1994, it was initially approved in the Netherlands for the treatment of major depressive disorder and in 1997, the FDA gave approval for this medication to be sold in the global market. Soon after, the FDA also gave approval for other companies to market their own generic Mirtazapine drugs.

Currently Approved Companies for Manufacturing Generic Remeron Versions Include:

  • Apotex INC
  • Aurobindo
  • Mylan
  • Sun Pharma Inds INC
  • TEVA
  • Upsher Smith Labs

In most cases, the generic version of the medication is called by its active ingredient: Mirtazapine. However, sometimes mirtazapine generic names vary. They can include:

  • Soltab
  • 6-Azamianserin
  • Mepirzapine
  • Org 3770
  • Mirtazapinum
  • Mirtax

Casually, these may be referred to with the brand name. For example, Remeron SolTab. However, these are not official names. Although it is safe to take the generic or brand name of the drug and the effects would still be the same, it is always advised to seek medical consultation and help to get the best product for the patient.

A woman holds Remeron pill and a glass of water.

Remeron Dosage Forms And Strength

Mirtazapine dosage strengths range from 15 mg to a maximum of 45 mg and oral administration is the only method of administering the drug. However, the National Institute of Health warns that the Mirtazapine class of drugs needs to undergo more studies to understand the relative benefits or potential harm of varying doses.

The Main Remeron Medication Dosage Forms Are:

  • Tablets: 15mg, 30mg 45mg
  • Orally disintegrating tablets: 15, 30, and 45 mg
  • Oral solution: 15mg per ml

All Mirtazapine tablets marketed under the Remeron brand name are film-coated, oval, and biconvex. Each tablet dose can be divided into two equal parts. These tablets are packed in blisters or bottles.

The Differences Between Remeron Branded Tablets Are Discussed in the Table Below:

DOSAGE COLOR IMPRINT
15MG Yellow ‘MSD’ on one side, ‘TZ3’ on the other side (on both sides of the score)
30MG Red-brown ‘MSD’ on one side, ‘TZ5’ on the other side (on both sides of the score)
45MG White ‘TZ7’ on one side and ‘Organon’ on the other side

Take note that the generic Remeron tablet versions vary in colors, forms, and imprints, depending on the manufacturer. Some manufacturers do not provide imprints while some manufacturers provide the tablet form alone. When it comes to sizes, some manufacturers decrease the size of the tablet depending on the dose. This means that the higher the dose means the bigger the tablet.

Mirtazapine Uses: What Is The Drug Used For?

The US Food & Drug Administration approved Remeron medication for the treatment of major depressive disorder or MDD in adult patients (18 years old above). The use of Mirtazapine for depression is efficient because its effects increase the production of norepinephrine and serotonin, the primary neurotransmitters that influence cognition and mood. Patients taking this medication experience improved feelings of well-being and mood, restoring the balance between neurotransmitters.

Although the FDA approved Mirtazapine use for depression, the drug is not used to treat depression related to bipolar disorders because patients with this mental health condition may increase their risk of suicide. Aside from this, when a patient with bipolar disorders is taking the Remeron medication, certain Remeron side effects might occur, including manic symptoms. This means it can make the patient experience a change of mental state from depression to mania.

Mirtazapine for Sleep Mirtazapine for sleep-related issues has shown significant results in a study made on 130 patients suffering from depression and insomnia. In this study, patients taking Mirtazapine were able to get improved sleep quantity and prolonged slow-wave sleep.
Mirtazapine for Depression According to the study published in the Annals of General Psychiatry, Mirtazapine can actually be used as the first line of choice for the treatment of MDD. In this study, it was found out that Mirtazapine is more effective compared to selective serotonin reuptake inhibitors (SSRIs).
Mirtazapine for Appetite Although most of the patients see Mirtazapine weight gain as a side effect they would like to avoid; there are those who actually benefit from this. Some doctors prescribe Mirtazapine for appetite stimulation in patients suffering from various medical conditions. Recent research has determined that the use of this medication can improve appetite in patients with advanced cancer, suffering from weight loss, and anorexia. There are encouraging results of Mirtazapine use for patients with advanced dementia who developed issues in eating behaviors that have led to weight loss and anorexia.
Mirtazapine for Anxiety Scientists discovered that Mirtazapine for anxiety could significantly improve symptoms of GAD, PTSD, anxiety with comorbid depression, social anxiety, and panic disorders. The use of Mirtazapine shows, in some cases, better results compared to the current standard treatment options, which include the use of SSRIs and tricyclic antidepressant drugs.

According to the study of medical doctors from the USA, Mirtazapine can also be used for reducing alcohol addiction. In this study, it was reported that this drug is well tolerated by patients with alcohol use disorder. In another study published in the Journal of Psychopharmacology, it was reported that patients who are dependent on alcohol were able to have faster alcohol detoxification and recovery when this medication was added to their detox process. Additionally, adding Mirtazapine on the initial treatment phase of patients with alcohol abuse dependence and addiction improved patient compliance to the detox and recovery process.

Overview Of Remeron Addiction And Abuse

According to the study of medical professionals from New York, Mirtazapine is not officially considered to have any notable abuse and addiction potential. However, Remeron addiction and abuse are still possible when continuous misuse of the drug is done. In most cases, this is because people assume that since it treats depression, it must have mood-boosting effects. Despite this, it is not known to easily produce a sense of euphoria. Moreover, misusing this drug may cause dangers to the health. In one study published in the American Journal of Case Reports, it was reported that a patient who abused this medication experienced tachyphylaxis or the loss response of tissues due to repeated administration of a drug.

Is Mirtazapine Addictive?

This brings up the question of if Remeron addiction exists. The answer can vary based on how a person looks at the concept of Remeron addiction. According to the medical community, Mirtazapine is not addictive. However, the body can become dependent on it, and stopping the medication suddenly might result in withdrawal. There is also the concern of psychological addiction such as drug-seeking behavior. Also, it is possible for users taking the medication to feel afraid to stop using Mirtazapine or even to crave it. According to the FDA, because this medication acts on the central nervous system once it is misused, this can lead to Remeron addiction and abuse. For this reason, the FDA advises medical doctors to carefully evaluate their patients for history of drug abuse and addiction before prescribing this medication.

Signs And Symptoms Of Remeron Abuse

When people abuse or misuse Mirtazapine, or any other drugs, signs, and symptoms would eventually appear. Moreover, it is important to understand that even though this medication acts on the nerves of the brain, it does not only cause psychological symptoms. Instead, physical symptoms may also be seen.

Below Are The Psychological Signs And Symptoms of Remeron Abuse:

  • Disorientation
  • Impaired memory function
  • Hallucination
  • Feelings of nausea

Some patients unknowingly abuse the medication by incrementation of the dose. Eventually, doing this would only lead to dangerous health events. Furthermore, as said, Remeron abuse does not only affect the psychological health of a patient.

It Also Includes Physical Signs And Symptoms Such As The Following:

  • Drowsiness
  • Tachycardia
  • Slurred speech
  • Breathing difficulties
  • Hyperpyrexia or high body temperature
  • Diaphoresis
  • Bowel hypermotility
  • Hypertension

In case a patient is seen to be abusing the drug, it is important to call a poison center or seek emergency medical help as soon as possible in order to avoid dangerous health events. A rehab center can also be considered for a safe recovery process for patients who seek help during Mirtazapine abuse and addiction.

A man suffers from Remeron addiction.

Who Is Most At Risk Of Remeron Abuse?

Mirtazapine can only be used by adult patients 18 years old and above. In compliance with the FDA, patients in this age group who have a history of drug abuse and addiction are at risk of Remeron abuse. According to the study of medical professionals in the United States, people who are at risk of Remeron abuse include those who experienced familial abuse and neglect, social risk factors such as bullying and being involved in a gang, and individual factors such as having a medical health condition called ADHD and a mental health condition such as depression.

Dangers Of Remeron Addiction, Abuse, And Getting Help

Abusing this medication may cause extreme dangers to the health and this is not just because of Remeron addiction, but also due to some dangerous interactions, such as for instance taking Mirtazapine and alcohol. Instead, people who abuse this medication may become dependent on it and this dependence may affect the whole being of a person from personal relationships to career. A patient who is dependent on Mirtazapine may also be at risk of overdose. For this reason, doctors prescribing this medication must strictly evaluate the drug abuse and addiction history of patients in order for them to not do the same. On the other hand, patients must always remember to strictly comply with the instructions of the doctor to avoid further mental and physical health issues.

Mirtazapine is a medication with legitimate therapeutic applications, but that does not stop people from abusing it. If someone is misusing the medication or considering it, they should seek help. A drug rehab center offers a safe recovery process and therapies needed for people to reframe their thinking and stop their abuse. Treatment for substance abuse is not easy, both mentally and physically. However, with the right help and correct recovery process, it will give a sober future.

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Published on: November 25th, 2019

Updated on: November 24th, 2021

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.