Mirtazapine And Alcohol. What Are Remeron Interactions With Other Drugs?

Last Updated: November 24, 2021

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Remeron is an atypical antidepressant that is effective in the treatment of depression and its symptoms. Known as Mirtazapine, the drug can be used to treat anxiety and difficulty in sleeping. The medication belongs to the noradrenergic and specific serotonergic antidepressant (NaSSA) drug class. Its mechanism of action is to enhance the release of norepinephrine and 5-HT1A-mediated serotonergic transmission. Mirtazapine accomplishes this by blocking the adrenergic alpha2- autoreceptors, hetero2-autoreceptors and antagonizing 5-HT2 and 5-HT3 receptors. Simply put, the medication increases chemicals in the brain responsible for mood elevation. However, is it possible to combine Remeron and alcohol to enhance the mood of patients? Mixing Mirtazapine and alcohol can have dire health effects on the user. Combining Mirtazapine and weed is a grave option as well.

Mirtazapine And Alcohol Interactions

As with most antidepressants, Remeron and alcohol should not be combined. Mirtazapine indications clearly state that alcohol should be avoided. Alcohol’s mode of action is to increase the effects of a neurotransmitter called Gamma-aminobutyric acid which is responsible for reducing the activities of the nerves cells or neurons transmitting chemical messages through the brain and nervous system. By doing so, alcohol suppresses the activity of the central nervous system. Remeron, on the other hand, increases serotonin and noradrenaline to elevate the mood of patients suffering from depression.

Taking Both Remeron And Alcohol May Have The Following Effects On The User:

  • Increase in Depression and Anxiety– Taking Remeron and alcohol can leave the user more depressed and anxious than they were. This is because the alcohol may inhibit the effects of the drug making the symptoms of depression worse. Though in the interim, alcohol will lift the mood of the patient, it has a long-term effect of reversing the outcome of the antidepressant.
  • Worsening of Side Effects– Side effects of the medication could be worsened by alcohol. There are several side effects of Remeron which include drowsiness and dizziness. Alcohol is also known to have similar effects on the human body. Therefore, combining both Remeron and alcohol can lead to the worsening of both symptoms.
  • Impairment of Thinking and Focus– Alcohol can inhibit thinking and alertness and when combined with the medication, the effects could be heightened. This is because of the sedative effects of Mirtazapine. Therefore, it is advisable to stay off alcohol while taking antidepressants such as Remeron to stay alert.

There is growing evidence that Remeron and alcohol should not be combined. However, don’t stop the medication cold turkey to indulge in drinking. This can spell dangerous health consequences. Always contact a medical doctor or a rehab center if you want to wean off the medication.

Remeron pills lie on the table with a bottle of alcohol.

Mirtazapine And Weed Interaction

Weed, also known as Cannabis, has various mental and physical effects on the user. It has several uses including medicinal and recreational. Its mechanism of action involves the main psychoactive ingredient of Cannabis known as tetrahydrocannabinol attaching itself to cannabinoid receptors in the brain and activating them. This results in the disruption of mental and physical functions. It also increases norepinephrine and serotonin to elevate the mood of a person. Weed has the potential to counter the effects of Mirtazapine on a patient. Also, combining Mirtazapine and weed could lead to serious health issues.

Some Of Which Are Listed Below:

  • Dizziness
  • Drowsiness
  • Loss of focus
  • Tarchichardia

It is better to stay off weed while receiving treatment for taking Remeron for depression. This is because the effects of the medication can be reversed by Cannabis. However, avoid the temptation to abruptly stop taking the medicine. Instead, contact a mental health facility to support your Mirtazapine withdrawal symptoms.

Commonly Encountered Remeron Interactions

Some drugs have a major interaction with Remeron which can lead to serious health issues. Other drugs don’t seem to have that problem and are safe to mix with Mirtazapine. We present a list of Remeron interactions.

Mirtazapine and Ambien (Zolpidem)

Zolpidem is a drug that is efficient in treating sleep problems. It belongs to the sedative-hypnotics drug class and works by slowing down activities in the brain to induce sleep. Mixing Mirtazapine and Ambien may have moderate health consequences. These include drowsiness, dizziness, difficulty, and confusion.

Mirtazapine and Cymbalta

Cymbalta is an antidepressant useful in curing depression. It works by increasing serotonin and norepinephrine in the brain. The drug class of Cymbalta is selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Mixing Mirtazapine and Cymbalta can lead to serotonin syndrome. This can cause side effects such as stomach cramps, vomiting, diarrhea, tremor, muscle spasms, and blurred vision.

Mirtazapine and Trazodone

Trazodone is a drug efficient in the treatment of depression and anxiety. It belongs to the serotonin modulators drug class and works by increasing serotonin in the brain to improve mental balance. When Mirtazapine and Trazodone are combined it increases the risk of serotonin syndrome. It is when there is too much serotonin in the system and is mostly caused by antidepressants. Side effects of mixing Remeron with Trazodone include seizures, increased heart rate, excessive sweating, shivering, etc. However, at a low dose, Mirtazapine and Trazodone can be used to treat insomnia.

Lexapro and Mirtazapine

Lexapro is also an antidepressant in the drug class of selective serotonin reuptake inhibitors (SSRIs). Lexapro works by blocking the reuptake of serotonin into the presynaptic neuron, thus increasing serotonin levels in the brain. Combining Lexapro and Mirtazipine can lead to serotonin toxicity. It is a serious condition that can end fatally. Side effects of mixing Lexapro and Mirtazapine include fever, confusion, extreme changes in blood pressure, muscle rigidity, diarrhea, and headaches.

Mirtazapine and Xanax

Xanax, marketed under the name Alprazolam, is a medication useful in the treatment of anxiety and general panic disorders. It belongs to the benzodiazepines drug class and works by enhancing the binding of the inhibitory neurotransmitter GABA at various GABA receptor sites in the central nervous system. This leads to a sedating and calming effect on the body. Mixing Mirtazapine and Xanax should be carefully considered due to their potential health effects. These include drowsiness, dizziness, difficulty in concentration, and confusion. Combining Mirtazapine and Xanax may also cause impairment in thinking, judgment, and motor coordination.

A woman suffers from a headache because of Remeron interactions.

Remeron and Zoloft

Zoloft is a medication used in treating depression, fear, panic attacks, and anxiety. Also known as Sertraline, Zoloft is an SSRI that inhibits the reuptake of serotonin in the central nervous system into human platelets. Though Zoloft is used to treat post-traumatic stress disorder, it is not fully effective. However, studies indicate that when mixed with Remeron, both medications are effective at treating depression and PTSD. There may be side effects associated with mixing two antidepressants. These include excessive sweating, shivering, and blurred vision.

Remeron and Wellbutrin

Wellbutrin is an atypical antidepressant that is efficient in treating a variety of ailments including anxiety, and mental/mood disorders. Smokers use it to help them cease the unhealthy habit. As a norepinephrine and dopamine reuptake inhibitor (NDRI), Wellbutrin works by increasing the levels of neurotransmitters norepinephrine and dopamine in the brain. This improves concentration and focus in patients. It is suspected that mixing Remeron with Wellbutrin may increase the chances of suffering from seizures. This is because Wellbutrin may rarely cause seizures so mixing both medications is likely to exacerbate the risk of seizures.

Effexor and Remeron

Also known as Venlafaxine, Effexor is a drug useful in treating depression. It elevates the mood of patients and energy levels. The mechanism of action of Effexor involves the increase of serotonin levels, norepinephrine, and dopamine by blocking the reuptake of transport proteins at the presynaptic terminal. Using Effexor and Remeron together may lead to serotonin syndrome since both drugs increase the neurotransmitter. This can lead to side effects such as hallucinations, seizures, increased heart rate, blurred vision, muscle spasms, stomach cramps, nausea, and extreme changes in blood pressure.

Caution Required When Taking Remeron

As already discussed, Remeron and alcohol should not be taken together due to the negative health consequences. Since the medication doesn’t interact well with most antidepressants it is better to contact a physician before administering both drugs. Also, people who use weed should stay away from Mirtazapine to avoid complications. Drug interactions also pose health hazards and may evoke some discomforting adverse reactions in patients, such as for example Remeron weight gain. The patient should be informed about this danger before being prescribed Remeron. Numerous drug rehab centers provide help to patients who develop an addiction to any drug. Substance abuse treatment in such centers facilitates a long-standing recovery.

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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.