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Mirtazapine Withdrawal And How Long Does Remeron Stay In Your System?

Last Updated: August 8, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Remeron is one of the prescription medications that is used for the treatment of depression. Although this drug is one of the effective antidepressants, patients using it are at risk of experiencing Mirtazapine withdrawal as a result of coming off the drug, along with some Mirtazapine side effects. Additionally, a patient under Mirtazapine treatment may encounter diverse Remeron withdrawal symptoms, and the intensity and duration of these symptoms might be different for every person. In 2017, one patient died 4 days after he suddenly stopped the use of the drug. This means that the half-life of this medication affects when the withdrawal syndrome would possibly occur. Furthermore, there are two approaches that can help one to come off the drug: a patient can either stop suddenly or taper off Remeron. Notably, many experts consider that coming off Mirtazapine successfully is associated with the tapering approach.

How Does Remeron Work?

Remeron belongs to the group of medications called tetracyclic antidepressants (TeCAs) and these medications work by increasing the levels of serotonin and noradrenaline in the brain. These two neurotransmitters are the ones that affect the mood of a person. When they are low, this could lead to depression and other mental health conditions such as attention-deficit hyperactivity disorder.

According to the study of medical doctors from London, the Remeron medication has a rapid onset of effect and a patient using it for the treatment of depression can see some improvements within the first two weeks of use. In the same study, it would only take 6 weeks to fully recover from depression if a patient is compliant with the drug treatment process.

What Is Remeron Withdrawal?

Remeron withdrawal or discontinuation syndrome occurs after a person decides on coming off Remeron medication. According to medical doctors from Georgia, as many as 20% of patients experience discontinuation syndrome from antidepressant drugs after drug withdrawal. The syndrome effect happens due to the drug’s mechanism of action: it changes neurotransmitter levels. Remeron acts like a trigger in this case, and when a person stops taking a drug, the body reacts to these in different symptoms.

Symptoms of Remeron withdrawal are not life-threatening. However, they make a person feel uncomfortable. Besides, some of the symptoms remind of the signs of depression. For that reason, a medical worker should consult a patient about all the aspects of drug discontinuation, Mirtazapine withdrawal peak, and possible outcomes.

A depressed woman looks at Remeron pills and experiences Remeron withdrawal symptoms.

Mirtazapine Withdrawal Symptoms

According to the FDA, there have been reports of adverse reactions regarding the abrupt discontinuation of antidepressant medications such as Remeron. According to the study of medical doctors from New York, Mirtazapine withdrawal symptoms may be psychological or somatic.

Some of the Most Common Psychological Symptoms Are as Follows:

  • Reduced Appetite– Remeron itself favors the appetite increase, as one of the effects of the medication is Mirtazapine and weight gain. Therefore, abstinence can lead to a poor appetite. As a result, a patient is likely to lose weight considerably.
  • Anxiety– Mirtazapine abstinence often leads to anxiety in patients. The symptom occurs as a result of the alterations of serotonin and norepinephrine neurotransmission. One can also experience irritability. Anxiety will gradually diminish due to drug absence.
  • Lack of Concentration– Some patients report poor concentration right after they stop taking this medication. Feeling hazy, incapable of focusing on different tasks, and experiencing racing thoughts are common for Mirtazapine withdrawal.
  • Crying Spell– Remeron abstinence can also result in sudden crying spells due to mood swings. Crying spells may aggravate depression; however, this symptom will subside.
  • Depression– Talking about depression, it may worsen during Remeron withdrawal; it may seem to a patient that his or her health condition is even more severe. In reality, one’s brain starts to function soberly, causing a chemical imbalance during abstinence. Keep in mind that some patients also experience suicidal thoughts, panic attacks, hypomania, and mania.
  • Depersonalization– In addition to depression, a patient is likely to experience depersonalization symptoms when using medications such as Mirtazapine. The effect of this is that patients may feel worse than they used to while being on a drug, and they start to panic as they think that they will stay in this ambiguous state of mind.
  • Sleep Changes– Mirtazapine is often used to enhance sleep. However, Remeron antidepressant abstinence may undermine one’s healthy sleep regime. Insomnia is also one of the Mirtazapine withdrawal symptoms.

In the same report from the FDA, the Remeron withdrawal symptoms above are mild and self-limiting. However, patients who are experiencing them must take them seriously as they may be causes of underlying health problems.

Furthermore, as said, physical or somatic symptoms are also possible and some of these include the following:

  • Diarrhea
  • Dizziness
  • Fatigue
  • Headaches
  • Heart palpitations
  • Itching
  • Sweating
  • Nausea

In case a patient is experiencing any of the somatic and psychological withdrawal symptoms listed above, it is advised to immediately seek medical care or consult a rehab or withdrawal center to avoid other dangers to the health.

Mirtazapine Withdrawal Timeline

An individual’s medical history and conditions are among the most determining factors affecting the Mirtazapine withdrawal symptoms timeline. It is essential to take into account that one can take some other drugs at the same time, which also impacts the Remeron abstinence timeline. Nevertheless, it is possible to define the approximate time to the event and particular symptoms of Remeron withdrawal.

Users can undergo Remeron withdrawal depending on their state of health. When patients stop taking any antidepressants, they may experience diverse psychological and somatic symptoms. Typically, patients report the occurrence of some abstinence signs after three days without a drug. However, some of them can feel specific withdrawal symptoms even after one missed dose. If talking about how long Mirtazapine withdrawal lasts, it can extend over weeks.

At the same time, one should take into account the period of taking a drug, whether a person is taking any other medicine or substance such as alcohol, and if a patient is suffering from other health conditions. For example, the alcohol and Remeron interaction. When alcohol is combined with Remeron, there would be an increase in the severity of withdrawal symptoms because the substance alcohol reduces the half-life of the drug.

How Long Does Mirtazapine Stay In Your System?

For those who are wondering, how long does Mirtazapine stay in your system? The answer is it depends on different factors such as genetics, age, liver and kidney functions, the dosage of the drug, other drugs being taken, and drug abuse or addiction history. According to a study of medical doctors from New Zealand, this drug would stay in the system for about  4-9 days. Taking note of this period, together with the drug’s half-life, is a must when the patient is vulnerable to drug withdrawal because the shorter half-life could lead to a more intense withdrawal.

Furthermore, the period of how long the Remeron medication stays in the urine, blood, saliva, and hair differs as well. Take a look at the information obtained from the Journal of Pharmacology and Pharmacotherapeutics:

  • Urine– Up to 4 to 8 days.
  • Blood– Up to 4 to 8 days.
  • Saliva– Up to 4 days.

As of today, there is no study yet about how long Mirtazapine can stay or be detected in the hair. However, any substance one takes may remain in hair cells for up to 90 days. The standard hair drug testing offers up to a 90-day window for drug detection.

How Long Does Mirtazapine Stay in Your System?

Mirtazapine Half Life

Half-life means the time it takes for a drug to reduce 50% of its original concentration. With regards to Mirtazapine half-life, it is reported that its half-life ranges from 20-50 hours. As said, the half-life varies from one person to another, depending on different factors such as genetics. According to the FDA, the usual Mirtazapine half-life for females is 37 hours while for males is 26 hours. Since males have a shorter Mirtazapine half-life, it can be said that they are more at risk of experiencing intense withdrawal symptoms.

A man leans his elbows on the table and suffers from Remeron withdrawal symptoms.

Mirtazapine Drug Test

Many users may be worried about Mirtazapine showing up on a drug test as this could expose abuse, addiction, or the medical condition it is meant to treat. However, having this drug in the system should not show up on a drug screening unless it is specifically designed to detect the drug. It is also not known to cause false-positive results.

Methods To Wean Off Remeron

Weaning off Remeron must be done together with a medical professional and it is best done in a detox center, where there are professionals who are trained in addiction medicine and detoxification. These professionals will help the individual detoxify themselves via their weaning-off process choice such as stopping suddenly and tapering.

Stopping Mirtazapine Suddenly (Not Recommended)

Whether a patient decides on sudden Mirtazapine discontinuation or tapering off it, a patient will experience some withdrawal symptoms. According to a medical doctor from Switzerland, stopping Mirtazapine suddenly may cause persistent panic attacks and other uncomfortable symptoms within 5 days after use. In case of an abrupt ending, a withdrawal effect can occur even earlier.

Tapering Off Remeron

Tapering off Remeron requires more time and patience from the side of a patient. The entire process must be supervised by a medical specialist as well. With tapering, a specialist lowers the Remeron dose gradually. Supervised tapering appears to be a more practical approach than suddenly stopping this drug, as it is a less harsh way to stop taking the drug.

Although there is no statistical data regarding the comparison of the effectiveness of these two approaches, tapering off antidepressants is recommended by specialists.

Always Consult Your Doctor Before Stopping Mirtazapine

There are no strict and general recommendations for getting off Remeron. Each case is individual. Nevertheless, Pharmacy Today, an official publication of the American Pharmacists Association, suggests that one should have a proper Mirtazapine withdrawal schedule during the tapering period. Thus, if the chosen antidepressant drugs have a shorter half-life, the tapering period will last longer and vice-versa. On average, it will take around 6-8 weeks to minimize the abstinence symptoms. Every patient should receive individual discontinuation recommendations for stopping mirtazapine successfully. Sometimes a person may need to take some supplements as well. Regular exercise, a healthy lifestyle, and breathing techniques can help a patient to come off any antidepressants successfully.

Stopping Remeron requires some time and strict discipline. Considering the nature of symptoms, patients may feel afflicted and disappointed. For that reason, one must receive complex therapy and help from the professional who will aid in overcoming the abstinence period. Moreover, if the symptoms are harsh or in case of drug misuse or addiction, patients should consider the professional help of a drug rehab center. A rehab center facility offers various types of substance abuse prevention and treatment options to meet the individual needs of each patient.

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Page Sources

  1. Al Zaabi, M. S., Sridhar, S. B., Tadross, T. M., & Shariff, A. (2021). Frequency and Predictors of Potential Drug Interactions among Psychiatry Outpatients on Treatment with Antidepressant Medications. Biomedical and Pharmacology Journal, 14(3).
  2. Alam, A., Voronovich, Z., & Carley, J. A. (2013). A review of therapeutic uses of mirtazapine in psychiatric and medical conditions. The primary care companion for CNS disorders, 15(5).
  3. Benazzi, F. (1998). Mirtazapine withdrawal symptoms. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 43(5), 525-525.
  4. Cosci, F. (2017). Withdrawal symptoms after discontinuation of a noradrenergic and specific serotonergic antidepressant: a case report and review of the literature. Personalized Medicine in Psychiatry, 1, 81-84.
  5. Davies, J., & Read, J. (2019). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: are guidelines evidence-based?. Addictive behaviors, 97, 111-121.
  6. Davis, R., & Wilde, M. I. (1996). Mirtazapine. Cns Drugs, 5(5), 389-402.
  7. Fauchère, P. A. (2004). Recurrent, persisting panic attacks after sudden discontinuation of mirtazapine treatment: A case report. International journal of psychiatry in clinical practice, 8(2), 127-129.
  8. Hartmann, P. M. (1999). Mirtazapine: a newer antidepressant. American family physician, 59(1), 159.
  9. Harvard Health. (2020b, March 25). Going off antidepressants. https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
  10. Khanra, S., & Das, S. (2017). Mirtazapine Is Effective in Steroid Withdrawal Syndrome Related Depression: A Case Report. Clinical Psychopharmacology and Neuroscience, 15(1), 73.
  11. Pombo, R., Johnson, E., Gamboa, A., & Omalu, B. (2017). Autopsy-proven mirtazapine withdrawal-induced mania/hypomania associated with sudden death. Journal of pharmacology & pharmacotherapeutics, 8(4), 185.
  12. Spitznogle, B., & Gerfin, F. (2019). Pruritus associated with abrupt mirtazapine discontinuation: Single case report. Mental Health Clinician, 9(6), 401-403.
  13. Tylee, A., & Walters, P. (2007). Onset of action of antidepressants.
  14. Warner, C. H., Bobo, W., Warner, C. M., Reid, S., & Rachal, J. (2006). Antidepressant discontinuation syndrome. American family physician, 74(3), 449-456.

Published on: November 25th, 2019

Updated on: August 8th, 2022

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.

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