Remeron withdrawal can also cause adverse effects, and the FDA and other regulatory bodies stipulate that this drug should never be stopped abruptly. A slow Remeron taper is recommended as this allows time for the body to adjust in a more gentle fashion. (7)
We will cover some of the most frequently asked about topics, below. Always consult your primary caregiver for specific concerns about taking Remeron, including reactions to the drug that seem unusual or make you feel uncomfortable. We can also provide more information on request concerning a Remeron taper and important information concerning stopping mirtazapine or Remeron. If the decision is made to stop taking mirtazapine, or any prescription drug, it should always be done with close medical oversight and competent guidance.
Remeron (mirtazapine) was approved primarily for the treatment of MDD or major depressive disorder. MDD symptoms are described in the DSM V and include these diagnostic criteria: symptoms should not be included that are clearly attributable to another medical or pathological condition, and the physiological effects of a substance are not attributable to the depressive episode. As stated, before diagnosing a person with MDD, at least the 2 above elements (along with other diagnostic criteria) must be verified. (1)
Antidepressants are often used in conjunction with multiple medications and electroshock therapy to treat psychiatrically diagnosed conditions. It should be noted that the DSM V diagnostic criteria changes apply to adults as well as to adolescents and children. (6)
It would follow that adequate testing, and investigation would have to be done to rule out these potential root causes for a depressed condition before attempting to medicate the patient. There may even be a list of Remeron alternative therapies, which could be more efficient.
Such investigations would have to include at a minimum, testing for nutritional deficiencies, environmental toxins, food or other allergies, the presence of neurotoxic elements like heavy metals, pathologies, drug use, addiction or dependence, and many other potential agents or influences or substances known to be causal agents in depressed states. These are the exact types of protocols that are used in the Alternative to Meds Center Remeron withdrawal treatment programs.
PTSD (post-traumatic stress disorder): In diagnosing PTSD disorders, some qualifying symptoms listed in the DSM V have been revised, for example in “Criterion A” the scope of the diagnosis was significantly narrowed. The diagnostic criteria no longer include the unexpected death of a family member or close friend, for example, who died of natural causes.
Emotional disorders: The most recent DSM V has now collapsed multiple types of disorders into one over-arching category which it refers to as “emotional disorders”. Emotional disorders, as a group, include the various bipolar disorders, the “distress disorders” which include major depressive disorder, generalized anxiety disorder, panic disorder, PTSD, and the “fear disorders” which are the phobias, i.e., social phobia, agoraphobia, etc. Information in the DSM-5 should, in general, be taken with the proverbial grain of salt since calls for reviewing the DSM by independent scientific researchers. The DSM-5 reportedly has unresolved significant credibility issues in recent years. (2)
Other off-label uses include insomnia (3), itching, nausea and tension headache and as an appetite stimulant (4) (5).
Remeron (mirtazapine) Alternative Names and Slang
As discussed earlier, there are a substantial number of names for mirtazapine around the world. When mirtazapine is combined with venlafaxine it is sometimes called “California Rocket Fuel”, indicating recreational use.
There can be a wide range of side effects experienced while taking mirtazapine or Remeron.
Common Remeron Side Effects can include:
Remeron withdrawal effects during cessation should be observed carefully, even when stopping Remeron slowly, as these include some potentially life-threatening events.
Remeron withdrawal symptoms from Remeron include:
Talk to a trusted healthcare practitioner who can help you devise and implement a structured, safe plan for Remeron withdrawal over a period of time. Never attempt a “cold turkey” approach to coming off antidepressants of any type. Stopping Remeron can be done most safely with guidance and attentive medical support.
Staying hydrated, getting enough rest, eating well are some of the things you can do to help to stop taking Remeron gently, and without getting extremely sick.
Remeron has been around since the late 1990s. Over time, a fairly substantial body of information has been able to accumulate on the drug. Here are some of the topics and questions that are often searched for.
Tolentino J, Schmidt S DSM 5 Criteria and Depression Severity: Implications for Clinical Practice. Front Psychiatry [INTERNET] October 2018 [cited March 9, 2020]
Frances A, Frances A DSM-5 Will Not Be Credible Without an Independent Scientific View. Psychiatric Times [INTERNET] November 2, 2011 [cited March 9, 2020
Karsten J, Hagenauw LA, Kamphuis J, Lancel M Low doses of mirtazapine or quetiapine for transient insomnia, a randomised, double-blind, cross-over, placebo-controlled trial. J. Psychopharmacol [INTERNET] March 2017 [cited March 9, 2020]
Tajti J, Almas J Effects of mirtazapine in patients with chronic tension-type headache [Literature Review]. PubMed, Neuropsychopharmacol Hung [INTERNET] June 2011] [cited March 9 2020]
Ringeisen H, Casanueva C, Stambaugh L, Bose J, Hedden S DSM-5 Changes: Implications for Child Serious Emotional Disturbance. Center for Behavioral Health Statistics and Quality.(2016). 2014 National Survey on Drug Use and Health: (unpublished internaldocumentation). Substance Abuse and Mental Health ServicesAdministration, Rockville, MD. [INTERNET] [cited March 9, 2020]
Mirtazapine (Remeron) Information Sheet. NAMI [INTERNET] [cited March 9, 2020]
Leonard S, Karlamangla A Dose-dependent Sedating and Stimulating Effects of Mirtazapine. UCLA Healthcare [INTERNET] Vol. 19 2015 [cited March 9, 2020]
Abdulkader A, Voronovich Z, Carley J A Review of Therapeutic Uses of Mirtazapine in Psychiatric and Medical Conditions. PMCID [INTERNET] October 2013 [cited March 9, 2020]
Pfeiffer C, LaMola S Zinc and Manganese in the Schizophrenias. Journal of Orthomolecular Medicine [INTERNET] 1st quarter 1999 [cited March 9, 2020
FDA Label Remeron/mirtazapine [INTERNET] [cited March 9, 2020]
Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona. He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine. Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.