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Remeron Addiction and Dependence Can Be Overcome

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Medically Reviewed Fact Checked

Last Updated on July 2, 2024 by Diane Ridaeus

Alternative to Meds Editorial Team Published Nov 4, 2019
Medically Reviewed by Dr Samuel Lee MD

Remeron addiction or dependence and eventual withdrawal symptoms may be too complex to solve without help.

The FDA approved Remeron, brand name for mirtazapine, only for MDD (major depressive disorder). However, in the medical literature, we find many other “off-label” uses. Know there are other choices for treatment that don’t rely on pharmaceuticals for success and you can read more about these, below.

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dealing with remeron addiction
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How Does Remeron Addiction or Dependence Develop?

The longer an antidepressant drug is taken, and the higher the dose, the more likely that addiction or dependence will develop.22

Additionally, Remeron has a relatively long half-life which may delay the awareness of a person developing dependence. For females, the half-life is 37 hours and for males it is 20-27 hours. Younger males can metabolize the drug on the faster side of that range, and older males take longer to metabolize the drug. After the half-life point, or if a dose is missed or delayed, withdrawals will likely become noticeable.2

Although it was first approved to treat depression, Remeron produces anxiolytic effects (anti-anxiety) over a relatively short period of time. Anxiolytic effects include sleepiness, drowsiness, relaxation, and sedation. These feelings can make a drug become habit-forming, as it may become difficult to get to sleep or feel relaxed and comfortable without it. Other effects include secondary pain relief that takes some weeks or longer to manifest, and as an appetite stimulant in chronic illness, such as cancer.17,19

Dependence can occur quite rapidly, often only discovered when the dosage is reduced, stopped, or even if a dose is accidentally missed. 15,16

Different classes of antidepressants affect the central nervous system in unique ways.  Remeron is different than the SSRI or SNRI types because of the mechanics and structure of the drug. 

how does remeron dependence developThis class of drugs is not well understood, even though they have been marketed since the 1950s.1

Becoming dependent on antidepressant drugs is not at all uncommon.

There are specific characteristics that indicate when dependence or addiction has developed.  If you notice these are occurring, speak to your prescriber or get some professional guidance to avoid further health problems. 

Be sure to do your own research, too,  as you may find your prescriber knows very little about the drug that they prescribed. 

Signs of Remeron addiction and dependence can include:
  • Withdrawal adverse effects occur when the drug is stopped or a dose is delayed
  • Taking more, or taking it more often than prescribed
  • Tolerance or lack of effect over time
  • Repeated attempts to reduce or stop taking the drug
  • Usual activities are interrupted or stopped because of drug use
  • Physical problems related to drug use
  • Psychological problems related to using the drug

Is Remeron Addiction and Dependence Possible Even Though Prescribed?

A massive international study was done to assess the rates of dependence and addiction to prescribed antidepressant drugs. Clinical tests showed that about 20% of antidepressant users will experience withdrawal if they stop taking it after only one month of use.3  Long-term use is quite a bit more likely to cause a large percentage (61%) of users to form tolerance (lack of effect, needing a higher dose) and dependence, and will suffer withdrawals if the drug is stopped.16   According to the DSM, withdrawal symptoms when the drug is stopped are clinical signs of drug dependence.15

Adverse Interactions When Combining Remeron and Other Substances

Remeron is metabolized in the liver by CYP enzymes. CYP enzymes are majorly involved in the metabolism of drugs, and because many drugs can decrease or increase certain CYP activity, this is one major cause of adverse interactions between drugs. For example, when the first drug limits CYP metabolism of the second drug, the second can accumulate in the body to levels that are toxic, potentially causing an overdose. Many such interactions are possible, and like a roulette wheel, their outcomes are largely unpredictable.1,2,5

Drug interactions including additive effects can occur by combining Remeron with any additional serotonergic herbs, drugs or alcohol. This caution also to applies to drugs that enhance or inhibit drug metabolism. The drug label warns that drug-drug interactions are a largely untested area of pharmacology, so one needs to be alert to possible adverse reactions.1,2

Avoid these when taking Remeron:

  • St Johns Wart
  • Tryptophan
  • Diazepam
  • other antidepressants
  • migraine medications
  • anti-seizure medications

NOTE: Always consult with your prescriber to avoid drug-drug interactions.

Is Remeron an SSRI?

No. Remeron is classified as an “atypical tetracyclic”, although the effects are similar to SSRIs. Remeron is sometimes referred to as a NASSA drug, an impressive acronym that stands for Noradrenaline And “Specific” Serotonin receptor Antidepressant.

Tetracyclic antidepressants are named after their structure of 4 molecular rings.  Like SSRIs, tetracyclics are psychoactive drugs but are thought to manipulate multiple hormones — not only serotonin, but also norepinephrine, and others. Mirtazapine is a relatively newer tetracyclic, marketed since the late 1980s. 

In addition to the SSRIs, SNRIs, and “classic” TCAs and MAOs, there are now NASSAs, SARIs, NeRIs, MASSAs, NRIs, NDRIs, SNDRIs, SMIs, SMSs, and many additional types of new generation antidepressant drugs (NGAs). This ever-expanding arsenal of antidepressant drugs is thought to manipulate various combinations and functions of a range of our natural neurochemicals — though there is a concerning lack of understanding that predicts how they do this.4,5,13,16

What is Remeron Prescribed for?

Remeron is FDA-approved to treat MDD (major depressive disorder). Remeron’s sedative effects have led to the common practice of “off-label” prescribing for conditions including insomnia, panic disorder, PTSD, OCD (obsessive-compulsive disorder), SAD (social anxiety disorder), tension headaches, and fibromyalgia.2,6

Remeron is an appetite stimulant for a large percentage of people who take it. It is associated with significant weight gain over a surprisingly short time span. It is sometimes prescribed for that very reason, off-label to encourage consuming food in cases of malnutrition.18

Why is Remeron Addiction So Hard to Deal With On Your Own?

Though a person may want to stop using this drug, they are often unable to do so easily because after Remeron addiction or dependence has developed, withdrawals can be extremely harsh, especially after suddenly stopping the drug.

In addition, the psychiatric symptoms brought on by toxic exposures are virtually ignored in the process of assessing a person’s mental health. If depression, anxiety, insomnia, or other symptoms arose after toxic exposures, drugging the patient will not address the real problem.8

There are multiple reasons for unwanted symptoms to emerge, and numbing these with drugs can only provide temporary relief at best. Original symptoms are likely to return and often with a vengeance, which will magnify the difficulties.1-3,7

After Remeron addiction or tolerance has developed, withdrawals can include:
  • Mania
  • Seizures
  • Low-sodium plasma level
  • Physical discomforts — electric shock-like sensations, tingling, shaking, sweating
  • Nausea, vomiting
  • Insomnia, disturbed sleep, unusual dreams, vivid nightmares
  • Headache
  • Achiness
  • Fatigue
  • Vertigo, dizziness, lightheadedness
  • Irritability, anxiety, agitation, hyperarousal
  • Mental confusion

However, withdrawing from this medication can be done safely, simply, and made more tolerable by accessing proper Remeron addiction help. Remeron withdrawal may be a very difficult monster to manage on your own without medical and clinical guidance and support. The safest way to withdraw from this addiction is in an inpatient center that can provide quality help and guidance. Out-patient treatment may be appropriate for some, and can be found through which is a directory for quality holistic-minded medical professionals and other resources by location across the US. We recommend looking for treatment that includes a protocol of safe tapering, focus on nutrition and hydration, CBT, neurotoxin removal, diet correction and nutritional supplementation, and other clinical and personal support in place.1

Many, many side effects of mirtazapine have shown up in medical research such as the ones below.1,20,21

Side effects of Remeron can include:
  • Acute psychosis
  • Suicidal thoughts or actions (see black box warning on package material)
  • Changes in white blood cell count
  • Increased cholesterol
  • Serotonin syndrome
  • Worsened anxiety
  • Worsened depression
  • Panic attacks
  • Violent or aggressive behavior
  • Compulsive behavior, dangerous impulsive actions
  • Heavy sedation, impaired ability to drive or operate heavy machinery
  • Sleep disturbances, sleep walking, vivid dreams, realistic nightmares
  • Significant weight gain, increased appetite

Can Depression Be Treated Without Addictive Drugs like Remeron?

Persons are usually put on antidepressant drugs before there have been any significant efforts to investigate why they may be depressed, experiencing migraines, PTSD, or suffering from lack of sleep. For many persons, it may be after or during an event that is emotionally traumatic that they start using these medications. But years later they are likely still on the drug, whose masking effects have waned, and are still suffering the same symptoms as before. But now they could also be suffering from antidepressant addiction and withdrawal symptoms. This can be extremely debilitating, leaving a person feeling hopeless in their continued suffering.2

Like fast food, drug therapy is meant to be quick and easy — but does nothing to improve health. And incidentally, with mirtazapine, it might even have a similar negative effect on your waistline.14

remeron addiction holistic detoxing sedona arizonaAntidepressants are not a cure. Drugs can only mask symptoms, which is a non-sustainable treatment for many persons. Drug therapy without a thorough investigation of root causes is akin to bailing out a sinking ship. That might get you to shore, but you will need to find out where the leaks are and actually repair them before that boat is seaworthy. It takes time to properly treat symptoms because it takes time to discover their root causes and then to plan and initiate the needed corrections.

Alternative to Meds Center uses a combination of orthomolecular principles, lab testing, neurotoxin removal, neurotransmitter rehabilitation, and other holistic detox methods to regain natural mental health without drugs. Tapering is slow and safe and monitored carefully while a client progresses through their inpatient program at the center. Depression and other unwanted symptoms in life can be investigated for prior causes and those are what need to be addressed, whether nutritional, lifestyle in origin, trauma-based, neurotoxin exposure related, or whatever is traced back to its causal factors. If these are addressed and resolved, the symptoms are authentically resolved. We have had tremendous success in using this holistic approach to recovery of natural mental health for our clients. The results are long-term, safe, and drug-free. 8-12

Where to Find the Best Treatment for Remeron Addiction?

Alternative to Meds Center is a drug treatment facility that is dedicated to discovering the medical reasons why an individual could be depressed, feeling anxious, or having trouble sleeping. Our Remeron alternative rehab protocol includes lab testing, natural substances for stabilization of the neurochemistry, body cleansing to remove accumulated environmental toxins, medication withdrawal techniques, targeted nutrition therapy, nebulized glutathione treatmentspeer support, personal exercise training, yoga, massage, and spa services, and many other natural therapies that can address and relieve troublesome symptoms, that drug therapy didn’t prove to be the answer for. Please call us for more details on the unique Remeron addiction and dependence help that we offer.


1. FDA drug label Remeron (mirtazapine) tablets approval 1984, revised or reissued 2009 [cited 2022 Sept 8]

2. Jilani TN, Gibbons JR, Faizy RM, et al. Mirtazapine. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. [cited 2022 Sept 8]

3. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017 May 29;189(21):E747. doi: 10.1503/cmaj.160991. PMID: 28554948; PMCID: PMC5449237. [cited 2022 Sept 8]

4. Protti M, Mandrioli R, Marasca C, Cavalli A, Serretti A, Mercolini L. New-generation, non-SSRI antidepressants: Drug-drug interactions and therapeutic drug monitoring. Part 2: NaSSAs, NRIs, SNDRIs, MASSAs, NDRIs, and others. Med Res Rev. 2020 Sep;40(5):1794-1832. doi: 10.1002/med.21671. Epub 2020 Apr 13. PMID: 32285503. [cited 2022 Sept 8]

5. Mandrioli R, Protti M, Mercolini L. New-Generation, Non-SSRI Antidepressants: Therapeutic Drug Monitoring and Pharmacological Interactions. Part 1: SNRIs, SMSs, SARIs. Curr Med Chem. 2018;25(7):772-792. doi: 10.2174/0929867324666170712165042. PMID: 28707591. [cited 2022 Sept 8]

6. Holm KJ, Markham A. Mirtazapine: a review of its use in major depression. Drugs. 1999 Apr;57(4):607-31. doi: 10.2165/00003495-199957040-00010. PMID: 10235695. [cited 2022 Sept 8]

7. Warner CH, Bobo W, Warner C, Reid S, Rachal J. Antidepressant discontinuation syndrome. Am Fam Physician. 2006 Aug 1;74(3):449-56. PMID: 16913164. [cited 2022 Sept 8]

8. Brown JS Jr. Psychiatric issues in toxic exposures. Psychiatr Clin North Am. 2007 Dec;30(4):837-54. doi: 10.1016/j.psc.2007.07.004. PMID: 17938048. [cited 2022 Sept 8]

9. Gautam M, Tripathi A, Deshmukh D, Gaur M. Cognitive Behavioral Therapy for Depression. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S223-S229. doi: 10.4103/psychiatry.IndianJPsychiatry_772_19. Epub 2020 Jan 17. PMID: 32055065; PMCID: PMC7001356. [cited 2022 Sept 8]

10. Brinsley J, Schuch F, Lederman O, Girard D, Smout M, Immink MA, Stubbs B, Firth J, Davison K, Rosenbaum S. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med. 2021 Sep;55(17):992-1000. doi: 10.1136/bjsports-2019-101242. Epub 2020 May 18. PMID: 32423912. [cited 2022 Sept 8]

11. Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41(1):15-28. doi: 10.2190/PM.41.1.c. PMID: 21495519. [cited 2022 Sept 8]

12. Saeed SA, Cunningham K, Bloch RM. Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation. Am Fam Physician. 2019 May 15;99(10):620-627. PMID: 31083878. [cited 2022 Sept 8]

13. Kent JM. SNaRIs, NaSSAs, and NaRIs: new agents for the treatment of depression. Lancet. 2000 Mar 11;355(9207):911-8. doi: 10.1016/S0140-6736(99)11381-3. Erratum in: Lancet 2000 Jun 3;355(9219):2000. PMID: 10752718. [cited 2023 July 3]

14. Davis R, Wilde MI. Mirtazapine : A Review of its Pharmacology and Therapeutic Potential in the Management of Major Depression. CNS Drugs. 1996 May;5(5):389-402. doi: 10.2165/00023210-199605050-00007. PMID: 26071050. [cited 2023 July 3]

15. Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. The American journal of psychiatry170(8), 834–851. [cited 2023 July 3]

16. Read J. How common and severe are six withdrawal effects from, and addiction to, antidepressants? The experiences of a large international sample of patients. Addict Behav. 2020 Mar;102:106157. doi: 10.1016/j.addbeh.2019.106157. Epub 2019 Nov 30. PMID: 31841871. [cited 2023 July 3]

17. Fitzgerald K, Buggy D, Tetracyclic Antidepressant in Postoperative Pain Management Journal 2006 [cited 2024 June 11]

18. Puzantian T. Mirtazapine, an antidepressant. Am J Health Syst Pharm. 1998 Jan 1;55(1):44-9. doi: 10.1093/ajhp/55.1.44. PMID: 9437474. [cited 2024 June 11]

19. Jilani TN, Gibbons JR, Faizy RM, Saadabadi A. Mirtazapine. 2023 Aug 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30085601.[cited 2024 June 11]

20. Yeh YW, Chen CH, Feng HM, Wang SC, Kuo SC, Chen CK. New onset somnambulism associated with different dosage of mirtazapine: a case report. Clin Neuropharmacol. 2009 Jul-Aug;32(4):232-3. doi: 10.1097/WNF.0b013e318187bafc. PMID: 19644232. [cited 2024 June 11]

21. Felthous AR, Wenger PJ, Hoevet R. Acute psychosis associated with dissociated sleep-wakefulness state after mirtazapine treatment. Pharmacotherapy. 2010 Apr;30(4):145e-50e. doi: 10.1592/phco.30.4.423. PMID: 20334466. [cited 2024 June 11]

22.  Fava GA, Offidani E. The mechanisms of tolerance in antidepressant action. Prog Neuropsychopharmacol Biol Psychiatry. 2011 Aug 15;35(7):1593-602. doi: 10.1016/j.pnpbp.2010.07.026. Epub 2010 Aug 20. PMID: 20728491.[cited 2024 July 2]

Originally Published by Diane Ridaeus Nov 4, 2019

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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