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.
You are unique. So should your treatment choices be.
Independently reviewed published evidence clearly demonstrates the success that our clients have enjoyed for more than 17 years. Using holistic and orthomolecular treatments, the body can be cleansed of neurotoxins, safely and gently tapered off medications, and natural mental health can be restored. Read on to find out more about our unique orthomolecular-based treatments offered in a beautifully pristine inpatient setting.
15 Years Experience by Professionals Who Understand Your Journey.
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.
This 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
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 ACAM.org 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
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
Antidepressants 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?
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]
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 psychiatry, 170(8), 834–851. https://doi.org/10.1176/appi.ajp.2013.12060782 [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]
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]
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.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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This class of drugs is not well understood, even though they have been marketed since the 1950s.1
Antidepressants 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.
