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Remeron Addiction

This entry was posted in Addiction on by .
Medically Reviewed Fact Checked

Last Updated on July 3, 2023 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 problems that are too complex to solve without help. Remeron dependence is a growing concern and can create just as troublesome side effects as many other drug addictions. After becoming dependent or addicted, a person often requires specialized treatment to overcome it. The FDA approved Remeron only for MDD (major depressive disorder). However, in the medical literature, we find many other “off-label” uses, which you can read more about, below. 

How Does Addiction to Remeron Develop?

Remeron commonly causes an individual to feel overly drowsy upon consumption.  As a result, this medication can become habit-forming to induce sleep and relaxation. Remeron has a half-life of 20-40 hours (on the short end for females, and longer for males) and is prescribed for daily or pre-bedtime use. Some individuals may become reliant on Remeron after taking it for a while. Some may not be aware of their developing dependence on this medication until they try not to take it. A massive study was done to assess internationally the rates of dependence and addiction to antidepressant drugs. Long-term use is 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, these are clinical signs of drug dependence.15

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 
  • 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 Possible Even When Not Prescribed?

Remeron (mirtazapine) is primarily an antidepressant, which produces anxiolytic effects. Anxiolytic effects include sleepiness, drowsiness, relaxation, and sedation. These feelings can make a drug become habit-forming. Some individuals, prescribed or not, may take this medication in combination with other intoxicating substances such as alcohol or other drugs. This is risky. Drug and alcohol interactions can create unpredictable consequences. In fact, some of these effects may be life-threatening. Accidental overdose is another risk, as judgment may be clouded as to timing and dosage. Remeron side effects, including allergic reactions and other potential problems, are described in more detail below.

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 pretty unpredictable.1,2,5

Drug interactions including additive effects can occur by combining Remeron with any serotonergic drugs including 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

Also of note, if a patient has impaired liver or kidney function, the drug will take longer to clear before the next dose is taken. This is of particular concern to females, whose Remeron half-life averages 37 hours, compared to males, whose Remeron half-life on average is 27 hours. Elderly males showed slower clearing rates as compared to younger males according to the clinical trial data.

Is Remeron an SSRI?

No, Remeron is not classified as an SSRI, though the effects are similar to SSRIs. It is a “non-SSRI”, one of a vast number of “new generation” antidepressant drugs that have come on the market since SSRIs. Remeron is a NASSA drug, an acronym that stands for Noradrenaline And “Specific” Serotonin receptor Antidepressant.

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 aims to manipulate various combinations of neurochemicals that are naturally created by, and found in the human body.4,5,13

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

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. 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. Whether you have a prescription for this medication or not, medical providers will not judge or refuse your treatment. The safest way to withdraw from this addiction is in an inpatient Remeron rehab center with a protocol of safe tapering, hydration, CBT, neurotoxin removal, diet correction and nutritional supplementation, and other clinical and personal support in place.1

Side effects of Remeron can include:

  • Suicidal thoughts or actions (see black box warning on package material)
  • Increased white blood cell count
  • Increased cholesterol
  • Serotonin syndrome
  • Worsened anxiety
  • Worsened depression
  • Panic attacks
  • Violent or aggressive behavior
  • Compulsive behavior, dangerous impulsive actions
  • 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 fast. And like fast food, it may temporarily quell hunger but does nothing to improve health. 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 do the needed corrections. 

And, to clarify any unintended confusion on the above analogy between fast food and drug therapy, regarding weight, Remeron is known to cause weight gain, and increase appetite, rather than having opposite effects.14

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 Remeron addiction 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]

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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Remeron Addiction
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