Increased appetite and weight gain are just two of the more common side effects of this commonly prescribed antidepressant.

Key takeaways:

• Mirtazapine is primarily prescribed to treat depression.
• It can also help manage anxiety, OCD, and insomnia.
• Increased appetite and weight gain are common side effects, but there are effective ways to combat them.

Mirtazapine (brand name: Remeron) is a prescription drug and tetracyclic antidepressant (TCA) mostly used to treat major depressive disorders. It inhibits the alpha-2 adrenergic receptors in the central nervous system, helping the body to produce increased levels of norepinephrine and serotonin, two neurotransmission chemicals used by nerve cells to send signals to each other. Low levels of these important chemicals can cause mental and physical issues. Mirtazapine helps restore balance, and in doing so can also treat a wide range of issues beyond depression including various forms of anxiety, panic, and OCD. Mirtazapine is also known to increase appetite, which can be beneficial or detrimental, depending on the patient. Let’s dive in for a deeper look at this commonly prescribed pharmaceutical.

Mirtazapine benefits

Improved mood and reduced anxiety are two of the biggest potential benefits of taking this potent drug. Mirtazapine used to treat OCD can help patients break out of constrictive thought and behavior patterns, especially if the tablets are combined with approaches like exposure and response prevention (ERP) or cognitive behavioral therapy (CBT). Mirtazapine has also proven effective in managing sleep disturbances. This can have associated positive effects due to the vital importance of good sleep for reducing stress and improving mental clarity.

Mirtazapine and weight

Increased appetite is one of the more frequent side effects people experience while taking mirtazapine, which can lead to significant weight gain. Hormonal and chemical changes caused by the medication are believed to be at the root of this issue, with one theory pointing to increases in the hormone leptin among people who take mirtazapine. Cravings for certain foods may also be caused by mirtazapine interfering with glucose levels and neurotransmission. As a result, the body starts to crave foods high in sugar and carbs. These effects don’t relegate mirtazapine to being universally risky in terms of weight gain. It has the off-label potential to help some patients gain weight if necessary. In either case, weight management while taking mirtazapine can be critical to good health. Generally speaking, following a nutrient-rich diet, hydrating sufficiently, and exercising carefully can help you avoid excessive weight gain if you’re taking mirtazapine. Whole grains, lean proteins, and fresh vegetables can make us feel fuller and combat cravings more successfully than snacks full of empty carbs. Always consult your doctor before adopting any dietary or physical program.

Other side effects of mirtazapine

In addition to cravings and weight gain, common reactions to mirtazapine include:

• Physical agitation/sense of restlessness
• Vision issues or ocular swelling
• Dizziness or confusion
• Constipation
• Sleepiness

Less frequently, mirtazapine may cause more serious side effects, including:

• Increased aggression or violence
• Panic attacks or increased anxiety
• Deeper depression
• Suicidal ideation

Mirtazapine can weaken the immune system due to its reductive effect on white blood cell (leukocyte) production. Fewer leukocytes increase the chances of catching an infection, so mirtazapine patients may experience body aches, chills, fatigue, and other flu-like symptoms. Severe allergic, epidermal, and respiratory reactions have been noted in patients taking mirtazapine. These may cause breathing difficulties, reddening and rashes accompanied by swelling, and pronounced itching that may coincide with joint pain and blistering.

Serotonin syndrome

Serotonin syndrome is one possible – and potentially fatal – side effect of taking mirtazapine by itself or in combination with other drugs (medicinal or recreational). Typical signs of this serotonin syndrome include:

• Altered mental states
• Hallucinations
• Neuromuscular excitation
• Autonomic dysfunction
• Diarrhea or vomiting

If you or a loved one experiences any of these symptoms call 911, especially in cases of breathing difficulties, collapse, or loss of consciousness. You can also contact Poison Control online or at 1-800-222-1222 for advice on medications and their effects. All side effects should be discussed with your doctor including changes in mood, thoughts, or behavior. Even seemingly mild side effects like restlessness or gastrointestinal issues can be signs of something more serious such as Serotonin syndrome or acute pancreatitis, respectively. Your doctor can offer advice on how to manage less serious effects so they won’t excessively impact your life, as well as ensure that they aren’t signs of a more serious reaction.

Precautions and warnings

It may be necessary for patients with certain conditions to avoid mirtazapine entirely. For example, anyone with low blood sodium levels is at greater risk of dizziness and confusion when taking mirtazapine. This drug can also lower blood pressure, which may make it unsuitable for anyone with a history of heart problems. Liver or kidney issues may also cause complications with the processing and absorption of mirtazapine. Pregnant or breastfeeding mothers should consult a doctor before taking mirtazapine or if they discover they’re pregnant while taking it. In such cases, a doctor may recommend a slow reduction of dosage over a monitored period of time, as stopping mirtazapine is a delicate process that can lead to withdrawal symptoms. Mirtazapine’s potential to cause mania might render it unsafe for anyone with prior or existing mania or bipolar disorder. Mirtazapine may also interact negatively with other medications and substances, including vitamins and herbs such as St. John’s Wort. Other substances to avoid mixing with mirtazapine include:

• Alcohol
• Antibiotics and antifungals
• Antipsychotics
• Anxiety medications
• Sedatives⠀ ⠀

Several other medications can cause problems with mirtazapine, so make sure your doctor has a list of everything you’re taking, including over-the-counter medications and dietary supplements.

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