|
What
is Remeron?
Remeron (mirtazapine), manufactured by Organon Inc., is a
medication that was approved by the Food and Drug Administration
(FDA) for the treatment of depression in June 1997. Remeron
was the first drug in a new class of antidepressants with
a unique ability to target specific serotonin receptors. Along
with its efficacy in the treatment of moderate to severe depression,
Remeron has proven to be effective for treating anxiety, motor
retardation, and cognitive and sleep disturbances associated
with depression.
How
is Remeron different from other antidepressants?
Remeron has a tetracyclic chemical structure that causes it
to act differently from other common antidepressants (SSRIs,
MAOIs, and tricyclics). While stimulating norepinephrine and
serotonin release, Remeron also has the unique ability to
block two specific serotonin receptors, thus causing fewer
serotonergic side effects (such as decreased interest in sex,
nausea, nervousness, insomnia, and diarrhea). In studies,
the use of Remeron, compared with tricyclic antidepressants,
also resulted in fewer anticholinergic symptoms (blurred vision,
dry mouth, indigestion, and constipation), cardiovascular
symptoms, and cognitive disturbances. Additionally, Remeron
has a relatively high safety margin in case of overdose and
a low tendency to cause seizures. It causes no significant
changes in vital signs (heart rate, blood pressure, or body
temperature) or ECG.
What
are the side effects of Remeron?
The most commonly reported drug-related side effects were
drowsiness, increased appetite, weight gain, and dizziness.
In studies, drowsiness generally appeared during the first
week of treatment but decreased in intensity over time, even
as dosages increased. Other side effects may also lessen in
severity, or go away, with prolonged use of the drug. However,
weight gain can sometimes be a persistent problem.
In clinical trials,
two out of 2,796 consumers treated with Remeron developed
agranulocytosis and a third consumer developed severe neutropenia
-- both potentially dangerous decreases in white blood cell
counts that cause extreme vulnerability to infection. These
consumers recovered after Remeron was stopped. However, it
should be noted that if a consumer develops a sore throat,
fever, inflammation of the mouth, or other signs of infection,
he or she should discontinue treatment with Remeron under
the supervision of a doctor. Since the introduction of Remeron
in the U.S. in 1997, agranulocytosis has not been a problem
and most scientists now believe it is not a specific side
effect of Remeron
How
does Remeron interact with other medications?
Remeron does not cause problematic interactions with most
other drugs and it is frequently prescribed in combination
with other antidepressants. Use of other drugs that cause
drowsiness (antihistamines, prescription painkillers, Valium,
Xanax) may increase this effect and impair driving or other
motor or coordination skills. Use with central nervous system
stimulants (Fastin, Dexedrine, Ritalin) may cause an increase
in agitation or even mania, especially in bipolar patients.
Immunocompromised
consumers, consumers with HIV, and consumers on steroid therapy
should call their physician at the first sign of sore throat,
fever, chills, sores in and around the soft tissue of the
mouth, or any general flu-like symptoms.
What
is the recommended dosage of Remeron?
Remeron is available in both 15 mg (yellow) and 30 mg (red-brown)
tablets. It is also available in Sol-Tabs preparation that
is dissolved under the tongue for those who have difficulty
swallowing pills. The recommended starting dose is 15 mg per
day given in a single dose before bedtime, and it can be taken
with or without food. It is recommended that one to two weeks
pass before making upward dosage adjustments, in small increments.
The effective dose range of Remeron is generally 15-45 mg/day,
but some patients do well with even higher doses. In patients
with liver and kidney disease, a smaller dose may be appropriate.
As with other antidepressants, it may take several weeks of
therapy before improvement is noticeable.
For more in-depth information about mental illness, treatments
and supports, and medications;
please choose from the following topics:
By
Illness | What is Mental Illness?
| Treatments & Supports
|
