Mirtazapine (Remeron)

Antidepressant (norepinephrine/serotonin receptor antagonist at alpha-2, 5-HT2, 5-HT3; in low dose is histamine antagonist promoting sleep)

Dosing

7.5-15mg/night for sleep, 30-45 mg/night for depression.

Management

Warn of fatigue, weight gain (30%). Treats nausea and itch. Treats akathisia in doses below 30mg/night, but can cause it above that. Reduces cravings in meth/amph (?cocaine) abuse. Reduces side effects of SSRIs. Raise by 2-3x if using with carbamazepine.

Good for anxious depression and geriatrics. Deepens sleep quality. Rumors that it augments antidepressants turned out to be false.

EMR Text