Can Mirtazapine Be Used For Sleep? Can Mirtazapine Be Used For Sleep?

Can Mirtazapine Be Used For Sleep?


Major depressive disorder (MDD) can be treated with mirtazapine, a tetracyclic antidepressant. Off-label use of the medication can lead to sleep-promoting side effects. Ask your healthcare provider about mirtazapine's sleep benefits if you have been prescribed it, I aim to explain what mirtazapine does, its potential side effects, interactions, and warnings in this article. Also, I'll talk about when you'd like to see a medical provider if you have sleep problems.

What is Mirtazapine?

Antidepressants such as mirtazapine (Remeron) are prescribed for major depressive disorder. As a result, it balances chemical messengers, known as neurotransmitters, that may contribute to depression symptoms. As a result, nerve cells in the central nervous system can communicate more effectively.

The antidepressant mirtazapine is less commonly prescribed, but that doesn't mean it's ineffective.


What Does It Treat?

The FDA has approved mirtazapine for the treatment of depression. Compared to other medications, it can provide faster relief from depression symptoms and anxiety. It improves sleep, nausea, and appetite when taken with mirtazapine. Additionally, it may help treat pain due to its side effects.


Mirtazapine can also be prescribed off-label for the following conditions:


  • Fibromyalgia

  • Insomnia

  • A combination of SSRIs and post-traumatic stress disorder (PTSD) is usually prescribed for PTSD.

  • Social anxiety disorder

  • Panic disorder


There were fewer side effects associated with mirtazapine than other antidepressants, despite it being as effective as amitriptyline.


The effects

Mirtazapine was equal to those of selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil), and fluoxetine (Prozac), but they began to show sooner than SSRIs.

The remission rate of depression-related symptoms was 74% higher in patients taking mirtazapine than in those taking SSRIs.


Mirtazapine For Sleep

Insomnia and sleep-related problems can be treated with mirtazapine, which is not strictly a sleep medication.

Mirtazapine can interfere with the histamine H1 receptor in the same way as antihistamines, which are also used off-label to treat sleep disorders.

Sleep can be prevented if this receptor is overactive. Sedative effects can be induced when it is blocked. Mirtazapine was found to improve sleep duration in a small study from 2002. The number of awakenings decreased, and the quality of sleep improved.


Mirtazapine has also been shown to interfere with sleep in other studies:


  • Support falling asleep faster.

  • Increase melatonin levels

  • Reduce night-time awakenings and promote sleep continuity.

  • Increase deep sleep (slow-wave sleep)


People with insomnia or other sleep-related issues may also suffer from depression, so mirtazapine may be a valuable medication for both conditions.

Although mirtazapine can improve sleep quality and may decrease rapid eye movement (REM), it does have some sleep benefits.


Potential Side Effects

Mirtazapine has mild side effects that may not affect everyone.


The following are common side effects:


  • Dry mouth

  • Increased appetite

  • Feelings of mania

  • Sweating

  • Lightheadedness or dizziness

  • Drowsy feelings

  • Weight gain


There can be severe side effects in some cases.


While taking mirtazapine, you may experience the following side effects:


  • Fever or other signs of infection

  • Shaking or tremors

  • Confusion

  • Swelling in the hands or feet


When people taking mirtazapine faint, experience rapid heartbeats, have seizures or lose their vision, immediate medical attention is necessary.


Oral tablets and tablets that dissolve in the mouth are available as forms of mirtazapine. There is no difference in dosage between the two formulations. Various tablet dosages are available, including 7.5mg, 15mg, 30mg, and 45mg. Generally, 15 mg is taken once daily before bedtime as a starting dose.

Up to 45 mg can be given per day by a healthcare provider. Following 1-2 weeks of taking mirtazapine, the dosage may be gradually increased.


There are several possible drug interactions with mirtazapine. The effectiveness of the medication may be affected by these factors. It is also possible for interactions to cause dangerous and preventable side effects.


Taking mirtazapine with the following medications is not recommended:


  • Intravenous methylene blue

  • Phenytoin (Dilantin)

  • Carbamazepine (Tegretol)

  • Benzodiazepines

  • Other medications that increase the risk of serotonin syndromes, such as lithium or triptans

  • Heart rhythm medications like amiodarone

  • Monoamine oxidase inhibitors (MAOIs)

  • Linezolid (Zyvox)

  • Warfarin


Interactions listed here are not all-inclusive.


Please inform your medical provider and pharmacist if you take any over-the-counter (OTC) medications, herbs, or dietary supplements.



Mirtazapine may increase the risk of suicidal thoughts in young adults, as with other antidepressants. A profound side effect may occur if mirtazapine is taken with other medications or substances that affect serotonin levels. A heart problem called QT prolongation may be associated with mirtazapine. Fast and irregular heartbeats, dizziness, and fainting are symptoms. Patients with a history of heart disease, low potassium or magnesium levels, and older adults are more likely to develop this complication.

Drowsiness can occur during the day when taking mirtazapine. Before you know how the medication affects you, avoid driving or operating heavy machinery. There can be complications if you suddenly stop taking mirtazapine. To help avoid side effects or complications, your healthcare provider will gradually taper your dosage if you must stop taking mirtazapine. The use of mirtazapine during pregnancy should only be recommended if it is the only option available to the patient's healthcare provider. In the third trimester, it can cause side effects in the infant.


When to See a Doctor

Seek medical attention if you have sleep problems and OTC remedies aren't helping. They can recommend an appropriate treatment option. You will be asked about your symptoms, medical conditions, and other factors that you think may contribute to sleep problems.


Consider speaking to your healthcare provider if you already take mirtazapine:


  • Questions about side effects

  • How to use mirtazapine for sleep

  • How mirtazapine may affect other aspects of your health

  • How to safely discontinue mirtazapine

  • Your dosage


A mental health emergency should be treated at an emergency room or by calling 112.


Frequently Asked Questions


What are the pros and cons of mirtazapine?


Tetracyclic antidepressants such as mirtazapine are used to treat depression. In addition to treating major depression, it may also be used to treat sleep disorders by some healthcare providers. Mirtazapine should only be taken according to the instructions.


Mirtazapine should be taken at night; at what time?


Mirtazapine should be taken as directed by your healthcare provider and pharmacist. Taking it every day at the same time is usually recommended.


What are the benefits of mirtazapine for sleep and anxiety?


In people with depression, mirtazapine may improve mood, reduce anxiety, and improve sleep. Other benefits may also be derived from it. To recommend the medication that will be most effective for you, your healthcare provider will consider your health conditions and symptoms.


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