|US brand name: Remeron|
|Generic name: mirtazapine|
At any dosage it will make you crave doughnuts. Seriously. You will want to invest in Krispy Kreme stock (or maybe something along similar lines that isn’t tanking); as Remeron’s antagonism of the serotonin 5HT2C and H1 receptors gives you the munchies for carbohydrates and sugars like you were 16 and smoking the best pot ever in the parking lot of a strip mall with a 24-hour doughnut shop beckoning you with glazed and jelly-filled ecstasy. People dipping spoons into a bag of sugar and eating it as is - not unheard of when on Remeron. This stuff is nothing more than legal marijuana, and if I knew crap about biochemistry I could probably prove that crazy statement. From a purely molecular-chemical perspective THC and mirtazapine are nothing alike. But there’s just something about how the two drugs work that is really close. And people who have self-medicated with pot respond really well to meds that really push the norepinephrine, and hard. Strattera, reboxetine, Cymbalta, and the more potent TCAs. And Remeron.
The production of extra serotonin and norepinephrine, and not just soaking neurons in what neurotransmitters are available for a longer period of time, is sometimes the best solution to recalcitrant depression. When it works it makes people feel really good. I mean really good. This is the closest thing to a happy pill on the market. Until you get all bummed out about how much weight you’ve put on and how little you do because you’re sleeping all the time.
As mirtazapine encourages your brain to actually produce more of the neurotransmitters serotonin and norepinephrine, talk to your doctor about taking their respective precursors, 5-HTP (or l-tryptophan) and l-tyrosine. Neurotransmitter/monoamine depletion is a controversial hypothesis, but it explains too many things, like antidepressant poop-out (tachyphylaxis) to dismiss outright.
This med is not for mild to moderate depression, it’s for people who are seriously depressed, who are willing to put up with the weight gain and the sleeping because those side effects suck much less than the dark pit of depressive despair one finds oneself in.
You probably don’t want to mix Remeron with Zyprexa as your choice of antipsychotic and antidepressant to treat bipolar disorder or severe treatment-resistant depression. One woman I know from the bipolar support forum on about.com was prescribed that combination as an inpatient in a Canadian hospital. She reported there how she ballooned up in weight, from 103 pounds to 162 pounds, in about six weeks, and carrying that on a 5′ 1″ frame. She gained a pound and a half a day, eating hospital food! As has been pointed out, that isn’t possible in this universe. Or at least is extremely unlikely. I have read several reports of people who were on cocktails of Remeron and an antipsychotic for refractory unipolar or bipolar depression. No one had, or will gain half a kilo a day, but rapid and extensive weight gain is as certain as sunrise over a suburban stripmall being accompanied by the scent of doughnuts.
What doctor in their right mind would prescribe Remeron and Zyprexa for someone not in their right mind? It’s not as crazy as it sounds: Combined treatment of olanzapine and mirtazapine in anorexia nervosa associated with major depression, Mirtazapine add-on improves olanzapine effect on negative symptoms of schizophrenia, and Management of symptons associated with advanced cancer: olanzapine and mirtazapine. I’m pretty sure she didn’t have cancer, but the other two uses could explain the perception of gaining a pound and a half a day.
Name, Address, Serial Number (Generic and Overseas Availability)
Available in the US as a generic? Yes
Shapes & Sizes (How Supplied)
You might be able to get it in pill form. These days Remeron SolTab - the orally disintegrating tablet - is the main way it’s prescribed and dispensed.