Mirtazapine Uses in Addiction Treatment & Potential Side Effects
Mirtazapine is an antidepressant medication that has off-label uses for addiction treatment.1,2 This article will explain what mirtazapine is used for and go over potential mirtazapine uses for addiction and co-occurring conditions.
What Is Mirtazapine?
Mirtazapine is a prescription antidepressant that was first approved to treat major depressive disorder but has since been investigated and used off-label to treat a wide range of other conditions, including neurological and substance use disorders.1
In the U.S., mirtazapine is marketed under the brand names Remeron (tablet form) or Remeron Soltab (an orally disintegrating tablet), and is also available as a generic medication.3
Mirtazapine is a tetracyclic antidepressant. Unlike many other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), or anti-anxiety drugs like,benzodiazepines, mirtazapine has a distinct mechanism of action.
What Is Mirtazapine Used For?
Mirtazapine may be used to treat various psychiatric and medical conditions, including:
- Different forms of depression, including major depressive disorder, treatment-resistant depression, and geriatric depression.1
- Anxiety disorders.2
- Pain conditions.1
- Neurological disorders.4
- To improve appetite and reverse weight loss caused by medical conditions.1,4
- Insomnia.1,4
- Nausea and vomiting after surgery.4
- Sexual dysfunction.1
Additionally, researchers and doctors have been investigating mirtazapine’s potential off-label uses for treating stimulant use disorder and for managing sleep disturbances.1,2
Mirtazapine for alcohol and opioid withdrawal has also been examined. Some research shows that it may help with post-withdrawal anxiety and depressive symptoms in people in recovery from alcohol addiction, as well as several symptoms of opioid withdrawal.1,5
Mirtazapine Side Effects
As with any medication, mirtazapine may cause side effects. The most common side effects include:3
- Sedation.
- Heightened appetite and weight gain.
- Dizziness.
- Raised cholesterol and triglyceride levels.
Rare, more serious side effects include angle-closure glaucoma, lowered white blood cell count that can increase the risk of infection, and serotonin syndrome.3
It is important to avoid alcohol and illicit drugs while taking mirtazapine, as they can interfere with its effectiveness and increase the risk of side effects. Inform your doctor about all other medications and supplements you are taking, as certain drug interactions can be dangerous or reduce mirtazapine’s intended effects.3
Mirtazapine Dosage
Your physician will work with you to determine the appropriate dosage for your needs. Treatment usually begins with a low dose which may be increased slowly over several weeks based on your response. Typical daily doses range from 15-45 mg.3
It’s important to take the medication consistently, even if you start to feel better. Do not stop taking mirtazapine suddenly without consulting a doctor before quitting as this can cause withdrawal effects. Your doctor can help you taper off of mirtazapine safely.3
Mirtazapine in Addiction Treatment
Researchers have investigated the off-label uses of mirtazapine in addiction treatment. Mirtazapine has no known potential for misuse, which makes it a viable option to prescribe to addiction patients.2
While results of research on mirtazapine for addiction treatment have been mixed,2 there have been some promising findings, particularly in the treatment of addiction with co-occurring disorders.1 For example, one clinical review indicated that mirtazapine is a practical treatment approach for people with alcohol dependence and comorbid depression, specifically showing reductions in depression and alcohol craving.1
Recent research has also shown that mirtazapine may help alleviate specific symptoms of opioid withdrawal, such as sleep problems, diarrhea, and anxiety.5
As with other medications used in mental and behavioral health treatment,6 research has shown that mirtazapine appears to be most effective when used in conjunction with established, evidence-based methods like behavioral therapy and peer support.1 For example, research shows that mirtazapine improved the effects of cognitive-behavioral therapy (CBT) in people who had undergone alcohol withdrawal and were struggling with social anxiety.1
Using Mirtazapine To Treat Stimulant Addiction
Using mirtazapine to treat stimulant addiction is an emerging area of interest, with some research supporting mirtazapine treatment for those struggling with amphetamine-type stimulant use disorder. Mirtazapine may also benefit those who have stimulant use disorder and co-occurring depressive symptoms.2
found that treatment with mirtazapine resulted in decreased amphetamine-type stimulant use, decreased sexual risk behaviors, and improved sleep.2
Finding The Right Addiction Treatment For You
If you or a loved one is struggling, American Addiction Centers (AAC) is here to provide evidence-based, individualized addiction treatment. Please call our free, confidential helpline any time of day or night at to speak to a knowledgeable admissions navigator about your treatment options, ask any questions about the rehab process, and quickly verify your insurance.
You can also view our treatment centers and learn more about the admissions process. No matter how things might seem at the moment, there is always hope and proper treatment can help people recover from addiction and regain control of their lives.
