Why is Remeron prescribed?
Remeron is prescribed for the treatment of major depression—that is,
a continuous depressed mood that interferes with everyday life. The
symptoms of major depression often include changes in appetite and
weight, difficulty sleeping, loss of interest in pleasurable
activities, constant fidgeting or a slowdown in movement, fatigue,
feelings of guilt or worthlessness, difficulty concentrating, slowed
thinking, and suicidal thoughts.
Remeron is thought to work by adjusting the balance of the brain's
natural chemical messengers, especially norepinephrine and serotonin.
It belongs to the class of drugs known as tetracyclics and is
chemically unrelated to other antidepressants such as serotonin
reuptake inhibitors and MAO inhibitors.
Most important fact about Remeron
Remeron makes some people drowsy or less alert, and may affect
judgment and thinking. Don't drive or participate in any hazardous
activity that requires full mental alertness until you know whether
Remeron has this effect on you.
How should you take Remeron?
Remeron may be taken with or without food. It is preferable to take
it in the evening before you go to sleep. Even though you may begin to
feel better in 1 to 4 weeks, continue taking this medication exactly as
prescribed. Regular daily doses are needed for the drug to work
If you are using Remeron SolTabs, an orally disintegrating form of
the drug, make sure your hands are dry before removing the tablet from
the blister pack and immediately place the tablet on your tongue. Do
not attempt to split the tablet; it will fall apart rapidly and can be
swallowed with saliva.
If you miss a dose...
Take the forgotten dose if you remember within a few hours.
Otherwise, skip the dose. Never try to "catch up" by doubling the dose.
Store at room temperature in a tight, light-resistant container.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in
intensity, tell your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Remeron.
Side effects may include:
Abnormal dreams and thinking, constipation, dizziness, dry mouth,
flu-like symptoms, increased appetite, sleepiness, weakness, weight gain
Why should Remeron not be prescribed?
If you have ever had an allergic reaction to Remeron or similar
drugs such as Ludiomil and Desyrel, you should not take this
medication. Be sure to tell your doctor about any drug reactions you
You should also avoid Remeron if you are taking drugs known as MAO inhibitors (see "Special warnings about this medication").
Special warnings about Remeron
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Remeron or
any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Remeron has not been studied in children
or adolescents and is not approved for treating anyone less than 18
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they are taking
antidepressants. Individuals being treated with Remeron and their
caregivers should watch for any change in symptoms or any new symptoms
that appear suddenly—especially agitation, anxiety, hostility, panic,
restlessness, extreme hyperactivity, and suicidal thinking or
behavior—and report them to the doctor immediately. Be especially
observant at the beginning of treatment or whenever there is a change
Serious, sometimes fatal reactions have been known to occur when
drugs such as Remeron are taken in combination with other drugs known
as MAO inhibitors, including the antidepressants phenelzine and
tranylcypromine. Never take Remeron with one of these drugs or within
14 days of discontinuing therapy with one of them; and allow at least
14 days between stopping Remeron and starting an MAO inhibitor.
If you develop flu-like symptoms, a sore throat, chills or fever,
mouth sores, or any other signs of infection, call your doctor; these
symptoms may signal a serious underlying condition.
Remeron tends to raise cholesterol levels in some people. If you
have a cholesterol problem, be sure to mention it to your doctor before
starting therapy with Remeron.
Remeron should be used with caution if you have active liver or
kidney disease, or heart or blood pressure problems. Also be sure to
tell your doctor if you have a history of seizures, mania (extremely
high spirits), hypomania (mild excitability), drug use, or any other
physical or emotional problems.
While first taking this medication you may feel dizzy or
light-headed, especially when getting up from a lying or sitting
position. If getting up slowly doesn't help, or if this problem
continues, notify your doctor.
If you must avoid phenylalanine, do not use the SolTab form of Remeron, which contains this substance.
Possible food and drug interactions when taking Remeron
Never combine Remeron with an MAO inhibitor; and do not drink
alcohol while taking this medication. If Remeron is taken with certain
other drugs, the effects of either could be increased, decreased, or
altered. It is especially important to check with your doctor before
combining Remeron with tranquilizers such as alprazolam.
Special information if you are pregnant or breastfeeding
The effects of Remeron during pregnancy have not been adequately
studied. If you are pregnant or plan to become pregnant, tell your
doctor immediately. It is not known whether Remeron appears in breast
milk. However, because many drugs do make their way into breast milk,
you should tell your doctor if you are breastfeeding or plan to
Recommended dosage for Remeron
The usual starting dose is 15 milligrams taken daily before going to
sleep. Depending upon your response, your dosage may be increased to as
much as 45 milligrams a day.
The safety and effectiveness of Remeron have not been established in children.
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.
Symptoms of Remeron overdose may include:
Drowsiness, impaired memory, mental confusion, rapid heartbeat