Last Updated:

May 16th, 2025

Taking Mirtazapine as Part of the Detox Process

Depression and anxiety are common symptoms during alcohol and drug withdrawal, making an already difficult detox phase even more challenging. Mirtazapine detox medication can offer significant relief from these symptoms, helping you get through this critical initial period of recovery safely and more comfortably. Mirtazapine’s effectiveness has seen it become one of the most used medications in addiction treatment, and understanding how it works, the benefits and the potential risks are all crucial for its effective and safe use.

Mirtazapine-pills-in-bottle

What is mirtazapine?

Mirtazapine, usually sold in Britain under the brand name Remeron, is an antidepressant that belongs to the noradrenergic and specific serotonergic antidepressant (NaSSA) class. Mirtazapine was first released in the 1990s for major depressive disorder, but since then, its use has been expanded to PTSD, panic and anxiety disorders and as a detox medication.

Mirtazapine comes in a range of pills and injections, including 15 mg, 30 mg and 45 mg. It is usually taken once a day, and the exact dosage differs between conditions, symptoms and individual responses to treatment.

How does Remeron work?

Remeron is often prescribed after other antidepressants don’t work due to its unique mechanism. It blocks particular serotonin receptors (5-HT2 and 5-HT3) along with alpha-2 adrenergic receptors, promoting norepinephrine and serotonin release. These are chemicals called neurotransmitters which affect your mood and emotions. Levels of these neurotransmitters are often low in people with conditions like anxiety and depression, and by raising them, Remeron can help alleviate the symptoms.

There are two secondary ways that Remeron helps with mental health conditions. First, Remeron’s action on your brain’s receptors increases histamine levels, creating a sedative effect. This can help with insomnia which is a common symptom of anxiety and depression.

Second, Remeron changes how your brain responds to triggers that bring on panic or stress. It does this by stimulating serotonergic and noradrenergic activity, which keeps you psychologically and emotionally stable and reduces the intensity and frequency of panic attacks and anxious episodes.

What are the potential side effects of mirtazapine?

While mirtazapine detox medication is very effective, it is a powerful drug that can produce adverse and even dangerous reactions. It is important that patients are aware of these risks and tell their doctors straight away if they notice any.

Common mirtazapine side effects

  • Mirtazapine weight gain: Long-term mirtazapine use is frequently linked to significant weight gain and changes in metabolism, which can potentially escalate the risk for diabetes and cardiovascular issues.
  • Drowsiness and sedation: These occur particularly at low doses due to mirtazapine’s antihistamine properties.
  • Dry mouth
  • Lightheadedness and dizziness
  • Gastrointestinal problems

Rarer and potentially more serious side effects of mirtazapine

  • Serotonin syndrome: This is a possibly fatal reaction that can develop when mirtazapine is combined with other drugs that enhance serotonin levels. Symptoms of serotonin syndrome include fever, accelerated heart rate, extreme agitation and confusion. If you notice any of these, seek urgent medical care.
  • Behavioural and mood changes: A small number of people taking mirtazapine may notice a decline in their mood or erratic behaviours, including suicidal thoughts. Again, these symptoms can be very serious and require swift medical care.
  • Sleep disturbances: Mirtazapine side effects can include a number of sleep issues, including intense nightmares, sleep paralysis, restless leg syndrome and instances of sleepwalking.
  • Skin issues: On rare occasions, mirtazapine can induce severe skin reactions such as toxic epidermal necrolysis and Stevens-Johnson syndrome, both of which require emergency medical response.
  • Liver harm: Mirtazapine is also linked to potential liver damage, which can range from mild enzyme increases to severe hepatitis. Those with existing liver issues should be particularly cautious, with regular liver function monitoring recommended.
  • A drop in white blood cell levels: Mirtazapine may cause severe neutropenia, a critical drop in white blood cells that heightens infection risk. This serious side effect of mirtazapine requires stopping the medication immediately and getting prompt medical testing.

Mirtazapine-tablet

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Is mirtazapine addictive?

While mirtazapine detox medication is not typically considered addictive, discontinuing its use suddenly can result in mirtazapine withdrawal. This can cause symptoms including agitation, dizziness and flu-like symptoms. To prevent mirtazapine withdrawal, your dosage should be tapered gradually under medical guidance.

Notable mirtazapine drug interactions

There are a number of drug interactions which can make mirtazapine less effective or even dangerous. Some of the most notable include:

Serotonergic drugs
As explained above, when mirtazapine is used together with other drugs that affect serotonin levels, such as SNRIs, SSRIs and some painkillers like tramadol, there is an increased danger of inducing serotonin syndrome.
CNS depressants
Combining mirtazapine and alcohol, benzodiazepines, opiates and other CNS depressants can amplify the sedative effects of all the substances. This can result in increased drowsiness, impaired motor skills and difficulty thinking clearly.
CYP450 enzyme substrates
Mirtazapine is metabolised primarily by two particular CYP450 enzymes. Interactions with drugs that affect these enzymes can significantly alter your body’s mirtazapine levels.
Monoamine oxidase inhibitors
The use of mirtazapine alongside MAOIs is particularly risky as it can also lead to serious reactions such as serotonin syndrome.
Anticoagulants
Mirtazapine can alter the effectiveness of warfarin and other anticoagulants, potentially leading to a heightened danger of bleeding.

Contact us today to learn more about mirtazapine and the detox process

Overcoming addiction is a tough journey, but with the right support, it’s entirely achievable. Connect with us at Addiction Helper to discuss how mirtazapine can aid your detox process and to explore rehab programmes that cover your needs. We are ready to assist you with expert advice, helping you embark on a path to successful recovery.

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Our compassionate team are ready and available to take your call, and guide you towards lasting the lasting addiction recovery you deserve.

Frequently Asked Questions

Can mirtazapine withdrawal cause severe insomnia?
Yes, mirtazapine withdrawal can cause severe insomnia. This occurs because mirtazapine often helps to regulate your sleep patterns by promoting serotonin and norepinephrine balance in your brain. When you stop taking mirtazapine, especially if you stop taking it abruptly, your brain may take some time to readjust to its absence, disrupting sleep patterns and potentially leading to significant insomnia. Gradually tapering off Remeron under medical supervision can help mitigate this symptom.
Why does mirtazapine withdrawal sometimes trigger nausea?
Nausea during mirtazapine withdrawal is a common symptom that results from your body’s readjustment to the absence of the drug. Mirtazapine interacts with serotonin receptors in your brain and gut which can affect your gastrointestinal functions. When mirtazapine is discontinued, especially if done suddenly, the sudden change in serotonin levels can disrupt normal functioning, leading to symptoms like nausea. Tapering your mirtazapine detox medication can help minimise this effect.
Can mirtazapine withdrawal cause brain fog or concentration issues?
Yes, mirtazapine withdrawal can lead to “brain fog” or concentration issues. Mirtazapine affects neurotransmitters in the brain, including serotonin and norepinephrine, which are crucial for cognitive functioning. When you stop taking Remeron, the sudden change in neurotransmitter levels can temporarily impair memory, focus and the ability to concentrate. Managing mirtazapine withdrawal under the care of a healthcare provider can help alleviate and shorten these issues.

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