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  • US Name:

    Remeron, Zisprin

  • Generic Names:

    Miro, Remeron

  • Active Ingredients:


  • Brand Manufacturer:


  • Manufacturer Location:

    The Netherlands

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Remeron, Zisprin

Prescription Required

Remeron/Zisprin is a tetracyclic antidepressant (TeCA) that can be prescribed to treat Major Depressive Disorder (MDD).

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Remeron/Zisprin (generic name: mirtazapine) is a tetracyclic antidepressant (TeCA) that can be prescribed to address symptoms of Major Depressive Disorder (MDD). This medication influences alpha 2 receptors in nerve cells, leading to the release of serotonin and norepinephrine neurotransmitters. Increased levels of these neurotransmitters aid in alleviating depression and related symptoms like sadness, low mood, loss of interest in activities and decreased appetite. It can also be prescribed off-label for other behavior conditions such as panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder, and social anxiety disorder. Other symptoms for which it can be useful include insomnia, headaches, fibromyalgia and migraines.


Doctors will prescribe the required dosage and dosing regime. Do not change the dose or stop taking the tablets without first consulting with the prescribing doctor or another qualified healthcare professional. Remeron or Zisprin comes in varied strengths in tablet form. It can be taken with or without food. Since mirtazapine has a sedative effect, it is best to take it in the evening just before going to sleep.

This text is for informational purposes only. Please consult your doctor or pharmacist before using any medication.

The most common side effects of  Remeron include:

  • increased appetite and weight gain
  • sleep disorders like sleepiness, drowsiness, fatigue, vivid dreams,
  • headaches
  • dry mouth
  • tremors
  • instability
  • stomach upsets (diarrhea, constipation, abdominal pain)
  • skin rash
  • arthritis
  • back pain
  • dizziness
  • hypotension while standing
  • swelling in the feet and ankles.

If these persist or worsen, consult with a doctor or pharmacist.

There are some rare but serious side effects that require immediate medical attention.

  • Hypersensitivity: rash, itching, redness, swelling of the skin, possibly accompanied by fever; swelling of the face, eyelids, lips, tongue, and throat; shortness of breath; feeling of suffocation in the throat.
  • Stevens-Johnson syndrome or TENS syndrome: rash, blisters on the skin or mouth, red and irritated eyes, itchy or peeling skin.
  • Serotonin syndrome: diarrhea, abdominal pain, nausea, restlessness, nervousness, irritability, rapid heartbeat, muscle pain, tremors, high fever, increased sweating.
  • Hyponatremia (low levels of sodium in the blood): headaches, difficulty concentrating, forgetfulness, confusion, difficulty maintaining balance.
  • Inflammation of the liver: weakness, fatigue, lack of appetite, nausea and vomiting, severe abdominal pain, dark urine, and jaundice in the skin or the white part of the eyes.
  • Mania: elation, feeling of superiority, fast and loud talking, restlessness, hyperactivity.
  • Aggravation of the state of depression, especially with suicidal thoughts (thoughts of death and self-harm), changes in behavior, worsening of depression, withdrawal, aggressive behavior, and inability to control anger.
  • Immune system suppression: high fever, sore throat, appearance of ulcers in the oral cavity,  pain in the mouth, convulsions, rapid heartbeat, fainting, dizziness.

Remeron is FDA-approved for the treatment of unipolar major depressive disorder (MDD).

Depression can arise from an imbalance of brain chemicals along with contributing factors. It often runs in families. It can be triggered by life events or certain health conditions. Sometimes, depression can emerge without a cause.

What are the signs of depression?

While symptoms may vary from person to person, the main indicators of depression are;

  • Persistent feelings of sadness, anxiety or emptiness
  • Loss of interest in most activities
  • Changes in appetite and weight
  • Shifts in sleep patterns, such as insomnia or excessive sleeping
  • Slowed physical movements or speech and thinking
  • Restlessness 
  • Increased irritability and agitation
  • Decreased energy levels and feeling consistently fatigued or sluggish
  • Continual feelings of worthlessness or excessive guilt
  • Difficulty focusing or making decisions
  • Recurring thoughts about death or suicide, or suicide attempts (Note: Immediate intervention is necessary)

If you experience five or more of these symptoms for two weeks, you may receive a diagnosis of depression. 

Off-label Clinical Uses

  • Insomnia
  • Panic disorder
  • Prophylaxis of chronic tension-type headache
  • Social anxiety disorder
  • Post-traumatic Stress Disorder(in combination with SSRI)
  • Fibromyalgia
  • Why is mirtazapine better than SSRI?
    Mirtazapine has an effect on both serotonin and norepinephrine levels, which makes it different from SSRIs. It also can have a faster onset of action than SSRIs. This makes it especially useful in an acute-phase treatment.
  • How fast does mirtazapine work for depression?
    It can take at least one week before for mirtazapine levels have built up enough for some effect to be felt. It usually takes between one to two months weeks before the full benefits are felt.
  • Does Remeron make you happier?
    Remeron (mirtazapine) can have many effects, such as reducing nervousness, improving mood, creating feelings of general well-being and improving appetite. It can also overcome insomnia and help people sleep better.
  • Can I drink alcohol while taking mirtazapine?
    Drinking alcohol may make the side effects worse and increase the bouts of depression. It is recommended to avoid drinking alcohol while being treated with mirtazapine.

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