Mirtazapine is shown to have antidepressant properties as well as many other beneficial uses, ranging from the treatment of anxiety and insomnia to OCD or PTSD. Mirtazapine is a complicated drug with confusing mechanisms of actions, but it also shows promising results in regards to other off-label usages.

NOTE: Selfhacked does not support taking or not taking this or any drug.  We think drugs should be only be tried as a last resort, if needed and/or your doctor recommends it.  Do not take this post as promoting the use of this medication.  It’s for informational purposes alone. It’s a popular drug and people should know what it’s used for, the evidence behind it and its drawbacks.

Introduction to Mirtazapine


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    Luke – thanks for that input. I would like to get off the clonazepam, but I will need something for sleep in the interim 6 weeks or so of misery I would have without the clonazepam. I have taken it for 20 years and have unsuccessfully tried to give it up several times. Ambien is not an option – I sleep, but after about 2 days I start feeling crazy and pressured, just miserable and frustrated. Without the clonazepam, my brain never shuts down. Psych doc once labelled me as BiPolar II, as SSRIs alone make me manic (but Symbyax, olanzapine & fluoxetine, worked for sleep. But put weight on). Any suggestions appreciated!

    1. Luke Matthews

      Look up something called the Ashton Taper Manual, it is the #1 recommendation for getting off benzodiazepines. It will not be easy, especially with the time you’ve spent on them. Taper SLOWLY. Request to be switched to diazepam in order to successfully complete the Ashton taper manual.


  • Xavier

    Well written article joe. Very informative and helps a lot to know more about a medication i was personally recently prescribed and very informative. I appreciate that the writing was able to make it easy to read for someone that doesn’t really know much about things like this.

  • Francisco Aglairton

    Dr. Ken Gillman, Australian psychopharmacologist and the creator of psychotropiccentral, is a great mirtazapine skeptic. Two links worth reading: [psychotropiccentral]

    My experience. It helped with sleep problems and depression (taken with pristiq). The problema: within 18 months I gained 25lbs. Had to taper it off (do it only under medical supervision).

  • Mimi

    I have had some experience w Remeron. All of this is correct. For those sensitive to SSRi it is a definite alternative. It was used after a rage outburst on a temporary basis and definitely helped the person. I knew of a heart surgeon who put a lot of his patients on it rather than refer to Psychiatrist. Not smart! Weight gain and sexual side efffects are the bain of Psychiatrist’s existence.

    1. Luke Matthews

      Hi, yeah weight gain is a common side effect on Mirtazapine.

      It is actually prescribed as an off-label appetite stimulant, and it can make you pretty voracious, craving carbs in particular.

      The general theories that are agreed on are the effect on Leptin/TNF systems, and or the histamine effects.

      If you are on an antidepressant though, you kind of need to ask yourself what is more important, weight gain or the relief of your depression?

  • tcjudi

    I have been taking 0.25mg clonazepam (1/2 0.5mg tab) for sleep at bedtime for years. At this low dose, it doesn’t seem to have any side effects. But if I stop taking it for a few days I have a lot more general aches and pain, so it must be a subtle help for that also. Docs don’t like to prescribe it since it is a benzo, but they do for me since it is such a low dose.

    1. daz

      Perhaps the clonazepam results in you getting more slow wave sleep…
      Which is when all your ‘aches and pains’ get repaired (I think).

    2. Luke Matthews

      Hi! Luke – writer here,
      Benzodiazepines are a very dangerous route and are not generally suggested to be prescribed for more than 4 weeks, Depending on the length of your use, regardless of you being on the lowest dosage possible, what you might be feeling is mild withdrawals due to not taking your clonazepam for a few days. If you think you can manage without clonazepam, you are already on the lowest dosage, so I don’t think the valium taper would be necessary, but please consult with your doctor and see about weaning off them, even at the lowest dosage possible cold turkey is not recommended depending on the length of your usage.

  • Jenssen

    i have a personal hate towards this drug. out of the 200 or so meds i have done in my life, this is one of the worst for all conditions indicated. i agree with the writer’s bad experience on this one, mine was exactly the same but doubled in strength. this drug in particular, has a long history of really bad side effect hence why its not popular and nobody really cares for it in modern times. i got it prescribed in a 3rd world country, that says a lot right there!

    1. daz

      thx for the feedback.
      I did some googling after I posted my comments about possibly using it to help sleep,
      The consensus is basically the same as yours…do not do it

    2. Luke Matthews

      The writer here, I understand that you had a bad experience and so did I but each and every person is different and some could actually find relief from this drug.. this is a prescription medication and should be worked with under a doctor’s supervision. Our differences may be similar and yours may be more intense than mine, but a doctor is prescribing a medication for a reason, and if he thinks you should have tried it, there was a reason he felt the need to prescribe it. You must let your doctor know when you are reacting badly to a medication as soon as possible. The side effects compared to SSRIs are actually minimal The only problem is the sleepiness and weight gain really, and if someone else uses the medication and doesn’t have that problem, then it would be a proper medication for them. Please don’t tell anyone to ever not use something based anecdotal experience, because there are 7 billion people in the world, and not one of us have the same exact brain. You say you have been on many medications especially with SSRIS it takes quite a while before it does its job. Have you ever considered a genome test done? They are very simple and can be done at a doctor or online. Joe offers genome test consultations that will help you find a medication to better suit your needs that you can discuss with your doctor

  • daz

    …on the sleep note,
    Anyone tried low dose Mirtazapine to improve sleep ?
    What did you do, & how did it go…

    1. Luke Matthews

      I have personally not used it myself for sleep because I felt pretty sleepy on the normal dosage. But, my grandpa was prescribed it at a half tablet of 15mg, for sleep after his heart attack because he was having trouble getting to and staying asleep, and it knocked him out very fast. The reason behind this effect is due to Mirtazapine’s histamine effects being STRONGER the LOWER the dosage is. Think about Benadryl, have you ever tried Benadryl and gotten very sleepy? Imagine that but stronger, that is what a low dosage of mirtazapine would feel like.

  • daz

    Thanks for the post Joe.

    I will have a look into the ~ 7.5mg dose for insomnia/improving sleep.

    & speak with my Doc at next visit.

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