Remeron side effects: common problems and simple fixes

Remeron (mirtazapine) helps a lot of people with depression and insomnia, but it comes with side effects you should know. Some are mild and manageable; others need quick attention. Below I explain what usually shows up, what tends to happen over time, and what to do about each problem.

Common side effects and how to handle them

Drowsiness and sedation are the most typical problems. If you feel sleepy, try taking Remeron at night. Don’t drive or operate heavy machinery until you know how it affects you. Dizziness can happen too—stand up slowly and avoid sudden moves.

Increased appetite and weight gain are also common. Track your weight weekly, focus on simple changes (smaller portions, more veggies, short daily walks), and tell your doctor if weight rises quickly. Dry mouth and constipation can be annoying: drink water, chew sugar-free gum, and eat fiber-rich foods. Over-the-counter remedies often help with constipation, but check with your pharmacist first.

Some people notice mild tremor, blurred vision, or increased cholesterol. These often show up after weeks on the drug—ask your doctor about blood tests for lipids if you’re on Remeron long-term.

Serious risks and when to seek help

Serious problems are rare but important. Watch for signs of infection (fever, sore throat, unusual bruising) because mirtazapine can rarely affect white blood cells. If that happens, call your doctor right away.

Be alert for symptoms of serotonin syndrome if you’re taking other antidepressants, tramadol, or certain migraine meds: high fever, fast heartbeat, severe agitation, tremors, or rigid muscles. That’s an emergency—go to the ER.

Mood changes like new or worsening depression, sudden anxiety, panic, or signs of mania (very high energy, racing thoughts) deserve a quick call to your prescriber. Suicidal thoughts sometimes appear when starting or adjusting doses—seek immediate help if that happens.

A few practical rules: don’t mix Remeron with alcohol (it increases sedation), and avoid MAO inhibitors for at least two weeks before or after stopping Remeron. If you plan pregnancy or are breastfeeding, talk to your doctor—there are specific risks and alternatives to consider.

Stopping Remeron abruptly can cause withdrawal symptoms—insomnia, irritability, or flu-like feelings. Work with your doctor to taper the dose slowly when it’s time to stop or switch medications.

Remeron helps many people, but side effects are real. Track what you notice, use simple fixes (take it at night, watch diet, stay hydrated), and keep your prescriber in the loop. If you notice severe symptoms—fever, severe dizziness, trouble breathing, suicidal thoughts—get medical help right away.