Top 20 Doctor insights on: Mirtazapine dosage for insomnia

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Remeron (mirtazapine) 1wk@15mg, 1wk@30mg, 3d@15=insomnia x3d?! I was only on higher dose 1wk. On med for 2, why sudden mod/sevr dc effects? (going bk to 30 per dr

Remeron (mirtazapine) 1wk@15mg, 1wk@30mg, 3d@15=insomnia x3d?! I was only on higher dose 1wk. On med for 2, why sudden mod/sevr dc effects? (going bk to 30 per dr

Remeron (mirtazapine) and Sleep: Apparently in order to control your insomnia and hopefully help with your depression and possibly even weight issues, your body is telling you it needs 30 mg to sleep. Remeron (mirtazapine) is often more sedating at lower doses than at higher doses, but for you this apparently does not hold. Take the 30 mg as recommended by your doctor. There is no withdrawal from remeron, (mirtazapine) rather just the return of insomnia. ...Read more

Dr. Ronald Krauser
381 Doctors shared insights

Mirtazapine (Definition)

Mirtazepine (remeron) is a noradrenergic/specific serotonergic antidepressant [nassa]. It is used for major depressive d/o, various anxiety disorders, chronic pain, and others. In some, it can help ssri-induced sexual dysfunction & "poop out." it can be sedating and also increase appetite -- good for some ...Read more


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I've been on 75mg of mirtazapine for 7 months, primarily for anxiety and insomnia. Is this high dose normal? How would you reccommend cutting back?

Almost, but why?: The dosage for mirtazepine may include and, rarely, exceed 90 mg. Dosage must reflect how your body metabolizes the drug. The important question is" how are you feeling? " if you have had very good or excellent relief of anxiety, and if you have learned anxiety management skills or remedied the situation for which you started the medication, then slow reduction is possible over months. ...Read more

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Does sleep eventually return after stopping mirtazapine for sleep? I read stopping mirtazapine causes insomnia.

Does sleep eventually return after stopping mirtazapine for sleep? I read stopping mirtazapine causes insomnia.

Insomnia.: That does not mean it is permanent. To get back on track use good sleep hygiene. Maintain a regular bedtime and awakening time schedule including weekends. Get up about the same time every day, regardless of what time you fell asleep. 2. Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime many include a warm bath or shower, aroma therapy, reading, or listening to sooth ...Read more

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I have been on mirtazapine for 6 months (15mg) my insomnia is back after tapering. It's day 7 on 0mg. How long until it stabilise?

I have been on mirtazapine for 6 months (15mg) my insomnia is back after tapering. It's day 7 on 0mg. How long until it stabilise?

Depends: Sedation is a common side effect of mirtazapine. It may have helped you with insomnia while you were taking it, but the effect won't last once you stop it. If you continue to have trouble sleeping, see your doctor. There are a number of helpful options for insomnia, including good sleep hygiene, CBT or short-term medications. ...Read more

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I take 15 mg remeron (mirtazapine) for insomnia for one week and a half. I slept great, but the last 2 nights I couldn't sleep at wall. Why?

I take 15 mg remeron (mirtazapine) for insomnia for one week and a half. I slept great, but the last 2 nights I couldn't sleep at wall. Why?

Physical dependence: A common issue with sedating sleep medications, dependence occurs when your body expects to receive the medication. When the medication is not received, you have the opposite effects. It is not the same as psychological addiction. You can try not to use the remeron/mirtazapine every night, try a lower dose, and be sure to be practicing good sleep hygiene. Alternative sleep aids are also an option. ...Read more

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I am trying to come off Mirtazapine. I have come down from 30mg to 7.5mg but when I go lower ie to 3.75 I get very nauseas and very bad insomnia.

I am trying to come off Mirtazapine. I have come down from 30mg to 7.5mg but when I go lower ie to 3.75 I get very nauseas and very bad insomnia.

Insomnia: You may need another medication to help with your depression and insomnia. If depressed, you may have to try another antidepressant. If only having problems to fall asleep, you may try melatonin or diphenhydramine over the counter. If not improving, you may need the advise of your psychiatrist to diagnose and treat your symptoms. ...Read more

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My insomnia improved, but never went away after stopping remeron (mirtazapine) at dr' s order, one yr ago. For the last wk I keep waking up at 3. What to do?

My insomnia improved, but never went away after stopping remeron (mirtazapine) at dr' s order, one yr ago. For the last wk I keep waking up at 3. What to do?

Why now?: If your insomnia has been better over the past year, I would wonder why you are waking up right now. Speak with your therapist about anything that may be on your mind or any changes in your life which may be creating stress. ...Read more

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What are the advantages of remeron (mirtazapine) and amitryptaline in insomnia managment? Which is better? What time do them take to have effect on insomnia?

What are the advantages of remeron (mirtazapine) and amitryptaline in insomnia managment? Which is better? What time do them take to have effect on insomnia?

Remeron, (mirtazapine) etc: Both Remeron (mirtazapine) ; amitriptylene can be used to aid sleep. Neither is "better, " but are available for use depending on need of the particular patient. It sounds like you have a significant insomnia problem and need a full evaluation of it rather than trying to cover it up with medications. Please work with your doctor to assess and appropriately treat your sleep problem. Take care. ...Read more

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Can remeron bi add to cymbalta (duloxetine) to reduce anxiety insomnia and to have mor appetite?

Can remeron bi add to cymbalta (duloxetine) to reduce anxiety insomnia and to have mor appetite?

Maybe. . .: Yes Remeron can be added to Cymbalta (duloxetine) but you need to discuss this w/your prescribing physician, preferably the one prescribing both. More concerning is that your Medications list doesn't show Cymbalta (duloxetine) but rather Zoloft, Risperdal & Ativan. While side effects of Zoloft are comparable to Cymbalta (duloxetine), Risperdal & Ativan carry other potential complications. Bottom line, check w/your psychiatrist. ...Read more

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When the first time I take mirtazapine sandoz, it really helps my insomnia But after 4 mths, I still exp diff in sleep do I need take melatonin too?

When the first time I take mirtazapine sandoz, it really helps my insomnia But after 4 mths, I still exp diff in sleep do I need take melatonin too?

Sleep problems: Try to get to bed at the same time every night. Turn off all electric devices an hour before bed time including texting? Listen to soft music. Take a warm bath and drink warm milk before bedtime. Hopeful these few tips with help you rather than taking more medication ...Read more

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I was on remeron (mirtazapine) 15 mg for insomnia for 2 months prescribed by a psychiatrist. I tapered for 2 wk and then stopped. I still have insomia. What to do?

Call psychiatrist: If your psychiatrist prescribed you Remeron (mirtazapine) for insomnia and it worked, it's possible, if not likely, that whatever was causing the insomnia is still there. Did your psychiatrist recommend you taper and stop, or did you or someone else recommend that? I explain to my patients that many psychiatric conditions, like many general medical conditions, require long term treatment. ...Read more

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Currently taking mirtazapine (remeron) 22.5mg. It helps w/ insomnia and appetite but not anxiety/panic. What would be a good second med/combo with remeron to help with panic/anxiety?

Currently taking mirtazapine (remeron) 22.5mg. It helps w/ insomnia and appetite but not anxiety/panic. What would be a good second med/combo with remeron to help with panic/anxiety?

See below: Talk to your prescribing provider as s/he is the most familiar with you and your medical history. Meanwhile try to establish daily routine to bring some predictability in your day; practice deep breathing, relaxation/ guided imagery (you can find scripts on the web); you can work with a therapist to help you guide through the process. Be well! ...Read more

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Am I likely to suffer any ill effects by stopping 30mg mirtazapine after 1 month and switching to 100mg trazodone plus 30mg buspirone for insomnia?

Am I likely to suffer any ill effects by stopping 30mg mirtazapine after 1 month and switching to 100mg trazodone plus 30mg buspirone for insomnia?

Maybe: "Ill" may be too strong a word. Doctors will probably disagree about this.
Drect switching from 30 dose of mirtazapine to a 100 mg dose of trazodone may be too sudden, and it may require more of a cross taper; without it, there may be various discontinuation affects that wouldn't help sleep. buspirone, even though it is an anti-anxiety medicine, is, for many, stimulating, and may keep you awake. ...Read more

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Just starting to lose weight other drugs was on, now dr ad 20mg mirtazapine to cipralex20mg, clonazapam2 for insomnia, appetite. How avoid weight gain?

Weight gain: Unfortunately most psychiatric medication can result in weight gain, but weight gain depends on what we eat, how much we eat and how much we excersize. Eat fruit, vegetable, healthy diet and excersize. Good luck. ...Read more

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I am currently taking remeron (mirtazapine) 30mg to help with my anxeity/insomnia. I have gained 15lbs. Are there any anxiety medications that help in sleeping and don't lead to weightgain?

I am currently taking remeron (mirtazapine) 30mg to help with my anxeity/insomnia. I have gained 15lbs. Are there any anxiety medications that help in sleeping and don't lead to weightgain?

Remeron (mirtazapine): Remeron can cause weight gain. There are other alternatives such as Lexapro or viibryd, (vilazodone hydrochloride) but please discuss your concerns with your prescribing doc. To explore all options. ...Read more

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Taken trazodone, seroquel (quetiapine) and remeron for chronic insomnia with no success, any other long term solutions?

Taken trazodone, seroquel (quetiapine) and remeron for chronic insomnia with no success, any other long term solutions?

Evaluation: You haven't said what type of evaluations you've had for your chronic insomnia. Medicating it has so far not been effective for you. Insomnia can be part of certain psychiatric conditions -- like depression, anxiety disorders, & substance abuse. There are also primary insomnias, which formal sleep studies can discern and for which focused treatments can be given. Please ask your doc about this. ...Read more

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Got insomnia & need sleep I take 30mg citalopram daily can I take 15mg mirtazapine tonight to help me sleep? Took mirtaz on its own before citalopram

Got insomnia & need sleep I take 30mg citalopram daily can I take 15mg mirtazapine tonight to help me sleep? Took mirtaz on its own before citalopram

Talk w ur doc first: Both citalopram and Mirtazapine are both antidepressants. Mirtazapine has a side effect of making a person sleepy so it sometimes is helpful in this regard. However your doctor may not want you to take two antidepressants so you should discuss this with him or her before you make that decision. ...Read more

Dr. Heidi Fowler
1,703 Doctors shared insights

Insomnia (Definition)

A sleep disorder in which you cannot fall or stay asleep. It usually accompanies another sleep, medical, or psychiatric disorder, and can lead to memory impairment, mood changes, and increased risk of ...Read more


Dr. Joseph Weiner
364 Doctors shared insights

Remeron (Definition)

Remeron is a serotonin antagonist and reuptake inhibitor which is a kind of ...Read more