I just started to take 15mg Remeron at bedtime. I am taking it for a myriad of reasons, one being sleep. I have been having issues with insomnia and take Ambien or Xanax but mostly just don't take anything and don't get a lot of sleep. I am also taking Remeron for the nausea control.

I am on day 2 of the Remeron. The first night I took it I slept very hard and very deep. It was VERY VERY hard getting up the next day and I spent most of the day in a fog, very lethargic and tired. I had also had a very active and busy day outside the day before and that could have contributed to my sleep as well.

Then last night, the second night I took it, I took it at 9:00pm and figured maybe if I took it earlier it might be better in the morning since I had to get up for church. I could not for the life of me go to sleep, and this is the same problem I have been having. I am disappointed that it did not help me go to sleep! I slept lightly when I finally went to sleep at midnight and woke often and had very vivid bizarre dreams. Not bad, just crazy! On the up side I did not have issues getting up this a.m. and have not been as spacey as I was yesterday. I am still dizzy in spots though.

I thought I would get on the web today to do research on Remeron and insomnia and I am frustrated to know that I am almost the only one that didn't get the sleep effects of it! UGH!

My questions are these:

Are the sleep effects of Remeron something that takes time to kick in like the AD effects or since I didn't have it I won't have it?

Is there anyone else out there that has had similar sleeping effects of Remeron and can you please share your experiences on what happened long term (months down the road)?

Thanks, AZ

Also, I found this on the web but only in one place by one person and I question it's validity. Can anyone tell me if these two statements are true or not? Has anyone else heard this?

Hi,

I have tried Remeron on and off for sleep for the last years.
I think that 15 mg of this drug is a low dose.

You should try 30 mg or 45 mg for sleep.
But I really sleep better on Elavil (amitriptyline).

So I'm back on Elavil, although I don't like this drug.
But amitriptyline is a good sleep aid.

I don't know about Remeron.
I would like to add something.

I don't feel rested the next day.
I have a problem to concentrate on my work.

Remeron is a modern drug that has few side effects.
Elavil is a "dirty drug" with bad side effects.

The answer to your first question is No.
You might give Remeron a shot.

Best regards,
X-ray

Hi az,

Please consult your doctor before making any med changes. xx

Need 30 mg or 45 mg in order to feel sleepy.

It is true that Mirtazapine, by blocking the 5-HT3 (Serotonin receptor type 3), it works like the medication Omeprazole,etc ( categorised as a proton pump inhibitors ) to alleviate nausea. So , unlike SSRI's ( Prozac, etc) and SNRI's ( Effexor, Cymbalta,etc), Mirtazapine works the oppposite way.

15mg nocte ( before bed ) is considered a small amount, the highest dose ever tried in the hospitalised in-patients is 120mg in the form of SolTab ( readily absopbed, so minimising the hangeover side effect on the following day), and it is also found that Mirtazapine is a "Nootropic" (cognitive enhancer, when research was done on subjects taking it at nite time, and assesed on the driving performance on the following day, comparing it to the placebo), it made the subjects taking it more alert than the placebo. ( well, I am not sure why some people get hangeover, perhaps, you should give it a time at least a couple of weeks for your body to get adjusted to this medications.)

According to my own experience, Mirtazapine works quite sedatingly on the first day I took it, 45mg. But, when combined with a substrate that is metabolised by the liver enzyme CYP 450 3A4 like Xanax ( Alprazolam ), the sedating effect could be double, even triple, leading to a hangeover on the following day ( that's why now I reduced my Xanax from 2mg to 0.5mg/day, and still got the same effect !).

In order for Mirtazapine to exert its sedating effect ( this is done through its antihistaminic action, like Diphenhydramine, Doxylamine, Chlorpheniramine-> Unisom,Benadryl,etc), it must be taken in a higher dose, 60mg is what is being recommended in the literature, but due to its wide marginal of safety, some people like me, am taking it 45mg thrice/day= 135mg/day, with no side effect, instead it helps me relax, less anxious, and I could cut down the use of my opioid painkiller, prescribed for my chronic tension headache.

I am taking it in the form of SolTab ( so it is fast absorbed, and metabolised completely, and out of the body without residual effect of some unbroken pieces of the tablet still sticking on the intestine on the following day, that's how some people get the hangeover from, I guess)

Another form of a similar medication like Mirtazapine is Mianserin ( Tolvon ), it is quite sedating, too, comes in 10mg, 20mg tablets, depending which country you are in.

About Trazodone, I just browsed through some research papers, that, it is actually not an SSRI, ( though some Doctors assume it works by blocking the re-uptake of Serotonin, it's true that it blocks the serotonin re-uptake, but Trazodone is categorised as an " atypical" Tricyclic Antidepressant, similar like the rest of the Tricyclics, it is Cardio-toxic ( can caused arrhythmias, or irregular heartbeat like other tricyclics do), SSRI's/ SNRI's like Prozac, Zoloft, Effexor, Cymbalta, Cipramil, etc do not cause Cardiac arrhythmias.

It is best if you can talk to your doctor about increasing the dose, and switching it to the SolTab form, and give it a time to work, if that is still unsuccesful, another safer option is Mianserin, which is also an analogue of Mirtazapine.

If that still does not work, you should talk to your doctor about other safe medications ( I call it safe, in terms, of they are non-cardiotoxic, lacks of anticholinergic or dry mouth/constipation, does not impair sexual performance, etc).

It also depends on the doctor, whether he/she is willing to prescribe a Hypnotic, like Zolpidem, Zopiclone, Eszopiclone, Ramelteon, Zaleplon, -> these are non-benzodiazepine hypnotic agents, or Triazolam,Midazolam, Nitrazepam, Temazepam,-> these are benzodiazepine hypnotic agents, it all depends on your doctor's opinion, but a recent research have shown that the non-Benzoz hypnotics are capable of being a carcinogenic ( cancer causing agents) compared to the Benzos like Alprazolam, Lorazepam, Oxazepam, Diazepam, Clonazepam, etc.

I myself would stick to a low dose benzo, along with a non cardiotoxic, non-anticholinergic antidepressant like NaSSA ( Mirtazapine) and its older analogue, Mianserin ( Tolvon ), which does not impair sexual performance either.

Thanks for the replies. I have no intention of changing dosage or stopping without my doc. I have an appointment in a month to review this med with my doctor.

The vivid dreams people talk about have started. I don't seem to fall asleep like others talk about though. Curious, it has been mentioned that this acts kinda like an antihistamine. When I take the antihistamines I don't get drowsy I get wired. I wonder if that is why Remeron doesn't make drowsy either.

As for the nausea, I am also on Omeprazole. I have a lot of stomach issues and Remeron and tricyclic's are being tried for gastroparesis and functional stomach issues.

I am taking it for this primarily and for other issues including questionable anxiety and insomnia.

I am confused though, I have read other posts on this board that said it helps with sleep at the lower dosages not larger.

I still wonder if the sleep effects are something that happen over time or immediately and if it is true it only has a small window of 1-2 hours for the hypnotic effects.

AZ

AZ,

Remeron is not helping me much with sleep either. I take it with Ambien CR and I think that the Ambien CR gets me into a deep enough sleep that I don't have or remember any dreams. I have been taking remeron for 6 weeks now, the last two weeks at 30mg. How much do you take?

Az,
When i was in hospital for depression this was one of the medications that i tried- they put me on that one at first especially because it was ment to help me sleep (nights were my worst times) And i took it for maybe 6 months before i tried something else, i also had very strange dreams, but for me it did help me sleep, the first week i took it i was so sleepy during the day too so i had it early and that did help, and after a little while i wasnt drowsy during the day anymore. See how you go for a while longer but if it still bothers you talk to your doctor.

Hi everyone, I'm on my 5th day of Remeron as a sleep aid and wow, I wish my doctor had mentioned what might happen the first day. The first night I took it, I tossed and turned and 6 hours of sleep wasn't nearly enough. I had to go to work and nothing would help wake me up. That is the most tired I have ever been in my life. Each day it seems to lessen - but I have another weird side-effect... Does anyone else feel a bit groggy and hyper-sensitive to sounds?

I feel in a bit of a fog most of the time and when anything makes a sudden sound it actually scares me and makes me jump a little. Just kind of creepy.

Just glad I have 3 day weekends and can sleep 8-12 hours - but I hope the effects lessen.

I'm on 15mg/day. Dry mouth hasn't been an issue, but the appetite definitely has increased.

Take Care,