The effects of mirtazapine for sleep on patients with depression

Mirtazapine is a commonly used antidepressant that can help those with trouble sleeping due to major depressive disorder fall asleep faster, stay asleep and improve the quality of their rest. 


Medically reviewed by

August 4, 2021

Depression may conjure up images of people who sleep all day, but this highly prevalent mood disorder also can lead to problems falling or staying asleep at night, called insomnia.  

If you’re struggling with chronic insomnia caused by depression, you might have been prescribed the drug mirtazapine, which is also sold under the brand name Remeron for sleep. Mirtazapine is a commonly used antidepressant that can help those with trouble sleeping due to major depressive disorder (MDD), as well as certain other mental health conditions, fall asleep faster, stay asleep and improve the quality of their rest. 

Keep reading to find out:

  • How mirtazapine for sleep works
  • How to safely use the drug 
  • What to expect from using mirtazapine

Mirtazapine: The basics

Mirtazapine is classified as an antidepressant. It is commonly prescribed to treat depression, obsessive-compulsive disorder (OCD), and anxiety. Studies have shown, however, that it can also help improve sleep patterns, so it is sometimes prescribed off-label to treat insomnia.

Important things to know about mirtazapine

Mirtazapine is a medication regularly prescribed for those with major depressive disorder, anxiety disorder, or insomnia caused by mental health conditions. It is classified as a tetracyclic antidepressant, which affects norepinephrine levels. Mirtazapine is different than many other common antidepressants that fall under the category of selective serotonin reuptake inhibitors (or SSRIs), which work by increasing the levels of serotonin, a neurotransmitter in the brain. We’ll go into more detail on how mirtazapine works later in this article.

As an antidepressant, Mirtazapine (Remeron) can take up to 4-6 weeks to start working. You might experience side effects that include headaches, dry mouth, weight gain, or nausea. 

Mirtazapine for sleep 

While mirtazapine technically isn’t a sleeping medication, its sedative effects can help those with insomnia or poor sleeping patterns. And, unlike some medications whose primary purpose is to treat insomnia (like Ambien or Lunesta), it does not pose the risks of dependency and tolerance.

How it works

Mirtazapine is a central nervous system (CNS) agent, which means it helps to regulate the nervous system in the brain. As a CNS (Central Nervous System) drug and an antidepressant, it increases the concentration of specific chemical messengers (called neurotransmitters) in the brain, including noradrenaline and serotonin. Because of the effects of Mirtazapine on these two neurotransmitters, it is sometimes referred to as a noradrenergic and specific serotonergic antidepressant, improving mood in patients with depression. 

Using mirtazapine or Remeron for sleep can be effective. The drug’s sedating effects can make you feel drowsy, thus reducing the time it takes for you to drift off. Plus, it helps you fall into a deeper sleep and improves sleep quality. A study of 16 people with major depressive disorder indicated that mirtazapine can improve sleep quality, including increasing the time needed (frequency) and duration of REM (or dream) sleep.  

Studies on the effectiveness of mirtazapine or Remeron for sleep

Though the United States Food and Drug Administration (FDA), hasn’t officially recognized mirtazapine as a treatment of insomnia, there are numerous clinical trials and systematic reviews that have shown its effectiveness in improving sleep.

According to the Journal of Clinical Sleep Medicine, in a 2018 study, 28 male patients with depression, suicidal ideation, and insomnia symptoms were given mirtazapine. While 6 patients stopped the study due to side effects, 22 of the patients exhibited “significant improvement or complete resolution of both insomnia and suicidal ideation.” This study suggests that mirtazapine can improve insomnia caused by depression.

In a 2016 study, previous studies from both Europe and America were compared to test the difference in effectiveness between using low doses and high doses of mirtazapine.The study found, in the U.S. trials, that lower doses (between 5-10 mg) were more effective at sedating study subjects than the European trials that used higher doses (between 15-20 mg). The U.S. study also notes that the sedation effects of mirtazapine were stronger in the first few weeks of treatment, which was further confirmed in a placebo-controlled study.

Using mirtazapine for sleep frequently has been proven to be a viable option for helping people with depression get a better night’s rest. If you have more questions about the proper use of mirtazapine, reach out to the experts at Minded or your doctor. 


How to use mirtazapine

Mirtazapine is a prescription medication that always should be taken according to your doctor or nurse practitioner’s instructions. In most cases, mirtazapine is prescribed as a daily drug taken by patients with depression before bedtime when they want to start feeling drowsy. Mirtazapine can be taken with or without food. 

Your dose of mirtazapine will be different depending on your prescriber’s judgment and how your body responds to this medication.

Possible side effects

If you’re using mirtazapine for sleep, you may experience some adverse effects, which usually are mild. If, however, you’re worried about any of the side effects of Remeron for sleep, talk to your doctor or get in touch with us at Minded. Our expert Care Team is always happy to help.

Here is some information about the side effects you might experience while taking mirtazapine for sleep. 

Sleep Disorders

Despite being used to help treat sleeping problems like insomnia, mirtazapine sometimes may cause a sleep disorder, like Restless Legs Syndrome (RLS) or Periodic Limb Movements (PLMS).

According to the American Journal of Medical Care, RLS presents in roughly 30% of people who take mirtazapine. Another study in Sleep found that 67% of healthy young men who took mirtazapine experienced increased PLMS, but this side effect decreased after the first few days of taking the medication.

Weight gain

Weight gain is another common side effect of taking mirtazapine, as is an increase in appetite. 

Daytime drowsiness

Because of mirtazapine’s sedating effects, it may make some people feel drowsy during the day. Daytime drowsiness occurs in roughly 54% of people who take mirtazapine.

Those with depression commonly experience symptoms of sleepiness and fatigue which can make additional daytime drowsiness troubling. 

Most people find, however, that daytime drowsiness is a short-term side effect, and disappears after a few weeks.

Dry mouth

You may experience dry mouth when taking mirtazapine, which may lead to oral and dental problems. This side effect is less common in mirtazapine than in some of the other antidepressants. 

We recommend chewing sugarless gum or melting ice cubes in your mouth for relief from dry mouth.

Strange dreams

Mirtazapine can often reduce the time needed to fall asleep and reduce sleep disturbances. However, in rare cases, it may cause strange dreams or nightmares.

Final thoughts: Using mirtazapine for sleep in patients with depression

Mirtazapine can be an effective antidepressant, for people with major depressive disorder (MDD). If you also have a sleep problem, mirtazapine for sleep can be helpful for improving the quality of your sleep by enabling you to fall asleep more easily and to reach deeper levels of sleep. 

At Minded, we want you to feel comfortable and confident about your mental health prescriptions. We can become your online healthcare providers, so you can get medication information you need, when you need it. Minded offers an affordable membership for ongoing psychiatric care. Get started today.



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