How to Treat Addiction & Abuse with Mirtazapine

Although primarily used to treat conditions such as panic disorder, anxiety, and other psychological disorders, there is some evidence to suggest that the antidepressant drug mirtazapine can be used to effectively treat substance abuse and addiction.

Mirtazapine works by re-addressing the balance of serotonin levels in the brain that can be affected by psychoactive substance misuse. Several studies have highlighted mirtazapine as a promising treatment for substance addiction; it is thought that the drug can reduce drug-seeking behaviours and cravings.

What Addictions Is Mirtazapine Used to Treat?

Medications for Abuse and Addiction

Substance abuse and addiction are typically treated with abstinence and behavioural therapy. However, during a programme of detoxification and rehabilitation, there may be certain medications that can help to ease withdrawal symptoms and make it easier for you to maintain sobriety.

Doctors might prescribe medication to help prevent certain withdrawal symptoms from occurring or else to lessen the severity of those that do occur. Other medications can block the effects of mood-altering substances or cause unpleasant symptoms to occur should you return to substance use.

You might also be prescribed medication to treat co-occurring disorders such as anxiety or depression, conditions that sometimes occur at the same time as addiction.

How to Choose the Right Medication

Choosing the right medication is a job for your doctor, who will fully assess your physical and mental requirements to decide if it is appropriate for you to take medication during your detox or rehab programme. The doctor will need to know about any underlying health problems you might have as well as any medication you are currently taking so as to prevent potential interactions from occurring.

What is Mirtazapine?

Mirtazapine is an antidepressant drug that is typically prescribed in the treatment of mental health disorders such as depression, generalised anxiety disorder, and other psychological conditions. It is also sometimes prescribed off-label to treat conditions such as insomnia and migraines. It has been tested for use in the treatment of substance abuse.

Brand Names for Mirtazapine


Remeron SolTa








History of Mirtazapine

Scientists at the Dutch pharmaceutical company Organon first synthesised mirtazapine in 1989. In 1994, the drug was approved for use in the Netherlands for the treatment of major depressive disorder. It was approved in 1996 by the FDA in the US under the trade name Remeron.

Is Mirtazapine Addictive?

The potential for abuse with mirtazapine is low and the drug is not classed as being addictive. Having said that, there have been some reports of individuals using the drug in large doses as a means to get high. If you are taking it, you may experience withdrawal symptoms such as anxiety and insomnia if you stop taking your medication abruptly. It is therefore recommended that you take it in tapering doses over a period of time before stopping completely.

What is the Mechanism of Action?

Mirtazapine works to address the chemical imbalance in the brain that causes conditions such as anxiety and depression. In terms of substance abuse, chronic use of psychoactive chemicals can disrupt the way the brain chemical serotonin is created.

Mirtazapine can also re-stabilise the production of another brain chemical, norepinephrine; it is believed that an imbalance of this chemical can result in the symptoms of anxiety that are often associated with substance abuse.

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How Long Does It Take for Mirtazapine to Work?

Improvements in symptoms may take a number of weeks to take effect when using mirtazapine. It can take between six and eight weeks before you notice a reduction in symptoms of anxiety or depression.

What Are the Side Effects of Mirtazapine?

  • Sedation
  • Fatigue
  • Drowsiness
  • Weight gain
  • Increased appetite
  • Insomnia
  • Constipation
  • Abnormal dreams
  • Palpitations

Facts/Statistics on Mirtazapine

Fact #1

The highest number of deaths in England and Wales attributed to mirtazapine poisoning was 90 in 2014.

Fact #2

That number had been steadily increasing since 2010, at which time it stood at 35.

Fact #3

However, in 2015 and 2016, the number of deaths fell by 14.44% and 6.49% respectively.

Studies Done on Mirtazapine
In January 2012, a study into the efficacy of mirtazapine in the treatment of cocaine dependence with comorbid depression, was published in the American Journal of Drug and Alcohol Abuse. The aim of the study was to ascertain if mirtazapine could be an effective treatment for cocaine addiction where a depressive disorder also existed. The conclusion was that while mirtazapine performed better than the placebo in terms of improving sleep, it did not perform better in terms of reducing cocaine use.

Another study, this time published in the Journal of Psychiatric Research, looked to determine if there were any therapeutic effects of mirtazapine on drug craving in cocaine addicts. Researchers wanted to see if mirtazapine could reduce cravings in cocaine addicts and therefore reduce the high relapse rate for this substance use disorder. Results of the study found that ‘mirtazapine attenuated the re-acquisition of cocaine-seeking responses’.

Scientists, therefore, concluded that mirtazapine could be a potential treatment for drug abuse and suggested it be considered as such.