Although Remeron (mirtazapine) is not FDA-approved as a sleep medication, it does help with sleep and many healthcare providers use it off-label for this purpose. Remeron is approved as an antidepressant, but it can help people with insomnia or depression get to sleep and several trials in depressed patients have shown benefits including:

• Increasing total sleep time
• Improving sleep efficiency
• Improving stage II, stage rapid eye movement, and slow wave sleep percentages
• Decreasing sleep latency and slow-wave sleep percentages.

Effects have persisted throughout treatment.

Before treatment with mirtazapine, many patients complained of it taking them a long time to get to sleep or waking up frequently during the night. Once they had started treatment, most found it easier and quicker to get to sleep and had fewer periods of wakefulness. A review found that while mirtazapine's effects on sleep were significantly more effective than placebo (an inactive medicine), they were somewhat similar to other antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). Because mirtazapine is not technically a sleep medication, it does not have the same risk of dependency and tolerance as traditional sleep medications, such as Ambien or Lunesta, do.

How does Remeron (mirtazapine) work?

Mirtazapine works by increasing the concentration of specific neurotransmitters in the brain, such as noradrenaline and serotonin, although the exact way it works for sleep is not known. In people who are depressed, it may ameliorate slow-wave sleep disturbances. It is unclear whether by reducing symptoms of depression, mirtazapine improves sleep or is it because of its effects on neurotransmitters.

What are the side effects of Remeron (mirtazapine)?

The most common side effects of Remeron include:

• anxiety
• drowsiness, dizziness
• dry mouth
• increased appetite
• muscle aches and pain, and joint pain
• weight gain.

Because mirtazapine causes sedation it can also make you sleepy during the day and affect your ability to drive or operate machinery. Do not drive if mirtazapine makes you sleepy.