Understanding Mirtazapine and Its Place on the Street
Mirtazapine is a tetracyclic antidepressant prescribed for major depressive disorder. It's known in the United States by brand names like Remeron and Remeron SolTab. Search results indicate that mirtazapine does not have any established or common slang or street names.
The absence of a street name is likely due to its pharmacological profile and the effects of its misuse. Unlike drugs that produce a significant euphoric high, mirtazapine's effects when abused are often described as sedative, deliriant, or hallucinogenic. While not addictive in the same way as other drugs, a potential for abuse and dependence exists. Individuals might misuse it for its sleep-inducing properties or to counteract the effects of stimulants.
The Pharmacology of Mirtazapine (Remeron)
Mirtazapine is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA). It blocks presynaptic alpha-2 adrenergic receptors, increasing norepinephrine and serotonin release. It also blocks 5-HT2 and 5-HT3 receptors, which may reduce side effects like nausea. Mirtazapine is a potent H1 receptor antagonist, causing sedation, increased appetite, and weight gain, particularly at lower doses. It is quickly absorbed and has a half-life allowing for once-daily dosing.
Legitimate Medical Uses
Mirtazapine is FDA-approved for major depressive disorder (MDD). It's also used off-label for conditions like insomnia, appetite stimulation in patients with weight loss, and anxiety disorders. It has also been used to prevent post-surgery nausea and vomiting.
Mirtazapine vs. Other Antidepressants: A Comparison
Mirtazapine differs from other antidepressants like SSRIs.
| Feature | Mirtazapine (Remeron) | Selective Serotonin Reuptake Inhibitors (SSRIs) |
|---|---|---|
| Mechanism | Alpha-2 antagonist; increases norepinephrine and serotonin release. | Inhibit serotonin reuptake. |
| Common Side Effects | Drowsiness, increased appetite, weight gain, dry mouth. | Nausea, insomnia, sexual dysfunction, headache. |
| Onset of Action | May have a faster onset of action than SSRIs in the initial weeks. | Generally takes several weeks to reach full effect. |
| Use in Insomnia | Often beneficial due to sedative properties. | Can sometimes cause or worsen insomnia. |
| Sexual Dysfunction | Significantly lower frequency of sexual side effects. | Common side effect. |
Risks of Misuse and Side Effects
Misuse of mirtazapine can lead to hallucinations, delusions, severe drowsiness, rapid heartbeat, and low blood pressure. Overdose is rarely fatal alone but is riskier when combined with substances like alcohol or benzodiazepines. Common side effects include drowsiness and increased appetite. Rare risks include agranulocytosis, serotonin syndrome, and increased suicidal thoughts in young adults. Withdrawal symptoms can occur if stopped abruptly.
Conclusion
There is no common street name for mirtazapine, likely because it lacks the euphoric effects sought by recreational users. Known by brand names like Remeron, it is an effective antidepressant with a unique profile, useful for depression with insomnia or poor appetite. Although its addiction potential is lower than controlled substances, misuse is dangerous and can cause dependence and health risks. Mirtazapine should only be used under a healthcare professional's guidance.
For anyone seeking help with substance use, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Visit them at: https://www.samhsa.gov/find-help/national-helpline
