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Mirtazapine (Remeron)

Antidepressantprescriptionoral · predicted

Noradrenergic and specific serotonergic antidepressant (NaSSA). Blocks alpha-2 adrenergic autoreceptors (increasing NE/5-HT release) and 5-HT2A/2C/3 receptors while sparing 5-HT1A. Potent H1 antagonist causing dose-dependent sedation and appetite stimulation — paradoxically more sedating at 15 mg than 30 mg due to noradrenergic activation at higher doses. Often combined with SSRIs ('California rocket fuel'). No sexual dysfunction.

Projected serum levels — 15 mg, once daily

Mirtazapine (Remeron)
Mirtazapine (Remeron) modeled serum levels, 15 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 2 days. 0 2.5 5 7.5 10 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 2
Mirtazapine (Remeron) modeled serum levels with a loading dose of 21.7 mg, then 15 mg once daily The first dose is larger so levels approach steady state faster. 0 2.5 5 7.5 10 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 15 mg once daily (oral).

Loading schedule: 21.7 mg on day 1, then 15 mg once daily — reaching therapeutic levels sooner.

Modeled steady state after ~2 days: peak ≈ 9.3 mg, trough ≈ 3.3 mg body load. Population-based estimate over 15 days for a 15 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Antidepressant
Route modeled
Oral
Model confidence
predicted
Half-life
26 h
Common dose
15 mg
Suggested maximum
45 mg/day
Reference dose range
7.5–45 mg (single dose)
Suggested cadence
once daily
Validated against
30 mg oral — Cmax 0.080 mg/L at 2 h

Documented interactions

  • danger
    1P-LSD (1-Propionyl-LSD) + Mirtazapine (Remeron) Serotonin risk

    1P-LSD (1-Propionyl-LSD) and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    25I-NBOMe + Mirtazapine (Remeron) Serotonin risk

    25I-NBOMe and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-I (2,5-Dimethoxy-4-iodophenethylamine) + Mirtazapine (Remeron) Serotonin risk

    2C-I (2,5-Dimethoxy-4-iodophenethylamine) and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) + Mirtazapine (Remeron) Serotonin risk

    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    3-MeO-PCP (3-Methoxyphencyclidine) + Mirtazapine (Remeron) Serotonin risk

    3-MeO-PCP (3-Methoxyphencyclidine) and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    4-AcO-DMT (Psilacetin) + Mirtazapine (Remeron) Serotonin risk

    4-AcO-DMT (Psilacetin) and Mirtazapine (Remeron) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

Serum checks 193 modeled interaction pairings for mirtazapine (remeron) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Mirtazapine versus amitriptyline in the treatment of major depression: a meta-analysis Watanabe N et al. · Journal of Clinical Psychiatry, 2008 DOI

    Meta-analysis of 11 RCTs finding mirtazapine comparable to amitriptyline for depression efficacy but with significantly better tolerability, particularly fewer anticholinergic side effects.

  2. Mirtazapine augmentation of SSRI treatment for depression (MIR Study): a randomised, double-blind, placebo-controlled trial Kessler DS et al. · Lancet Psychiatry, 2018 DOI

    Large UK pragmatic RCT (480 patients) found mirtazapine augmentation of SSRIs modestly improved depression scores at 12 weeks but without clinically significant benefit over SSRI monotherapy at 12 months.

  3. Clinical pharmacokinetics and pharmacodynamics of mirtazapine Timmer CJ et al. · Clinical Pharmacokinetics, 2000 DOI

    Comprehensive PK review establishing mirtazapine half-life of 20-40 hours (mean 30h), rapid absorption (tmax 2h), 50% oral bioavailability, and linear pharmacokinetics across the 15-80 mg dose range.

3 published studies referenced in the app, each with a plain-language summary.