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Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.
Mirtazapine (Remeron) isn’t a benzodiazepine. This antidepressant blocks brain receptors to increase norepinephrine and serotonin. Benzos enhance GABA activity for immediate anxiety relief.
People confuse mirtazapine with a benzo because both cause sedation and help with sleep, but mirtazapine takes weeks to work while benzos act within hours.
If you’re struggling with benzodiazepine dependence or need guidance on depression and anxiety treatment, Ardu’s mental health programs can help you find the path to recovery.
Mirtazapine belongs to the noradrenergic and specific serotonergic antidepressant (NaSSA) class. This tetracyclic antidepressant medication blocks alpha-2 adrenergic receptors and specific serotonin receptors (5-HT2A, 5-HT2C, and 5-HT3) to increase neurotransmitter activity in your brain.
The medication targets pathways that control mood, sleep, and appetite. Selective serotonin reuptake inhibitors (SSRIs) block serotonin reabsorption, but mirtazapine increases serotonin signaling and norepinephrine by preventing their inhibition at receptor sites.
Originally known as Org 3770, mirtazapine provides rapid improvement with minimal anticholinergic effects compared to SSRIs. Alam et al. found that mirtazapine shows a faster onset of action than SSRIs, with effects seen as early as 1–2 weeks, while avoiding the dry mouth, constipation, and cognitive dulling associated with other antidepressants.
Mirtazapine is sold under the brand name Remeron. Healthcare providers prescribe this antidepressant drug for:
Mirtazapine comes in regular tablets and Remeron Soltab (orally disintegrating tablets) with typical dosing between 15–45 mg daily, usually taken at bedtime.
Mirtazapine is an antidepressant medication in the NaSSA class that isn’t a controlled substance under the Controlled Substances Act.
Benzodiazepines are controlled substances that require special prescribing protocols due to their addiction risks.
Mirtazapine blocks specific serotonin and adrenergic receptors to increase neurotransmitter availability gradually.
Benzodiazepines enhance GABA receptor activity in the central nervous system for immediate calming effects.
Mirtazapine builds therapeutic effects over 2–4 weeks as brain chemistry adjusts.
Benzodiazepines work within 30–60 minutes but are intended for short-term relief only.
Healthcare providers prescribe mirtazapine for major depressive disorder, anxiety disorders, and sleep disturbance as long-term treatment.
Benzodiazepines treat anxiety disorders and acute panic disorder episodes.
Mirtazapine has minimal abuse potential and doesn’t cause respiratory depression when used alone.
Benzodiazepines carry a high addiction risk, can cause life-threatening respiratory complications with alcohol, and create severe physical dependence within weeks of regular use.
If you notice your benzodiazepine use becoming problematic, seeking professional help early prevents dangerous withdrawal complications and breaks the cycle of dependence. Our benzodiazepine detox services help you safely overcome benzo dependence with expert support throughout the process.
Mirtazapine produces moderate sedation through its antihistamine blocking properties. The sedation is strongest at 15 mg and decreases at higher doses (30–45 mg) as norepinephrine effects take over.
The sedative effects peak 1–2 hours after taking the medication and last 6–8 hours. Sedation is strongest during your first few weeks of treatment but often diminishes as your body adjusts.
Mirtazapine’s sedation is gentle and safe, and you can expect:
Brannon and Stone found that mirtazapine’s sleep-promoting properties provide dual benefits: improving mood symptoms and chronic pain conditions. Their case study showed a patient’s back pain decreased from 10 to 3 on a pain scale while taking mirtazapine, demonstrating how better sleep quality can reduce pain perception.
Your age, other medications, and liver function influence how much sedation you experience. Elderly patients and those taking other central nervous system medications may feel stronger effects.
Mirtazapine isn’t addictive because it doesn’t produce euphoria or drug-seeking behavior. Your body can develop physical dependence and tolerance with extended use. Physical dependence differs from addiction. Your body adjusts to the medication’s presence, but you won’t develop compulsive use patterns.
If you stop mirtazapine abruptly, you may experience withdrawal symptoms, such as:
Your healthcare provider will recommend tapering the dose over several weeks to restore chemical balance and prevent rebound depression.
Most mirtazapine side effects are mild and improve as your body adjusts during the first few weeks of treatment.
Most patients experience:
These effects are temporary and manageable. Serious side effects are rare, but they require immediate medical attention. These include:
Contact your healthcare provider immediately if you experience any of these severe effects.
Mental health treatment requires expert care, personalized approaches, and comprehensive support that addresses symptoms and underlying causes. Our specialized mental health treatment program provides evidence-based care for those struggling with depression, anxiety, and medication management challenges.
Managing depression and anxiety often requires more than medication alone. We provide the comprehensive care, education, and support needed for lasting recovery and improved quality of life.
Our benzodiazepine rehab programs offer medically supervised withdrawal and personalized therapy to help you break free from dependence safely.
We offer:
If you or a loved one is struggling with depression, anxiety, or questions about medication management, our compassionate team is ready to help. Call us at (801) 872-8480 to learn more about our treatment options and take the first step toward better mental health.
Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.
They serve different purposes. Diazepam treats acute anxiety but creates dependency and doesn’t improve depression. Mirtazapine works for melancholic, treatment-resistant, and geriatric depression while helping with sleep and anxiety long-term. For affective disorders, mirtazapine is safer and more effective.
Benzodiazepines don’t treat depression and worsen it long-term by affecting dopamine release and disrupting circadian rhythms. They can increase suicidal thoughts. Antidepressants work better for depression with anxiety. If you have alcohol dependence, addiction treatment addresses both issues together.
Mirtazapine isn’t suitable for people with severe liver problems, a history of cardiac arrest, or serious heart conditions. Pregnancy warnings apply as mirtazapine affects fetal development. Patients with neurological disorders, like sleep myoclonus, may experience worsened symptoms. Those taking monoamine oxidase inhibitors and people with serotonin transporter genetic variations should avoid this antidepressant class.
Clonazepam and alprazolam are potent benzodiazepines. All benzos carry serious risks, including benzodiazepine withdrawal that can cause cardiac arrest if stopped suddenly. For anxious patients with depressive symptoms, safer alternatives from the antidepressant class work better long-term without dangerous withdrawal risks.
No antidepressant works like Xanax because they’re different drug classes. Mirtazapine comes closest because it affects sleep patterns and provides immediate sedation, unlike other antidepressants. However, mirtazapine works through serotonin transporter mechanisms rather than GABA.
Alam A, Voronovich Z, Carley JA. A review of therapeutic uses of mirtazapine in psychiatric and medical conditions. Prim Care Companion CNS Disord. 2013;15(5):PCC.13r01525. doi: 10.4088/PCC.13r01525. Epub 2013 Oct 10. PMID: 24511451; PMCID: PMC3907331
The Controlled Substances Act. (n.d.). DEA. https://www.dea.gov/drug-information/csa
The Use of Mirtazapine in a Patient with Chronic Pain, Brannon, Guy E et al., Journal of Pain and Symptom Management, Volume 18, Issue 5, 382 – 385
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