What is the mirtazapine (Remeron) dose for insomnia?

From the Guidelines

The recommended dose of mirtazapine (Remeron) for insomnia is 7.5 mg at bedtime 1.

Key Considerations

• The initial dose of mirtazapine for insomnia is 7.5 mg 1, which can be administered at bedtime to promote sleep.
• The maximum dose of mirtazapine for insomnia is 30 mg at bedtime 1, but this may not be necessary for all patients, and the dose should be individualized based on patient response and tolerability.
• Mirtazapine is considered potent and well tolerated 1, and it can promote sleep, appetite, and weight gain, making it a useful option for patients with insomnia and other comorbid conditions.
• Some patients may require dose adjustments, but the general guideline is to start with a low dose and titrate upwards as needed, with the goal of finding the minimum effective dose to minimize side effects and maximize efficacy.

From the FDA Drug Label

2. 1 Recommended Dosage The recommended starting dose of mirtazapine tablets is 15 mg once daily, administered orally, preferably in the evening prior to sleep. If patients do not have an adequate response to the initial 15 mg dose, increase the dose up to a maximum of 45 mg per day

The recommended dose of mirtazapine (Remeron) for insomnia is 15 mg once daily, administered orally, preferably in the evening prior to sleep, and can be increased up to a maximum of 45 mg per day if necessary 2.

• The dose should be adjusted based on the patient's response to the medication.
• Dose changes should not be made in intervals of less than 1 to 2 weeks to allow sufficient time for evaluation of response to a given dose.

From the Research

Mirtazapine Dosage for Insomnia

• The dosage of mirtazapine for insomnia is not explicitly stated in the provided studies, but it can be inferred from the studies that the dosage range is between 7.5 mg to 15 mg per day 3, 4, 5.
• A study published in 2021 suggests that low-dose mirtazapine (7.5-15 mg/day) may be effective in treating insomnia disorder 3.
• Another study published in 2017 found that 15 mg of mirtazapine per day did not improve sleep disorders in patients with Alzheimer's disease, but instead increased daytime sleepiness 5.
• A case study published in 2012 reported that a low dose of 7.5 mg of mirtazapine per day improved nausea and appetite loss in a patient with pancreatic cancer, without causing somnolence or disturbance of daily life 4.

Dosage Considerations

• The recommended starting dosage of mirtazapine is 15 mg/day, but it can be increased to 30 mg/day or 45 mg/day if necessary 6.
• In patients with hepatic or renal insufficiency, careful dosage titration and regular monitoring for adverse events are recommended 6.
• Concomitant use of mirtazapine and other medications, such as diazepam or alcohol, may impair cognitive and/or motor performance 6.