Remeron and Effexor Together (Mirtazapine & Venlafaxine)

Mirtazapine 15mg Image by Garzfoth

My new psychiatrist thought it a good idea to try adding Remeron (Mirtazapine) to my current meds (Effexor and Klonopin) but I had to lower the dose of Effexor from 225mg to 150mg and only start with half a tablet of Remeron. The lowest pill form is 15mg so I split it in half and took 7.5mg at night, which really helped with my insomnia.

Since both Effexor and Remeron are antidepressants there is always a chance, though rare, of Serotonin Syndrome, a potentially deadly drug interaction. And hence the lower dose of Effexor. I've tried Effexor with other drugs in the same class and never experienced any negative symptoms.

I've been on this new cocktail (150mg Effexor, 7.5mg Remeron, 0.5mg Klonopin) for a few weeks now and I definitely felt better on 225mg Effexor and 0.5 Klonopin. I can't say whether Remeron is working or not for my depression/anxiety because I'm on such a low dose and because I know that 150mg of Effexor does not work for me. I've lowered it before and felt my depression worsen.

I've googled this combo and some people swear by taking both and they're at an even higher dose of both drugs than me. Some at 262.5mg - 300mg Effexor and 15mg-45mg of Remeron. I think the dosage caps depend on the country you're in and/or which form of the drug you're taking, ie. XR.

I'm not sure what to do. Up the Effexor and stay on the low dose of Remeron? Ever since I lowered the dose of Effexor and added Remeron, I've felt as if the Klonopin wasn't working at all. It worked wonderfully before I decreased Effexor and started Remeron.

This combo is not working for me so I'll contact my doctor as soon as possible to see if I can up my Effexor to my original therapeutic dose.