Key takeaways:
Mixing mirtazapine (Remeron) and alcohol isn’t recommended. The combination may lead to side effects such as dizziness, sleepiness, and trouble concentrating. It can also increase the risk of more serious issues, such as worsening depression.
Combining mirtazapine and alcohol may be more risky for certain groups of people. This includes adults who are 65 years or older and those who have liver or kidney problems.
The safest bet is to avoid alcohol entirely while taking mirtazapine. However, since everyone reacts to alcohol differently, your prescriber can tell you whether you should avoid alcohol completely or if occasional drinks are OK.
Mirtazapine (Remeron) is a prescription-only antidepressant that’s FDA approved to treat depression in adults. It’s also sometimes prescribed off-label to treat other conditions, such as insomnia (trouble sleeping), post-traumatic stress disorder (PTSD), and generalized anxiety disorder.
Depression and anxiety are often intertwined with alcohol consumption. In fact, almost one-third of people who receive treatment for alcohol use disorder also have depression, and about half live with an anxiety-related health condition.
Whether you drink alcohol regularly or just once in a while, it’s normal to wonder if it’s safe to mix it with mirtazapine. Keep reading to learn more about the potential downsides of mixing the two.
It’s best to limit or avoid alcohol while taking mirtazapine. There are three main reasons for this, which are described below.
Alcohol and mirtazapine can cause some of the same side effects. Taking them together may raise your risk of experiencing these effects — and make them feel stronger or more noticeable.
Common side effects shared by mirtazapine and alcohol include:
Dizziness
Coordination problems
Trouble concentrating
Confusion
Nausea
Mirtazapine may increase your liver enzyme levels. These enzymes, or proteins, help your liver do its job, which includes processing medications. A mild increase in these enzymes can happen during illness, but significantly high levels may signal liver damage.
Heavy alcohol use is a well-known cause of liver injury, so combining alcohol with mirtazapine could further strain your liver. While an occasional drink may not cause serious harm, limiting alcohol can help protect your liver while you’re taking mirtazapine.
Drinking alcohol while taking an antidepressant, such as mirtazapine, may affect how your body responds to the antidepressant. This could mean that your depression symptoms worsen or come back.
Can you take mirtazapine (Remeron) for sleep? Pharmacists answer questions about this off-label mirtazapine use.
Mirtazapine interactions, explained: Mirtazapine and alcohol can interact negatively. Learn more about a few other mirtazapine interactions here.
How to take mirtazapine: It’s best to take mirtazapine as prescribed without skipping doses. This dosage guide explains typical mirtazapine dosages and what to do if you miss a dose.
What’s more, drinking alcohol could lead to skipping or forgetting to take mirtazapine doses. Skipping or missing doses could reduce the effects of the medication, which may result in worsening or returning depression symptoms.
It’s hard to generalize if having just 1 or 2 drinks is safe with mirtazapine.
Some experts recommend avoiding alcohol altogether while taking mirtazapine. Mirtazapine alone can affect your coordination and concentration. Adding alcohol can intensify these side effects. This is especially risky for some people.
That said, not everyone will feel these effects to the same degree. Some people may be able to drink small amounts of alcohol without noticeable issues.
If you’re interested in having an occasional drink while prescribed mirtazapine, it’s best to talk with your healthcare team about how much alcohol is potentially safe to consume. They can make the final call on whether 1 or 2 drinks would be safe for you.
Keep in mind: While you may not always experience serious harm from drinking, no amount of alcohol is considered safe to drink. Even small amounts of alcohol can increase your risk of cancer, other health problems, and death. So it’s best for your health to avoid alcohol altogether.
Yes, certain groups of people may be more at risk for side effects when combining alcohol and mirtazapine. This includes people who:
Are 65 or older
Have liver problems
Have kidney problems
Mirtazapine is cleared more slowly from the body in these groups of people. This means that there’s a greater chance the medication will build up and cause side effects.
Alcohol mainly interacts with mirtazapine by increasing its side effects, especially those that affect your thinking and coordination.
With or without alcohol consumption, common mirtazapine side effects include:
Sleepiness
Dizziness
Dry mouth
Constipation
Although rare, it’s possible to have serious side effects with mirtazapine, including:
Skin reactions
Increased cholesterol levels
Low blood sodium levels
Low levels of platelets (cells that help with blood clotting)
Liver problems
Heart rhythm issues
Low white blood cell counts, which makes it harder to fight infections
Mania or hypomania in people with bipolar disorder
In rare cases, mixing mirtazapine and alcohol may result in more serious side effects. Call 911 or go to the nearest ER if you experience any of the following:
Thoughts of suicide or self-harm
Blood in your urine or stool
Bleeding that doesn’t stop
Extreme tiredness or drowsiness
Severe vomiting
Also seek emergency medical attention if you, a friend, or a loved one has any of the following symptoms of alcohol poisoning:
Confusion
Excessive sleepiness
Vomiting
Clammy, blue, or pale skin
Low body temperature
Slow heart rate
Abnormal or slowed breathing
Seizures
Loss of consciousness
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text “HOME” to 741-741 to reach the Crisis Text Line.
Mirtazapine lasts about 4 to 10 days in the body. If your prescriber wants you to avoid alcohol altogether while taking mirtazapine, consider waiting at least 10 days after stopping mirtazapine to drink alcohol.
Keep in mind that mirtazapine is typically prescribed as a maintenance treatment for depression and other conditions. So it’s important to take it as prescribed and not skip doses or stop the medication without checking with your prescriber first.
You should also avoid stopping treatment with mirtazapine suddenly. Doing so could lead to withdrawal symptoms, such as:
Dizziness
Nausea or vomiting
Strange dreams
Sensations of pins and needles
Agitation or anxiety
Confusion
Fatigue
Headaches
Mirtazapine (Remeron) is a prescription-only antidepressant. It’s best to limit or avoid alcohol while taking mirtazapine. Mixing mirtazapine and alcohol can increase the likelihood of side effects such as excessive sleepiness, nausea, and problems with concentration and memory. It can also increase the risk of more serious side effects, including liver problems or worsening depression.
The safest thing to do is to avoid alcohol altogether with mirtazapine. But everyone processes and reacts to alcohol differently. Based on your medical history and lifestyle, your prescriber can tell you if you should avoid alcohol completely or if occasional drinks are OK.
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McHugh, R. K., et al. (2019). Alcohol use disorder and depressive disorders. Alcohol Research.
National Institute on Alcohol Abuse and Alcoholism. (2025). Alcohol’s effects on the body. National Institutes of Health.
RemedyRepack. (2025). Mirtazapine - mirtazapine tablet, film coated [package insert].
White, A., et al. (2025). Alcohol-medication interactions: Potentially dangerous mixes. National Institute on Alcohol Abuse and Alcoholism.
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