Lexapro vs. Remeron
See how Lexapro and Remeron compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lexapro is an SSRI approved for depression and generalized anxiety, while Remeron is a tetracyclic antidepressant approved only for depression.
Remeron causes far more sedation, appetite increase, and weight gain, while Lexapro more often causes nausea and sexual side effects.
Both carry a boxed warning for suicidal thoughts in children, adolescents, and young adults and cannot be combined with MAOIs.
Lexapro vs. Remeron Drug Summary
Lexapro
Lexapro (escitalopram) is an SSRI antidepressant approved for major depressive disorder and generalized anxiety disorder in adults. It comes as a tablet or oral solution taken once daily, usually starting at 10 mg and moving to 20 mg after two weeks if needed.
Remeron
Remeron (mirtazapine) is a tetracyclic antidepressant approved for major depressive disorder in adults. It is taken once daily, typically at bedtime, starting at 15 mg and titrated up to a maintenance dose of 45 mg, and is available as a standard or dissolving tablet.
Lexapro vs. Remeron Side Effects
Lexapro
Remeron
Lexapro vs. Remeron Dosage
Lexapro
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 2 onward |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 15 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Lexapro
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 2 onward |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 15 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Lexapro vs. Remeron Indications
Lexapro
Lexapro is FDA-approved for major depressive disorder in adults and adolescents 12 to 17, and for generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety in pediatric patients.
Major depressive disorder in adults
Major depressive disorder in adolescents 12-17
Generalized anxiety disorder in adults
Not approved for pediatric anxiety disorders
Remeron
Remeron is FDA-approved only for major depressive disorder in adults. It is often prescribed off-label for insomnia, anxiety, or to stimulate appetite in people who are underweight.
Major depressive disorder in adults
Off-label: insomnia
Off-label: anxiety disorders
Off-label: appetite or weight stimulation
Lexapro vs. Remeron Pros and Cons
Lexapro
Lexapro is a widely used SSRI with a long safety record and broad availability as a generic. It tends to be less sedating than Remeron during the day but carries a higher chance of nausea and sexual side effects.
Pros
Approved for both depression and anxiety
Less sedating, easier to take during the day
Available as tablet or liquid for flexible dosing
Generic version widely covered by insurance
Cons
Higher risk of sexual side effects like ejaculation issues
Can cause insomnia instead of helping with sleep
Costs roughly $440 to $603 per month before insurance
Remeron
Remeron is a sedating antidepressant often chosen for people with depression who also struggle with insomnia or poor appetite. It is less likely to cause sexual side effects than Lexapro but carries a much higher chance of daytime sleepiness and weight gain.
Pros
Generic mirtazapine costs as little as $10 to $40 a month
Helps with sleep and appetite when depression affects both
Available as a dissolving tablet for easy swallowing
Lower risk of sexual side effects than SSRIs like Lexapro
Cons
Significant sedation, especially at lower doses
Often causes increased appetite and weight gain
Carries a rare risk of serious neutropenia requiring monitoring
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.