Zoloft vs. Remeron
See how Zoloft and Remeron compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Zoloft is an SSRI approved for six conditions including depression, OCD, panic disorder, and PTSD, while Remeron is only FDA-approved for major depressive disorder in adults.
Remeron is more sedating and is usually taken at bedtime, while Zoloft is typically non-sedating and taken in the morning.
Both carry a boxed warning for increased suicidal thoughts in children, adolescents, and young adults, so any switch between them should be guided by a doctor.
Zoloft vs. Remeron Drug Summary
Zoloft
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder along with several anxiety-related conditions, including OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It increases serotonin activity in the brain and is taken as a once-daily tablet, usually in the morning.
Remeron
Remeron (mirtazapine) is a tetracyclic antidepressant approved for major depressive disorder in adults. It boosts norepinephrine and serotonin activity and is taken as a once-daily tablet, typically at bedtime because of its sedating effect.
Zoloft vs. Remeron Side Effects
Zoloft
Remeron
Zoloft vs. Remeron Dosage
Zoloft
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 25 to 50 mg once daily | At the start |
| Maximum dose | Up to 200 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| 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 |
Zoloft
| STAGE | DOSE | WHEN |
| Starting dose | 25 to 50 mg once daily | At the start |
| Maximum dose | Up to 200 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
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 |
Zoloft vs. Remeron Indications
Zoloft
Zoloft is FDA-approved for major depressive disorder and five additional conditions, giving prescribers more approved options than most SSRIs. Its label covers both mood disorders and several anxiety-spectrum conditions.
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Panic disorder
Post-traumatic stress disorder (PTSD)
Social anxiety disorder and PMDD
Remeron
Remeron's FDA approval covers only major depressive disorder in adults. Off-label use for insomnia, anxiety, or appetite stimulation is common in practice but is not an FDA-approved use, so patients should discuss these uses with their prescriber.
Major depressive disorder (MDD) in adults
Not approved for pediatric depression
Off-label: insomnia
Off-label: anxiety disorders
Off-label: appetite/weight stimulation
Zoloft vs. Remeron Pros and Cons
Zoloft
Zoloft's broad FDA approval across mood and anxiety disorders makes it a common first-line choice, and its non-sedating profile suits patients who prefer taking it in the morning. Sexual side effects and early GI upset are the main tradeoffs patients report.
Pros
Approved for six conditions, not just depression
Non-sedating, typically taken in the morning
Less likely to cause weight gain than Remeron
Widely used first-line SSRI with decades of data
Cons
Sexual side effects common, up to 14% in men
Early nausea and diarrhea are common at start
Can cause insomnia instead of helping with sleep
Requires weekly dose changes to reach target dose
Remeron
Remeron's sedating profile and appetite-stimulating effect make it a useful option for depression paired with insomnia or poor appetite, and sexual side effects are less common than with SSRIs. Its narrower FDA approval and need for blood monitoring are the main tradeoffs.
Pros
Sedating effect can help sleep and mood together
Lower rates of sexual side effects than SSRIs
Can stimulate appetite in patients with poor intake
Simple three-step dosing schedule
Cons
Approved only for major depressive disorder
Significant weight gain and appetite increase common
Requires monitoring for rare but serious neutropenia
More sedating, can be harder to take during the day
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