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Mirtazapine is a NaSSA, tetracyclic antidepressant used primarily in the treatment of major depression and severe mood disorders, although prescribed off-label for sleep, and is commonly also indicated as an anxiolytic, hypnotic, antiemetic and appetite stimulant. It is also a 5-HT2A antagonist. It should not be taken with tryptophan or any MAOI (monoamine oxidase inhibitor), as this can cause adverse effects. Common side effects include decreased or ncreased movement, mood or mental changes including anxiety and apathy, shortness of breath, and skin rash, and although these side effects are common they also are usually temporary, leaving once the body stabilizes on the medication.


[top]Introduction to Mirtazapine

Mirtazapine is a tetracyclic antidepressant used primarily in the treatment of depression. Mirtazapine is one of the few noradrenergic and specific serotonergic antidepressants (NaSSAs). It has been demonstrated to have far fewer side effects than most other typical anti-depressants on the market.

Mirtazapine is unusual for an anti depressant as it has effects that are apparent instantly. The instant effects are sedating, which can help people with sleep, whereas the long term anti depressant/anxiety effects will not become apparent until amounts in the body have built up to a sufficient level over months of use. It takes 5 days for a given dosage to build in the bloodstream to stable levels.

[top]Using Mirtazapine

The usual starting dose of mirtazapine is 15 mg, given at bed-time. This can be increased to 45mg over time, but close doctor supervision is indicated for an increase above that amount.

[top]Ways of Administration

Mirtazapine is normally supplied in oral tablets.

[top]Effects of Mirtazapine

[top]Combinations with Mirtazapine

[top]Different Uses for Mirtazapine

Mirtazapine can also be prescribed for secondary symptoms of Autistic spectrum disorders, and for disorders such as anorexia when an anti-depressant is also appropriate.

[top]Pharmacology of Mirtazapine

Receptor Affinity pA2 or pKi
2-Adrenergic autoreceptor 7.7
2-Adrenergic heteroreceptor 8.0
Postsynaptic 2-adrenoceptor 7.3
Presynaptic 2-adrenoceptor 6.8
1-Adrenoceptor 6.5
Serotonin 5-HT1A 5.3
Serotonin 5-HT1B 4.9
Serotonin 5-HT1D 5.3
Serotonin 5-HT2A 8.2
Serotonin 5-HT2B 6.7
Serotonin 5-HT2C 7.9
Serotonin 5-HT3 8.1
Histamine H1 9.3
Muscarinic 6.2
Dopamine D1 5.8
Dopamine D2 5.6

[top]Chemistry of Mirtazapine

Systematic(IUPAC) name:1,2,3,4,10,14b-Hexahydro-2-methylpyrazino[2,1-a]pyrido[2,3-c][2]benzazepine
Synonyms:1,2,3,4,10,14b-hexahydrobenzo[c]pyrazino[1,2-a]pyrido[3,2-f]-azepine, 6-azamianserin, Org-3770, mepirzepine, Remeron, Zispin
Molecular Formula:C17H19N3
Molar mass:265.36 g/mol.
CAS Registry Number:61337-67-5
Melting Point:114-116C
Boiling Point:no data
Flash Point:no data
Solubility:Freely soluble in methanol, toluene; soluble in ethyl ether, chloroform; sparingly soluble in n-hexane; practically insoluble in water.
Additionnal data:none
Notes:Aspect : white crystals; crystallyzed from petroleum ether

[top]The Dangers of Mirtazapine

[top]Physical Health Risks

[top]Physical Problem 1

[top]Physical Problem 2


[top]Reported Deaths

When Robin Williams Committed suicide on August 11, 2014, the coronor's autopsy report found that he had taken Mirtazapine shortly before hanging himself. Mirtazapine was never found to be a causal factor in his death however.

[top]Mental Health Risks

[top]Mental Health Risk 1

[top]Mental Health Risk 2

[top]Side Effects

Some side effects of Mirtazapine include increased appetite, weight gain, and drowsiness. In extremely high doses it can cause hallucinations as a deliriant anti-histamine.


[top]Physical Addiction

[top]Mental Addiction

[top]Producing/Growing Mirtazapine

[top]Forms of Mirtazapine

[top]Legal Status of Mirtazapine

[top]United Nations


Mirtazapine is a schedule IV (4) drug in the U.S. as of March 2015.



Mirtazapine is a schedule 4 drug in Australia. It is available by prescription only.


Mirtazapine is a prescription only drug in the United Kingdom

[top]Other Countries

[top]History of Mirtazapine

[top]More Mirtazapine Sections


[1]Merck Index, fifteenth edition (2013)

Created by Synesthesiac, 07-04-2012 at 22:53
Last edited by NorthQueensland, 16-11-2015 at 20:53
Last comment by NeuroChi on 09-09-2015 at 05:43
7 Comments, 25,029 Views

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