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Mirtazapine

NaSSA • Brands: Remeron

Last reviewed: 2025-09-26

General information

Indicated for: Major depressive disorder.

Dosing & forms

  • Forms/strengths: —
  • Frequency: —
  • Food: —
  • Typical range: 15–45 mg at bedtime

Mechanism (brief)

Central presynaptic α2 antagonist; increases noradrenergic and serotonergic transmission with 5-HT2/5-HT3 antagonism.

Metabolism & Half‑life

  • Metabolism: Hepatic metabolism via CYP1A2, CYP2D6, and CYP3A4.
  • Half‑life: ~20–40 h (longer in hepatic/renal impairment).

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

  • Weight/BMI and metabolic parameters — Baseline and periodically
  • Assess for sedation and daytime somnolence — Each visit early in therapy

Sources