Mirtazapine for Moderate, Severe, or Refractory Depression

Course overview

Mirtazapine is an antidepressant with a labeled use for the treatment of major depressive disorder. Ongoing studies are comparing the benefits and risks of mirtazapine in specific population groups, including the elderly and individuals with severe mood dysregulation. Mirtazapine is known to be well-tolerated and effective. Combination therapy for individuals with treatment-resistant depression has been investigated in terms of the clinical benefits of mirtazapine when administered with other psychotropic agents. Mirtazapine has a low potential to interact with antipsychotics, tricyclic antidepressants, and some selective serotonin reuptake inhibitors (CYP2D6 metabolizers), making it an option for non-responders to monotherapy for depression, anxiety symptoms, and sleep disturbance. The basic pharmacological profile of mirtazapine, clinical indications, and the potential for mirtazapine toxicity are discussed in the following sections, which include prescribing and current published information.