Generic Mirtazapine

Common use
Mirtazapine is an antidepressant primarily used to treat major depressive disorder (MDD). It works by increasing the levels of neurotransmitters such as serotonin and norepinephrine in the brain, which help improve mood and emotional balance. In some cases, it’s also prescribed for anxiety disorders, insomnia, or as an appetite stimulant, especially in elderly patients. Its sedative properties make it useful when depression is accompanied by sleep disturbances.

Dosage and direction
Mirtazapine is usually taken once daily at bedtime due to its sedative effect. The typical starting dose is 15 mg, which may be gradually increased by your doctor depending on response and tolerance. It can be taken with or without food. Do not stop taking the medication abruptly without consulting your healthcare provider, as withdrawal symptoms may occur.

Precautions
Before taking mirtazapine, inform your doctor if you have a history of bipolar disorder, seizures, liver or kidney problems, or suicidal thoughts. The drug can cause drowsiness, so avoid driving or operating machinery until you know how it affects you. Alcohol should be avoided, as it can intensify drowsiness and dizziness. Elderly patients may be more sensitive to side effects such as confusion or low sodium levels.

Contraindications
Mirtazapine should not be used by individuals allergic to the drug or any of its components. It is contraindicated in combination with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping such medications. Caution is advised during pregnancy and breastfeeding unless the potential benefits outweigh the risks. It is not recommended for children or adolescents without a doctor’s direction.

Possible side effect
Common side effects include drowsiness, increased appetite, weight gain, and dry mouth. Some patients may experience dizziness, constipation, or unusual dreams. Rare but serious side effects include low white blood cell counts, serotonin syndrome, or suicidal thoughts, especially in younger adults. Contact your doctor if you notice mood changes, fever, sore throat, or unusual bleeding.

Drug interaction
Mirtazapine may interact with other antidepressants, antipsychotics, anticonvulsants, and drugs that affect serotonin levels. Combining it with alcohol or benzodiazepines can enhance sedative effects. St. John’s Wort and other herbal supplements should be avoided unless approved by your doctor. Always inform your healthcare provider about all medications and supplements you’re taking.

Missed dose
If you miss a dose, take it as soon as you remember unless it’s close to your next scheduled dose. Do not double the dose to make up for the missed one. Try to take mirtazapine at the same time every day to maintain consistent blood levels. If multiple doses are missed, consult your doctor for guidance.

Overdose
An overdose of mirtazapine may cause confusion, rapid heartbeat, severe drowsiness, or loss of consciousness. Seizures and cardiac issues can also occur in severe cases. Seek emergency medical help if an overdose is suspected. Treatment involves supportive care and monitoring in a medical facility.

Storage
Store mirtazapine at room temperature between 20°C and 25°C (68°F and 77°F). Keep it in a dry place away from heat, light, and moisture. Do not store it in the bathroom. Keep out of reach of children and pets, and properly discard expired medication.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Clinical Verification

Last Clinically Updated: August 15, 2026

Written By

Dr. Elena Vance, PharmD

Clinical Specialist in Neuropharmacology

Fact Checked By

Marcus Thorne, MS

Biomedical Data & FDA Label Verification

Medically Reviewed By

Dr. Arthur Campbell, MD

Board-Certified Psychiatrist (ABPN)