Mirtazapine
Antidepressant — NaSSA
Indications
Depression (esp. with insomnia, low weight, anxiety)
Adult dose
Start 15–30 mg nocte; usual 30–45 mg, max 45 mg.
Common side effects
Sedation (paradoxically less at higher doses)Increased appetite/weight gainDry mouthVivid dreams
Serious side effects
Agranulocytosis (rare)HyponatraemiaSerotonin syndrome (in combinations)Restless legs
Contraindications
MAOI within 14 days
Monitoring
- FBC if signs of infection (sore throat, fever)
- Weight
Notable interactions
- Sedatives/alcohol
- MAOIs
- Strong CYP3A4 inhibitors raise levels
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.