a pre-synaptic alpha-2 receptor blocker which is used to treat depression. It also has a useful anti-anxiety action Mirtazapine probably acts by increasing the release of noradrenaline from presynaptic nerve terminals.
drug interactions include:
alcohol and benzodiazepine potentiation
side effects include increased appetite, dry mouth and drowsiness. Side effects are significantly less than tricyclics. Reversible blood dyscrasias have been reported.
mirtazapine should be viewed as one more alternative for patients unable to tolerate established first-line therapies, but more studies are needed to clarify its optimum place in treatment, especially in more severely ill patients