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Mirtazapine is an atypical tetracyclic antidepressant primarily used to treat major depressive disorder in adults. It is also prescribed off-label for conditions such as anxiety disorders, insomnia, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and to stimulate appetite. The drug acts mainly by antagonizing central presynaptic alpha 2 adrenergic inhibitory autoreceptors and heteroreceptors, which increases the release of norepinephrine and serotonin. Additionally, it is a potent antagonist or inverse agonist at histamine H1 receptors and serotonin 5‑HT2A/5‑HT2C/5‑HT3 receptors. Unlike many other antidepressants, mirtazapine does not inhibit the reuptake of monoamines nor does it inhibit monoamine oxidase[1][4][5][7]. It was originally developed by Organon.
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