Mirtazapine decreases the pain feeling in healthy participants

Clin J Pain. 2008 Feb;24(2):116-9. doi: 10.1097/AJP.0b013e318159f94a.


Objectives: The treatment of neuropathic pain is mainly based on antiepileptics, tricyclic antidepressants, and opiates. These drugs have important side effects disturbing the patient's quality of life. Mirtazapine (MTZ) is a new and well-tolerated tricyclic antidepressants with both monoaminergic and opioid properties that might favorably influence pain. The aim of this study was to assess whether MTZ can reduce the pain induced by a standardized stimulus presented to healthy human participants. The nociceptive flexion reflex (NFR) to an electric stimulus was chosen to determine the pain threshold.

Methods: The effect of MTZ compared to placebo was assessed on 10 healthy participants in a double-blinded cross-over design. The NFR was measured the day after a single oral dose of drug (30 mg) or placebo.

Results: A significant increase in upper limb (+29%, P=0.006) NFR threshold was observed.

Discussion: MTZ increases the pain tolerance in healthy participants. The potential benefit of this effect on pain should be investigated more thoroughly in chronic neuropathic pain patients. The NFR might serve as an additional tool for the monitoring of these patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics / administration & dosage*
  • Analgesics / adverse effects
  • Antidepressive Agents, Tricyclic / administration & dosage*
  • Antidepressive Agents, Tricyclic / adverse effects
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Administration Schedule
  • Electric Stimulation / adverse effects
  • Female
  • Humans
  • Leg / innervation
  • Leg / physiopathology
  • Male
  • Mianserin / administration & dosage
  • Mianserin / adverse effects
  • Mianserin / analogs & derivatives*
  • Middle Aged
  • Mirtazapine
  • Neuralgia / drug therapy*
  • Neuralgia / physiopathology
  • Nociceptors / drug effects
  • Nociceptors / physiology
  • Pain Measurement / drug effects
  • Pain Threshold / drug effects
  • Pain Threshold / physiology
  • Peripheral Nerves / drug effects
  • Peripheral Nerves / physiopathology
  • Peripheral Nervous System Diseases / drug therapy*
  • Peripheral Nervous System Diseases / physiopathology
  • Placebo Effect
  • Reaction Time / drug effects
  • Reaction Time / physiology
  • Reflex / drug effects
  • Reflex / physiology
  • Treatment Outcome


  • Analgesics
  • Antidepressive Agents, Tricyclic
  • Mianserin
  • Mirtazapine