Mirtazapine: pharmacology in relation to adverse effects

Acta Psychiatr Scand Suppl. 1997:391:31-7. doi: 10.1111/j.1600-0447.1997.tb05956.x.


Mirtazapine is a new antidepressant that falls into the general class of receptor-blocking drugs rather than being an uptake or enzyme inhibitor. It can be described as a noradrenergic and specific serotonergic antidepressant (NaSSA). The unique pharmacology of mirtazapine means that it has a very different side effect profile from the tricyclic antidepressants, producing less alpha 1 adrenergic and muscarinic blockade, and the selective serotonin reuptake inhibitors (SSRIs) and the serotonin-noradrenaline reuptake inhibitors (SNRIs), causing much less nausea and sexual dysfunction by virtue of its blockade of 5-HT2 and 5-HT3 receptors.

MeSH terms

  • Adrenergic alpha-Antagonists / adverse effects
  • Adrenergic alpha-Antagonists / pharmacology*
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antidepressive Agents, Second-Generation / pharmacology*
  • Humans
  • Mianserin / adverse effects
  • Mianserin / analogs & derivatives*
  • Mianserin / pharmacology
  • Mirtazapine
  • Receptors, Serotonin / drug effects
  • Serotonin / physiology
  • Synapses / drug effects


  • Adrenergic alpha-Antagonists
  • Antidepressive Agents, Second-Generation
  • Receptors, Serotonin
  • Mianserin
  • Serotonin
  • Mirtazapine