Mirtazapine is an antidepressant that is typically used second or third line.

Mechanism of action

Mirtazapine works by blocking alpha2-adrenergic receptors, which increases the release of neurotransmitters.

Adverse effects

Mirtazapine has fewer side effects and interactions than many other antidepressants and so is useful in older people who may be affected more or be taking other medications.

Two side effects of mirtazapine, sedation and an increased appetite, can be beneficial in older people that are suffering from insomnia and poor appetite.

It is generally taken in the evening as it can be sedative.