Enhances central noradrenergic and serotonergic activity, perhaps by antagonism at central presynaptic alpha-2 adrenergic inhibitory autoreceptors and heteroreceptors. Moderate antagonist of peripheral alpha-1 adrenergic receptors and muscarinic receptors. Rapidly and completely absorbed from the GI tract. Within 2 hr.
Females exhibit significantly longer elimination half-lives than males.
Known or suspected seizure disorders. The effect of mirtazapine for longer than 6 weeks has not been evaluated, although treatment is indicated for 6 months or longer. Safety and efficacy have not been determined in children. Somnolence, dizziness, activation of mania or hypomania, suicidal ideation, sedation, drowsiness, abnormal dreams, abnormal thinking, tremor, confusion, hypesthesia, apathy, depression, hypokinesia, vertigo, twitching, agitation, anxiety, amnesia, hyperkinesia, paresthesia, ataxia, delirium, delusions, depersonalization, dyskinesia, extrapyramidal syndrome, increased libido, abnormal coordination, dysarthria, hallucinations, neurosis, dystonia, hostility, increased reflexes, emotional lability, euphoria, paranoid reaction. Hypertension, vasodilation, angina pectoris, MI bradycardia, ventricular extrasystoles, syncope, migraine, orthostatic hypotension.