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Mirtazapine is an atypical tetracyclic antidepressant (TeCA) primarily prescribed for major depressive disorder. This drug inhibits central presynaptic α2-adrenergic receptors, leading to increased serotonin and norepinephrine release, contributing to its sedative, antiemetic, anxiolytic, and appetite-stimulating effects. Mirtazapine is also used off-label for conditions such as insomnia, panic disorder, posttraumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder, social anxiety disorder, and migraines. Clinicians often consider mirtazapine for patients with concurrent depression and insomnia or those with a low body weight profile and an inadequate response to selective serotonin reuptake inhibitors (SSRIs).
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