A tetracyclic antidepressant that blocks specific serotonin and norepinephrine receptors while enhancing their release, used to treat depression and often prescribed for its appetite-stimulating and sleep-promoting effects.
Developed by Organon (now Merck) in the 1980s, named for its chemical structure as a piperazinoazepine compound. The '-ine' suffix follows standard pharmaceutical nomenclature for nitrogen-containing drugs.
Mirtazapine works backwards from most antidepressants - instead of preventing serotonin breakdown, it blocks the receptors that normally shut down serotonin release, like removing the brakes from a car. It's particularly useful for depressed patients who have lost their appetite or can't sleep, but the weight gain can be dramatic - some patients gain 20+ pounds.
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