Mirtazapine for Anxiety: Is It Effective?

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Andreas Meistad
Feb 6, 20233 min read

Mirtazapine for anxiety: Is it effective?

Anxiety is a common mental health disorder that can have a significant impact on daily life. It can manifest in various forms, such as generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and others. Many people with anxiety turn to medications to help manage their symptoms. One such medication is mirtazapine, which is an antidepressant that is also used off-label to treat anxiety.

What is Mirtazapine?

Mirtazapine is a type of antidepressant known as a tetracyclic antidepressant. It was first approved by the FDA in 1996 for the treatment of depression. Since then, it has also been used off-label to treat anxiety and a variety of other conditions, including insomnia, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

How does Mirtazapine work?

Mirtazapine works by increasing the levels of certain neurotransmitters in the brain, including serotonin and norepinephrine. These neurotransmitters play a role in mood regulation and are thought to be imbalanced in people with depression and anxiety. By increasing their levels, mirtazapine may help to improve mood and reduce anxiety symptoms.

Mirtazapine is also believed to have anti-inflammatory effects, which may contribute to its effectiveness in treating anxiety. Inflammation has been linked to a variety of mental health conditions, including anxiety.

Is Mirtazapine effective for anxiety?

The evidence on the effectiveness of mirtazapine for anxiety is mixed. Some studies have found that mirtazapine can reduce anxiety symptoms in people with GAD, social anxiety disorder, and panic disorder. However, other studies have not found a significant improvement in anxiety symptoms with mirtazapine treatment.

One small study published in the Journal of Clinical Psychiatry found that mirtazapine was effective in reducing anxiety symptoms in people with GAD. Another study published in the Journal of Psychopharmacology found that mirtazapine was effective in reducing anxiety symptoms in people with social anxiety disorder.

However, a review of the literature on the use of mirtazapine for anxiety disorders, published in the Journal of Clinical Psychopharmacology, found that the evidence for its effectiveness was limited. The review concluded that more research is needed to determine the efficacy of mirtazapine for anxiety disorders.

It is important to note that mirtazapine is not FDA-approved for the treatment of anxiety and should only be used off-label for this purpose. It is important to discuss all treatment options with a mental health professional before starting any medication.

What are the potential side effects of mirtazapine?

Like all medications, mirtazapine can cause side effects. The most common side effects of mirtazapine include:

  • Drowsiness
  • Dry mouth
  • Increased appetite
  • Weight gain
  • Less common side effects of mirtazapine include:
  • Constipation
  • Dizziness
  • Headache
  • Nausea
  • Sexual dysfunction

In rare cases, mirtazapine can cause more serious side effects, including an increased risk of suicide, particularly in children, adolescents, and young adults. It is important to discuss the potential risks and benefits of mirtazapine with a healthcare provider before starting treatment.

Check Your Mental Health Quality
How Is Your Sleep?Very poor
How often do you feel worry?Very often

CBT-I: A Long-Term Sleep Fix

Many people choose natural treatments to boost health and improve sleep. However, Mirtazapine has not been well studied, and its safety and effectiveness aren’t yet understood.

Cognitive behavioral therapy for insomnia (CBT-I) is a natural, side-effect-free sleep treatment. It involves relearning your sleep habits and addressing issues that are getting in the way of quality sleep. Studies show that CBT-I works as well as or better than sleep medications and that its effects last after the treatment is done.1

Fill out Dawn Health’s questionnaire to get started with CBT-I right from your computer — no in-person visits necessary. Quality, natural sleep is possible when you embark on a CBT-I treatment journey.

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Andreas Meistad

Therapist specializing in applying CBT principles for the treatment of insomnia.

It’s time to stop blaming the night monsters.

Let’s work together to transform your sleep for the better.