ModerateTricyclic antidepressants (TCA)×Other antidepressants (NaSSA)
Updated · Methodology
Mechanism
Additive sedation, anticholinergic effect, and weight gain. Mirtazapine's serotonergic effect (via α2-blockade) is not pronounced on a TCA.
Symptoms
Deep sedation, drowsiness, dry mouth, constipation, weight gain. Older patients: delirium and fall risk.
Management
Avoid the combination, especially in older patients. For resistant depression augmentation: mirtazapine + SSRI (sertraline, escitalopram) instead of a TCA. For neuropathic pain: gabapentin or pregabalin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Remeron (mirtazapine) prescribing information (2020)– ; DailyMed setid 98ad1917-a094-44f5-a28f-a64a8cfcd887
- AEMPS: Ficha técnica: Mirtazapina Cinfa 30 mg (nº registro 67068), secciones 4.5 y 4.7 (2026)– AEMPS, CIMA, nº registro 67068, revisión 06/2026, secciones 4.5 y 4.7