How Effective Is Mirtazapine for Anxiety?

Mirtazapine is an oral, antidepressant drug primarily indicated for the treatment of depression. Use of mirtazapine for anxiety has also shown to be nearly 80 percent effective in clinical trials. Particularly helpful to patients experiencing both anxiety and depression, complaints of gaining weight and feeling sleepy are some common side effects of taking the drug. It has not been approved by the U.S. Food and Drug Administration (FDA) for use in treating anxiety or for use in children.

​Belonging to a group of medications referred to as serotonin and norepinephrine reuptake inhibitors (SNRIs), mirtazapine acts on neurotransmitters of the brain, chemicals responsible for transmission or stopping electrical impulses between nerve cells. Affecting action of norepinephrine and serotonin neurotransmitters specifically, SNRIs are prescribed for the purpose of mood adjustment and regulation. A hormone necessary for stress adaptation and response, norepinephrine increases physiological arousal, namely heart rate, breathing, and sweating. Too much of this hormone produces anxiousness and intense fear, while too little can result in fatigue and an overall depressed mood. Patients do report successful relief from bothersome symptoms with mirtazapine for anxiety due to its ability to increase serotonin transmission into brain cells and by suppressing excess serotonin postsynaptically.

Even though only approved for treatment of depression in the U.S., doctors worldwide do prescribe mirtazapine for anxiety, being used successfully for several conditions, including generalized anxiety disorder, panic, post-traumatic stress disorder (PTSD), and social anxiety disorder. Those with symptoms of both anxiety and depression also have found it to be especially helpful, most likely due to its affect on both neurotransmitters. Despite effectiveness, it is reported to be the most sedating of newer antidepressants, a troublesome downside to taking this drug, often remedied by taking before bedtime and the sedation effect is reported to improve over time. Other mirtazapine side effects include weight gain and many notice an increase in appetite. Less commonly, suicidal attempts and increased thoughts of suicide have been linked with taking antidepressant drugs, including mirtazapine for anxiety.

In addition to medication therapy, physicians treat anxiety disorders using cognitive-behavioral therapy (CBT), used by psychiatrists and psychologists to help patients suffering from symptoms such as intense fear and worry, nervousness, and sleeplessness. CBT works by adjusting perceptions regarding certain situations that contribute to the production of anxiety and fears. Training in awareness ​of physiological states, learning how to regulate the effects of anxiety through use of breathing and relaxation techniques are also part of CBT. All of this is done while attending psychotherapy sessions and it has been proven to be highly effective when done in combination with taking mirtazapine for anxiety. A treatment combination helps patients regain normal functioning in daily life, particularly with relationships and career-related activities.