Mirtazapine-nortriptyline

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Mirtazapine
Type Antidepressant
Group other
links
Medscape Mirtazapine
PubChem 4205
PubMed Mirtazapine
Kompas (Dutch) Mirtazapine
Wikipedia Mirtazapine
Nortriptyline
Type Antidepressant
Group TCA
links
Medscape Nortriptyline
PubChem 4543
PubMed Nortriptyline
Kompas (Dutch) Nortriptyline
Wikipedia Nortriptyline

Switch medication from mirtazapine to nortriptyline.[1] [2]

Nietinrijdenbord.png Stop mirtazapine
  • Before day 1: gradually reduce dosage of mirtazapine to a maximum of 30 mg/ day.
  • Day 1: reduce a dosage of 30 mg/day to 15 mg/day.
Eenrichtingbord.png Start nortriptyline

No wash-out period is needed.

  • Day 1: simultaneously start administration of nortriptyline in a dosage of 50 mg/day.
  • Day 8: stop administration of mirtazapine and continue administration of nortriptyline. If necessary, increase dosage of nortriptyline.
  • "Start low, go slow" is not required, but caution is necessary.


  1. Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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