Mirtazapine vs Sertraline: side-by-side comparison
Mirtazapine (Atypical antidepressant (NaSSA)) and Sertraline (Selective serotonin reuptake inhibitor (SSRI)) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.
| Property | Mirtazapine | Sertraline |
|---|---|---|
| Therapeutic class | Atypical antidepressant (NaSSA) | Selective serotonin reuptake inhibitor (SSRI) |
| CAS | 85650-52-8 | 79617-96-2 |
| ATC | N06AX11 | N06AB06 |
| Molecular weight | 265.36 g/mol | 306.2 g/mol |
| Brands with this active ingredient | 1 | 2 |
What they share
Mirtazapine and Sertraline share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.
Key differences
Mirtazapine acts by a different mechanism than Sertraline, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.
Mechanisms compared
Mirtazapine: Mirtazapine antagonises presynaptic α2-adrenergic autoreceptors and heteroreceptors, increasing noradrenaline and serotonin release. Sertraline: Sertraline selectively blocks the reuptake of serotonin (5-HT) by the presynaptic neuron, increasing the concentration of serotonin in the synaptic cleft.
Indications compared
Mirtazapine: Mirtazapine is approved for major depressive disorder. Sertraline: Sertraline is approved for several psychiatric indications in adults: major depressive disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), soc…
Safety profile
Mirtazapine: Common adverse effects include sedation (highest at low doses 7.5–15mg, paradoxically less at higher doses), increased appetite, weight gain, dry mouth and dizziness. Sertraline: Common adverse effects include nausea, diarrhoea, insomnia, sexual dysfunction, dry mouth and sweating, particularly during the first weeks of treatment.
Frequently asked questions
Is Mirtazapine better than Sertraline? ▾
Mirtazapine and Sertraline are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Mirtazapine and Sertraline be combined? ▾
Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.
Do they have the same side-effect profile? ▾
No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.
Products with Mirtazapine
Products with Sertraline
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.