Amitriptyline vs Mirtazapine: side-by-side comparison
Amitriptyline (Tricyclic antidepressant (TCA)) and Mirtazapine (Atypical antidepressant (NaSSA)) 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 | Amitriptyline | Mirtazapine |
|---|---|---|
| Therapeutic class | Tricyclic antidepressant (TCA) | Atypical antidepressant (NaSSA) |
| CAS | 50-48-6 | 85650-52-8 |
| ATC | N06AA09 | N06AX11 |
| Molecular weight | 277.40 g/mol | 265.36 g/mol |
| Brands with this active ingredient | 1 | 1 |
What they share
Amitriptyline and Mirtazapine 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
Amitriptyline acts by a different mechanism than Mirtazapine, 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
Amitriptyline: L'amitriptyline inhibe la recapture de la sérotonine et de la noradrénaline au niveau des synapses centrales, augmentant les concentrations synaptiques de ces deux neurotransmetteurs. Mirtazapine: La mirtazapine antagonise les autorécepteurs et hétérorécepteurs α2-adrénergiques présynaptiques, ce qui augmente la libération de noradrénaline et de sérotonine.
Indications compared
Amitriptyline: L'amitriptyline est autorisée dans la dépression caractérisée, mais son usage contemporain est dominé par les indications hors AMM à faible dose : douleurs neuropathiques, fibromyalgie, céphalées de tension chroniques, p… Mirtazapine: La mirtazapine est autorisée dans la dépression caractérisée.
Safety profile
Amitriptyline: Les effets indésirables fréquents reflètent les activités anticholinergique, antihistaminique et α1-bloquante : sécheresse buccale, constipation, dysurie, vision floue, sédation, prise de poids et hypotension orthostatiq… Mirtazapine: Les effets indésirables fréquents comprennent la sédation (maximale aux faibles doses de 7,5 à 15 mg, paradoxalement moindre aux doses supérieures), l'augmentation de l'appétit, la prise de poids, la sécheresse buccale e…
Questions fréquentes
Is Amitriptyline better than Mirtazapine? ▾
Amitriptyline and Mirtazapine are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Amitriptyline and Mirtazapine 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 Amitriptyline
Products with Mirtazapine
Les informations publiées sur ce site sont fournies à titre documentaire et pédagogique. Elles ne remplacent pas l'avis d'un professionnel de santé qualifié.