Recommended dosage for older adults	7.5–15 mg (slower upward titration recommended for older adults) [31]
Indications	Major depressive disorder [29]; “off-label” use for management of Insomnia [31, 32]
Contraindications	Hypersensitivity to mirtazapine or any component ingredients; current or recent (past 2 weeks) use of MAOIs and other drugs that affect the serotonergic neurotransmitter systems [29]
Main drug interactions	MAOIs; serotonergic drugs; drugs affecting hepatic metabolism; drugs that are metabolized by and/or inhibit cytochrome P450 enzymes [29]
Main side effects	Reported in ≥ 5% and more frequently than in those treated with placebo: somnolence, increased appetite, weight gain, dizziness [29]
Special points	Mirtazapine is not currently approved by the FDA for the treatment of insomnia and current ACP guidelines indicate evidence for the use of antidepressants is insufficient or of low strength [25]. Due to the greater likelihood of renal impairment in older adulthood and risk of decreased clearance of mirtazapine in individuals with impaired renal functioning, particular caution is advised in dose selection for older adults [29]. Antidepressants may increase the risk of suicidal thoughts and behaviors.