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Mirtazapine may not be the right choice for every patient. In such cases, it is important to discuss with a medical provider potential mirtazapine alternatives.

Mirtazapine Alternatives

What are your options when it comes to alternatives for mirtazapine?

For Sleep and Insomnia

Mirtazapine is a sedating antidepressant, which means it causes drowsiness. Similar drugs would have the same effect, such as trazodone (Desyrel). Both medications lead to sleepiness and help someone stay asleep, both of which are primary symptoms of insomnia. There are other options not listed here.

For Appetite

Increased appetite is a side effect of mirtazapine. Someone looking to recreate that effect might try drugs approved by the FDA for that purpose, such as megestrol (Megace), dronabinol (Marinol), or oxandrolone (Oxandrin). Dronabinol is a cannabinoid medication, and megestrol and oxandrolone are both synthetic hormones.  There are other options not listed here.

For Anxiety

There are many drugs similar to mirtazapine used for the treatment of anxiety include duloxetine (Cymbalta) and bupropion (Wellbutrin).  There are other options not listed here.

For Cats

Mirtazapine is approved as an appetite stimulant in cats. Other options to consider would be cyproheptadine (Periactin), an antihistamine known to promote weight gain, and capromorelin (Entyce), an FDA-approved veterinary appetite stimulant.  There are other options not listed here.

For Weight Gain and Appetite Stimulation

Appetite stimulation is a side effect of mirtazapine, but there are other options, such as megestrol acetate, which is a progesterone-based drug used to treat anorexia and to supplement care plans for HIV and cancer.  There are other options not listed here.

For Nausea

One could try an antiemetic such as palonosetron (Aloxi), which is used to combat nausea in chemotherapy patients. Other tricyclic antidepressants are sometimes used for nausea as well, such as olanzapine (Zyprexa) or risperidone (Risperdal).  There are other options not listed here.

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