Optimal Dose of Mirtazapine for Sleep

Dosing Considerations

• Mirtazapine is used off-label for insomnia at lower doses than those used for depression, according to the American Academy of Sleep Medicine 1, 2

Evidence for Efficacy

• The American Academy of Sleep Medicine suggests that mirtazapine has been shown to improve sleep quality and duration when used at low doses 1

Clinical Considerations

• Administration of mirtazapine on an empty stomach is advised to maximize effectiveness, as recommended by the American Academy of Sleep Medicine 1
• Mirtazapine has potential advantages over benzodiazepines and Z-drugs, including being a non-scheduled medication, according to the American Academy of Sleep Medicine 1

Important Precautions

• The American Academy of Sleep Medicine notes that mirtazapine is not FDA-approved specifically for insomnia treatment 1, 3
• Caution is advised in elderly patients, who may require lower doses, as recommended by the American Academy of Sleep Medicine 1

Alternative Options for Insomnia

• The American Academy of Sleep Medicine suggests the following FDA-approved medications for insomnia: Eszopiclone (2-3 mg), Zolpidem (10 mg), Doxepin (3-6 mg), Suvorexant (10-20 mg), and Ramelteon (8 mg) 3, 4