Mirtazapine Administration Guidelines

Clinical Recommendations

• The National Comprehensive Cancer Network guidelines recommend mirtazapine 7.5-30 mg at bedtime for management of insomnia in palliative care patients 1, 2
• According to the National Comprehensive Cancer Network, evening administration of mirtazapine allows the sedating effects to facilitate sleep rather than cause daytime impairment, and is particularly beneficial for patients with depression who have comorbid insomnia and anxiety symptoms 1, 2

Special Considerations

• If a patient experiences persistent daytime sedation despite evening dosing, the National Comprehensive Cancer Network suggests evaluating for other causes of sedation, considering dose adjustment, or potentially switching to a different antidepressant—not to shift administration to morning 2