Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/5/2025

Mirtazapine Administration Timing

Rationale for Evening Administration

  • The sedative properties of mirtazapine can help address sleep disturbances that often accompany depression, as noted by the National Comprehensive Cancer Network 1

Clinical Benefits of Evening Administration

  • The National Comprehensive Cancer Network recommends mirtazapine as particularly effective for patients with both depression and insomnia 1

Precautions and Considerations

  • Mirtazapine may worsen obstructive sleep apnea in some patients, so caution is advised in patients with this condition, according to the British Journal of Pharmacology and the American Academy of Sleep Medicine 2, 3

Special Populations

  • Women may require higher dosing than men to achieve the same therapeutic effect, though evening administration remains recommended for both, as suggested by the American Academy of Sleep Medicine 3

REFERENCES

1

palliative care version 1.2016. [LINK]

Journal of the National Comprehensive Cancer Network : JNCCN, 2016

3

best practice guide for the treatment of rem sleep behavior disorder (rbd). [LINK]

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2010