Maz

Quick links to important sections

Maz

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Maz

What is Maz? (Mirtazapine)

Property Description
Active ingredient Mirtazapine
Form Tablet, Orally Disintegrating Tablet (ODT)
Pharmacological class Noradrenergic and Specific Serotonergic Antidepressant (NaSSA)
Type Synthetic, Single-ingredient
Route of administration Oral

What is Mirtazapine (Maz)? Identity and Chemical Class

Maz is a recognized trade name for the synthetic, prescription-only medication (POM) containing the active ingredient Mirtazapine. Chemically, Mirtazapine is a piperazino-azepine derivative (C17H19N3) primarily administered for oral use in two forms: the standard tablet and the orally disintegrating tablet (ODT). This formulation, available globally under brands like Remeron and Zispin, is a single-ingredient product.

Classification: Is Mirtazapine a Tetracyclic or a NaSSA?

Mirtazapine is classified as an antidepressant belonging to the unique functional group known as a Noradrenergic and Specific Serotonergic Antidepressant (NaSSA). While structurally it falls within the tetracyclic compound category, the NaSSA designation accurately reflects its specific mechanism: it functions as a potent antagonist of the central presynaptic alpha2-adrenergic inhibitory autoreceptors. This mechanism is clinically recognized for resulting in the simultaneous and specific enhancement of both noradrenaline and serotonin levels in the brain, distinguishing it from selective reuptake inhibitors.

The General Purpose of Mirtazapine

The general purpose of Mirtazapine is to help stabilize mood and improve emotional resilience by correcting specific neurochemical imbalances. Its action via alpha2-adrenergic receptor antagonism facilitates the necessary increase in mood-regulating neurotransmitters. The drug also exerts powerful histamine H1 receptor antagonist activity, which is a key property often utilized to provide a calming effect, a feature often needed when emotional imbalance is compounded by sleep disruption. This dual therapeutic effect provides a comprehensive pathway toward improving overall emotional stability.

Regulatory References

  1. according to the National Institutes of Health

What side effects are possible with Maz?

Possible Side Effects and Safety Information

The medicine's safety profile is defined by officially documented adverse reactions, classified by frequency and the body system affected, according to regulatory standards.

Adverse Reaction Scope

Category Description
Key adverse reaction categories Side effects grouped by frequency (Very Common to Not Known) and System-Organ Class (e.g., Nervous System, Metabolism and Nutrition, Blood and Lymphatic System).
Frequency classification Very Common (ge 1/10): Somnolence/Sedation, Increased Appetite, Weight Gain, Dry Mouth. Common (ge 1/100 to <1/10): Lethargy, Dizziness, Headache, Nausea, Vomiting, Peripheral Oedema, Fatigue. Rare (ge 1/10,000 to <1/1,000): Agranulocytosis.
System-organ classes involved Nervous System Disorders, Metabolism and Nutrition Disorders, Psychiatric Disorders, Gastrointestinal Disorders, and Blood and Lymphatic System Disorders.
Serious adverse reactions Officially documented serious reactions include Agranulocytosis (a rare blood disorder), Serotonin Syndrome, and the presence of a Boxed Warning concerning suicide-related events (thoughts and behaviours). Severe Cutaneous Adverse Reactions (SCARs), such as Stevens-Johnson Syndrome (SJS), have also been reported.
Population-specific safety considerations The medicine is not approved for the paediatric population (under 18 years) due to an observed increased risk of suicide-related events. Older adults may be at greater risk for certain effects, including hyponatraemia. Clearance is reduced in patients with renal or hepatic impairment.
Dose- or exposure-related patterns Somnolence, increased appetite, and weight gain are often more frequently observed at the start of treatment. The risk of suicide-related events is noted to be a concern early in treatment and following dose changes.
Safety-related restrictions or limitations The medicine is contraindicated for concurrent use with or within fourteen days of discontinuing Monoamine Oxidase Inhibitors (MAOIs).

Safety Classifications (High-Level)

Classification Description
Regulatory frequency framework used Standard frequency tiers are used to classify adverse events, distinguishing between expected effects and rare events.
Regulatory basis Information is based on official prescribing documents, including the FDA Prescribing Information and EMA Summary of Product Characteristics (SmPC).
Context-of-use safety notes Official documents include a Boxed Warning regarding the increased risk of suicidal thoughts and behaviour in children, adolescents, and young adults (up to 24 years of age) when using this type of medication.

Resulting Safety Structure

The regulatory documentation establishes the safety profile by distinguishing between:

  • Commonly observed adverse reactions (e.g., weight gain, somnolence, increased appetite).
  • Rare, but critical risks (e.g., agranulocytosis, Serotonin Syndrome).
  • Specific constraints on use, such as the MAOI contraindication and the warning regarding the paediatric population.

Connection to the overall safety profile

The official safety information structures the understanding of potential risks by systematically categorizing adverse events and explicitly defining constraints, ensuring all relevant parties are aware of the most frequently observed effects and the specific high-risk conditions, such as the suicide-related event warning for younger adults.

Overdose and Emergency Response

The official regulatory profile for Mirtazapine (Maz) overdose documents specific central nervous system and cardiovascular manifestations. Overdose may present with signs such as drowsiness, disorientation, impaired memory, and tachycardia (fast heart rate).

The potential for serious outcomes exists, particularly when Mirtazapine is taken alongside other substances (mixed overdoses). Severe manifestations reported include seizures, significant CNS or respiratory depression, and severe cardiac rhythm disturbances, specifically QTc prolongation and Torsades de Pointes. Fatalities have been reported, primarily in mixed overdose cases.

Immediate medical attention is required for any suspected overdose. Emergency services must be contacted immediately if the individual is collapsed, experiencing trouble breathing, is unresponsive, or has had a seizure.

Management is supportive and symptomatic, as no specific antidote is known. Official procedures typically involve obtaining an ECG and initiating continuous cardiac monitoring for a minimum of six hours. Actions like gastric decontamination, using gastric lavage followed by activated charcoal, may be initiated. Emesis (inducing vomiting) is explicitly contraindicated. Clearance of Mirtazapine is reduced in patients with moderate to severe renal or hepatic impairment, a factor relevant to the overdose context.

Therapeutic Uses of Maz

What Maz Treats: Main Uses and Benefits

Maz is commonly used to help manage symptoms of Major Depressive Disorder (MDD), assisting in supporting mood stability during episodes marked by persistent sadness, loss of pleasure (anhedonia), and emotional emptiness. The drug's use is relevant for managing conditions that involve emotional dysregulation, such as MDD in adults. It supports the patient during difficult episodes by easing distress and assists with managing associated anxiety symptoms, helping to ease the overall symptom load.

The primary therapeutic applications include Major Depressive Disorder, alongside symptomatic support for insomnia and appetite loss that interfere with daily functioning.

Maz is commonly applied in scenarios where depressive episodes are associated with symptoms that interfere with daily functioning, specifically sleep and appetite. It is considered relevant for managing sleep-related symptoms and may assist with a sense of calm that supports sleep quality. Furthermore, it assists with appetite stimulation, which is relevant for easing symptoms that interfere with nutritional intake. Its use may also be relevant in challenging clinical situations, such as managing symptoms for geriatric patients or those with treatment-resistant depression.


Quick Fact: Supportive Symptom Management
Maz is often relevant when conditions involve a combination of emotional distress and key physical symptoms. Its use is relevant for managing conditions characterized by periods of heightened symptoms, supporting relief for both mood instability and sleep/appetite disruption.

Eligibility and Restrictions for Use

Who can and cannot use Maz?

Maz (Mirtazapine) is officially indicated for use in adults for the treatment of Major Depressive Disorder. Certain populations are strictly contraindicated from using this medicine.


Absolute Contraindications

  • Patients with a known hypersensitivity to Mirtazapine or any of its excipients must not use Maz.
  • It is contraindicated for use concurrently with Monoamine Oxidase Inhibitors (MAOIs), or within 14 days of discontinuing an MAOI.

Age and Condition Restrictions

  • Age: The medicine is not recommended for children and adolescents under 18 years of age because safety and effectiveness have not been established in this group. Older adults require close supervision during dose adjustments due to reduced drug clearance.
  • Organ Function: Caution is required when prescribing Maz to patients with moderate-to-severe renal impairment or hepatic impairment due to a documented reduction in drug clearance.
  • Comorbidities: Use requires caution in patients with a history of mania/hypomania, seizure disorder, or risk factors for QTc prolongation. The Orally Disintegrating Tablet (ODT) formulation is restricted for patients with Phenylketonuria (PKU).

During pregnancy, Maz should be used only if clearly needed, and caution is advised during lactation as the drug is excreted into breast milk.

What should I know about interactions with other medicines?

Interactions with other Medicines and Products

The official interaction profile for Maz is defined by its role as a substrate for metabolic enzymes and drug transporters, and its dependence on gastric pH for absorption.


Documented Interaction Categories

Category Regulatory Constraint
Strong CYP3A4 Inducers Co-administration is contraindicated. Inducers (e.g., Rifampin) significantly decrease Maz exposure, which can result in reduced effectiveness.
Strong/Moderate CYP3A4 Inhibitors Requires dose modification (reduction) of Maz. Inhibitors (e.g., Ketoconazole, Clarithromycin) increase Maz exposure.
Acid-Reducing Agents Co-administration with Proton Pump Inhibitors, H2-Receptor Antagonists, or Antacids decreases Maz absorption. Specific timing separation or avoidance is required.
P-glycoprotein (P-gp) Substrates/Inhibitors Co-administration may alter the exposure of Maz or the co-administered drug, as Maz is a substrate and inhibitor of the P-gp transporter.

Contextual Constraints

Regulatory documentation specifies that Maz must be taken with food. This requirement is in place to ensure adequate drug absorption and mitigate changes in exposure that can occur in the absence of food.

Mechanism of Action

How Maz Works: Mechanism of Action

Dual Enhancement of Noradrenaline and Serotonin Release

Mirtazapine initiates its effect by acting as an antagonist of the presynaptic alpha2-adrenergic autoreceptors and heteroreceptors . This specific blockade removes the natural inhibitory feedback that limits neurotransmitter output, thereby resulting in an enhancement of Noradrenaline (NE) and Serotonin (5-HT) release into the central nervous system.


Shaping the Serotonergic Response Quality

The drug blocks the postsynaptic 5-HT2 and 5-HT3 receptors. By channeling the newly released Serotonin away from these sites and directing its activity toward the 5-HT1 receptors, Mirtazapine modulates the quality of the serotonergic response, influencing pathways associated with gastrointestinal and satiety signaling.


Central Arousal Modulation via Histamine Blockade

Mirtazapine exhibits strong affinity for the central Histamine H1 receptor, acting as an antagonist. Blocking this receptor directly interrupts the histamine-driven wakefulness pathway, producing a physiological change towards central sedation and dampening of the arousal state.

Dosage and Administration Information

Maz is administered orally and is available in multiple forms, including a standard film-coated tablet, an orally disintegrating tablet (ODT), and an oral solution. The standard adult initial dose is typically 15 mg or 30 mg daily, with a usual maintenance range from 15 mg to a maximum of 45 mg per day. The medication is intended for once-daily use, preferentially taken as a single dose in the evening before sleep, and can be taken with or without food.

The official usage protocol dictates that dose changes must not occur in intervals shorter than one to two weeks to allow for assessment. Standard tablets must be swallowed whole with fluid and should not be crushed or chewed. Conversely, ODTs are administered by placing them on the tongue to dissolve and swallowing them with saliva, without the need for water. The ODT must be handled with dry hands and used immediately.

Regarding the course of use, treatment typically continues for at least six months after initial response. Discontinuation requires a gradual dose reduction process (tapering). Maz is not approved for use in children or adolescents under 18 years of age. For older adults, the same dosing principles apply, but increases in the dose should be made under close supervision. Dose adjustments must also be considered for patients with moderate to severe renal or hepatic impairment.

Recent Clinical Evidence

Maz: Recent Clinical Evidence

This section describes the types of research studies that have examined Maz and what those studies focused on, using language that highlights the areas of research structure and areas that remain to be studied in the evidence landscape. The findings described here are related to group patterns observed in research, not individual patient results.


Evidence for Use in Major Depressive Disorder (MDD)

Maz was studied for Major Depressive Disorder (MDD) primarily through short-term Randomized Controlled Trials (RCTs), supported by systematic reviews and meta-analyses. These studies generally included adults and focused on measuring variations in symptom intensity or variability using specialized rating scales.

Research describes patterns observed in the studies regarding measured variations in depression severity scores. Furthermore, in relapse observation designs, studies monitored outcomes over longer periods, with some follow-up lasting up to approximately 40 weeks.


Research on Supportive Symptom Management

This block addresses research exploring Maz's use in managing common issues that can occur alongside depression, specifically reviewing studies that examined sleep disturbance and appetite loss.

Studies exploring symptoms of insomnia were conducted through short-term Randomized Controlled Trials that included patients with MDD and sleep complaints or focused on older adults with chronic insomnia. Studies report how symptoms evolved in the observed populations, with some trial reports describing measured variations in sleep quality metrics.

Research examined appetite loss through preliminary exploratory studies and some Randomized Clinical Trials. These focused on specific populations with conditions marked by functional limitations, such as individuals with advanced illness experiencing associated weight loss.


What is Still Uncertain About Maz's Research Base

The research base, while contributing to the broader evidence landscape, has several known limitations. Follow-up durations were limited for many studies, meaning long-term effects are not fully established across the research. Comparative evidence is lacking in some areas, and research is ongoing to address these known gaps.

Key Studies & References Mirtazapine: MedlinePlus Drug Information

Frequently Asked Questions (FAQ)

Common questions about Maz (FAQ)

Q: Do people typically feel tired after starting Maz?

Somnolence, or feeling tired/drowsy, is listed in official regulatory documents as a Very Common adverse reaction, reported in 1 out of 10 people or more. Official documents note this effect is often observed at the start of treatment, which aligns with the medication's property of causing central sedation.

Q: Is it normal to have mild headaches when first taking Maz?

Headache is listed in the official product information as a Common adverse reaction. This means the event has been reported in at least 1 out of every 100 people who have used the medication. However, official documents do not specify the exact timing or duration of this effect, such as only occurring when first starting treatment.

Q: Does Maz affect sleep patterns?

Yes, official information indicates that Maz affects sleep. The medication’s mechanism includes a potent blocking action on the Histamine H1 receptor, which contributes to central sedation. The medication is frequently administered in the evening, as this property may be utilized in its usage.

Q: What should I know about the long-term use of Maz?

Studies and official information indicate that the full research base has known limitations in follow-up duration, meaning long-term effects are not fully established across all research. Research monitoring relapse, which is one type of long-term study, typically observed patients for periods up to approximately 40 weeks.

Q: Where can I find summaries of the research evidence for Maz?

Official drug information and summaries of clinical trials are published by government bodies and authoritative institutions. Key sources include the FDA (via DailyMed), the EMA (Summary of Product Characteristics or SmPC), and the NIH (MedlinePlus), which provide regulatory-based facts and summaries.

Q: Does Maz affect blood pressure?

Regulatory documents note the possibility of orthostatic hypotension (low blood pressure upon standing) in some patients.

Q: Is it true that Maz can cause mood changes?

Yes, official warnings mention the potential for changes in mental status. Regulatory documents note the risk of activation of mania or hypomania in some patients. Furthermore, the official label includes a Boxed Warning concerning suicide-related events (thoughts and behaviors), particularly for younger adults.

Q: Are the initial side effects of Maz temporary?

Official documents state that side effects like somnolence (drowsiness), increased appetite, and weight gain are more frequently observed at the start of treatment. While this suggests that the frequency may decrease over time, regulatory documents do not guarantee that these or any other effects will definitely subside.

Q: What type of healthcare professional usually prescribes Maz?

Maz is classified as a prescription-only medication. Dose adjustments and monitoring are required for specific populations, such as the elderly or those with reduced kidney function, and are made by a licensed healthcare professional, such as a doctor or psychiatrist.

Q: How quickly does Maz start to work after the first dose?

Pharmacokinetic data indicates that peak blood concentrations are typically attained within about 2 hours after an oral dose. However, official clinical studies suggest that the observable antidepressant effects may take longer, with improvement sometimes noted as early as one week into treatment.

Q: Can Maz be taken with vitamins or supplements?

The official label contains warnings about co-administration with certain products. Specifically, regulatory documents warn against using Maz with herbal preparations that affect serotonin levels, such as St. John’s Wort, due to the potential risk of Serotonin Syndrome.

Q: Are there any common foods that should be avoided when taking Maz?

Official documents state that the medication can be taken with or without food. The core warnings focus on interactions with other medicines and substances, and no specific common foods are typically listed for avoidance in the main regulatory documents.

Q: What happens if I accidentally miss a dose of Maz?

Official patient information generally describes protocols for a missed dose, which often include instructions to take the next dose at the regular scheduled time without making up the skipped dose.

Q: Is Maz a controlled substance or addictive?

According to regulatory classification in the United States, Maz (mirtazapine) is not classified as a controlled substance by the Drug Enforcement Administration (DEA).

Q: Does Maz interact with alcohol?

Official documentation advises caution regarding the combination of Maz and alcohol due to the potential for additive Central Nervous System (CNS) depression, which can increase effects like drowsiness or sedation.

Q: If I stop taking Maz, are there any expected changes?

Official documents include a warning about a discontinuation syndrome that may occur upon stopping treatment. Official guidance specifies that treatment requires a gradual dose reduction process, often referred to as tapering, when discontinuation is necessary.

Q: What is the recommended storage temperature for Maz?

The official prescribing information requires the medicine to be stored at a controlled room temperature, typically between 20 C to 25 C (68 F to 77 F). It must also be kept away from excessive moisture and light to maintain product stability.

Q: Are there known interactions with common over-the-counter cold medicines?

Regulatory documents generally advise caution when Maz is co-administered with any other Central Nervous System (CNS) depressants. This is due to the risk of additive effects, which could increase levels of sedation or drowsiness.

Q: How long does the drug stay in my system after I stop taking it?

Pharmacokinetic data from official sources indicates that the mean elimination half-life of the medicine in the general population is approximately 20 to 40 hours. This measure relates to the time required for the body to reduce the amount of medicine by half.

How should Maz be stored and disposed of?

How to Store and Dispose of Maz

The storage and disposal of Maz (Mirtazapine) must adhere strictly to the conditions documented in official regulatory labeling to maintain product stability and ensure household safety.


Storage Requirements

Condition Requirement
Temperature Store at controlled room temperature, 20 C to 25 C (68 F to 77 F). Do not freeze.
Protection Keep away from excessive moisture and heat. The standard tablets must be stored in a light-resistant, tightly closed container.
Packaging Orally Disintegrating Tablets (ODT) must remain in their original blister unit until use.
Child Safety Mandatory requirement: Keep this medicine out of the reach and sight of children.

Disposal Instructions

Unused or expired Maz should preferably be disposed of through an authorized drug take-back program. If a take-back program is not available, official instructions allow mixing the uncrushed medication with an unappealing substance, placing the mixture in a sealed container, and discarding it with household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Maz found in:

A-Z Index: