Supplements and Mirtazapine.
Mirtazapine, sold under the brand names Zispin, Remeron, is a noradrenergic and specific serotonergic antidepressant (NaSSA).
Mirtazapine is a noradrenergic and specific serotonergic antidepressant (NaSSA). UK prescribing places it as a second line antidepressant, or as first line when sedation and appetite stimulation are clinically desired. It antagonises alpha-2 adrenoceptors (increasing noradrenaline and serotonin release) and blocks 5-HT2 and 5-HT3 receptors. The clinical profile differs from SSRI prescribing. Sedation is heaviest at the lowest doses; 15mg is often more sedating than 30mg, since higher doses recruit noradrenergic activation. Weight gain over six months is a real consideration. Supplement interactions matter on the sedation side. Valerian, kava (where available), magnesium glycinate at higher doses, and 5-HTP can all add to drowsiness in the first weeks. Serotonin syndrome risk is lower than with SSRIs given the receptor blocking action. But the BNF still flags St John's Wort and the MAOI co-prescription rule. Bone marrow effects are rare but documented. Any unexplained fever or sore throat warrants prompt GP review.
Below are the 1 documented pair we have explicitly assessed against Mirtazapine in the Distil database: 1 amber. The pairs cluster around 1 mechanism: Additive serotonergic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 15 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive serotonergic activity
Amber Does Saffron Extract interact with ?
Saffron has its own mild antidepressant effect that appears to act on serotonin, and mirtazapine raises serotonin and noradrenaline signalling too. Taking them together may add up. Most people tolerate it, but discuss it with your GP before stacking, especially if your dose has recently changed.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.