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 is assessed against PubMed-indexed evidence.
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, based on case reports and 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.
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- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
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It's a paid report: £79, or £49 founder pricing while we earn our first reviews. The interactions check is one section of it, and you can read a real one in full before you decide.
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