Medication · nassa antidepressant

Supplements and Mirtazapine.

Not yet catalogued in the Distil interactions database. We surface that distinction explicitly.

Mirtazapine, sold under the brand name Zispin, 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.

We have not yet completed an explicit assessment of supplement interactions with Mirtazapine in the Distil database. That is different from saying nothing exists. We surface this distinction deliberately: the Distil checker tells you when we have explicitly assessed a pair and when we have not, because both are useful information. If you take Mirtazapine alongside a supplement, the checker below will surface anything already in our database, and the missing-item form at the bottom of the page routes uncatalogued pairs into our next curation pass.

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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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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Your supplements

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How we decide

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 methodology

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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.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.