Mirtazapine can be used to treat which combination?

• A. Major depressive disorder with poor appetite
• B. Major depressive disorder with insomnia
• C. Obsessive-compulsive disorder
• D. Social anxiety disorder

Answer: (A)

Mirtazapine is a noradrenergic and specific serotonergic antidepressant (NaSSA) that increases central NE and 5-HT activity while blocking certain 5-HT receptors, and it also has strong antihistaminic effects. This combination gives it two clinically important advantages in depression: it often helps with sleep because of its sedating properties, and it frequently increases appetite and can promote weight gain. That makes it particularly well-suited for major depressive disorder when poor appetite is a prominent feature, since you’re addressing the eating symptoms directly while achieving antidepressant effects.

Obsessive-compulsive disorder and social anxiety disorder are typically treated first-line with selective serotonin reuptake inhibitors (SSRI families) or SNRIs; mirtazapine is not the standard initial choice for these conditions. So the combination most classically matched to mirtazapine’s profile is major depressive disorder with poor appetite.