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Author Credentials

Rebecca Katlyn Hicks, BA Iram Kingson, BA & MS Jordan Gaal, DO Suzanne Holroyd, MD

Author ORCID Identifier

https://orcid.org/0009-0006-9913-1917

Keywords

Obsessive-compulsive disorder, OCD, chronic psychiatric condition, intrusive thoughts, obsessions, repetitive behaviors, compulsions, selective serotonin reuptake inhibitors, SSRIs, cognitive-behavioral therapy, CBT, treatment-resistant OCD, mirtazapine, atypical antidepressant, adjunctive therapy, serotonin reuptake inhibitors, pharmacological properties, serotonin, noradrenaline, histamine receptors, therapeutic effects, dosage, adverse effects, mechanisms of action, clinical trials, observational studies, case reports, response prevention, exposure therapy, augmentation strategy, treatment outcomes, anxiety, insomnia, weight gain, depression, neurochemical pathways, treatment algorithms, antidepressant side effects, alternative treatments, antidepressant medication, drug interactions, clinical evidence, remission rates, efficacy, safety, serotonin, noradrenergic receptors, therapeutic armamentarium, anxiety disorders, sedative effects, appetite stimulation, sexual dysfunction, side effects, major depression, mood disorders, psychiatric conditions, pharmacological profile, neurobiological mechanisms

Disciplines

Medical Pharmacology | Medicine and Health Sciences | Mental Disorders | Other Medical Sciences | Other Mental and Social Health | Other Pharmacy and Pharmaceutical Sciences | Psychiatric and Mental Health | Psychiatry | Therapeutics

Abstract

Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). While selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are first-line treatments for OCD, a significant proportion of patients remain refractory to these interventions. Mirtazapine, an atypical antidepressant with unique pharmacological properties, has emerged as a potential adjunctive therapy for treatment-resistant OCD. This review synthesizes existing evidence regarding the efficacy and safety profile of mirtazapine in OCD management. We analyze clinical trials, observational studies, and case reports, distinguishing high- vs. low-quality evidence, and discuss mechanisms underlying mirtazapine's therapeutic effects. Additionally, dosage, treatment duration, and adverse effects are considered to provide clinicians with practical guidance. Overall, this review highlights the need for further research to clarify the optimal role of mirtazapine in OCD treatment.

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