Mirtazapine for chronic insomnia in older adults: weighing the risks and potential benefits

A Randomized Double-Blind Placebo-Controlled Trial-The MIRAGE Study Mirtazapine is an antidepressant with sedating properties although it does not have regulatory approval for use in chronic insomnia In this randomised controlled trial of older adults with chronic insomnia, low-dose mirtazapine led to a statistically significant reduction in insomnia severity compared to placebo Adverse effects including daytime drowsiness, abnormal dreams and dizziness were more common in the group receiving mirtazapine A therapeutic trial of mirtazapine may be reasonable for older adults with chronic insomnia where nonpharmacological therapies are not available or have been ineffective