Can Mirtazapine be used to treat obsessive-compulsive disorder (OCD)?

This article will discuss the therapeutic benefits of Mirtazapine for the management and treatment of OCD. we will also discuss how this medication can help such patients and what alternatives are available in case Mirtazapine fails to provide adequate relief from the symptoms. 

Can Mirtazapine be used to treat obsessive-compulsive disorder (OCD)?

Yes, Mirtazapine can be used for the management and treatment of OCD. however, it is one of the off-label uses of Mirtazapine, including other conditions like anxiety, panic disorders, insomnia, etc (1).

Mirtazapine is primarily approved by the Food and Drug Administration (FDA) for the treatment of depression, but the antidepressant can provide relief in other symptoms as well (2). 

It is important to note that Mirtazapine is a prescription medication, which should never be used without a doctor’s approval. You can safely take the med if your doctor believes that Mirtazapine is the right choice of medication for your OCD or if other approved medications can not be used for some reason.

What does research suggest?

Several research studies have indicated that Mirtazapine can help people with OCD because of how it works. 

According to research, Mirtazapine has additional effects like calming, anti-nausea, and appetite-boosting qualities. This has led to its off-label use in various conditions such as OCD, insomnia, anxiety disorders, and even headaches (1).

Another research study showed that Mirtazapine was beneficial for treating OCD in the open-label phase, with significant improvement in symptoms (3). 

Some participants experienced side effects, and not all continued to the next phase. Around half of the participants responded positively, regardless of mood disorders. In the double-blind phase, those on Mirtazapine showed better results than the placebo group (3). 

This suggests Mirtazapine could be a useful option for OCD treatment, but further research is needed to confirm these findings with larger studies (3).

Another research study aimed to assess whether adding Mirtazapine to Sertraline treatment benefits patients with obsessive-compulsive disorder (OCD) who didn’t respond well to sertraline monotherapy (4). 

They studied 61 resistant OCD patients, randomly giving some Mirtazapine and others a placebo alongside their current Sertraline treatment. The primary measure was the reduction in OCD symptoms using a scale (4). 

The results showed that the group receiving Mirtazapine had a significant decrease in OCD symptoms compared to the placebo group. This suggests that Mirtazapine can be a helpful addition to Sertraline, an SSRI, for improving OCD symptoms (4).

Is Mirtazapine the right choice of medication for everyone with OCD?

Mirtazapine may not be the ideal choice for every person with OCD and the right medication should only be decided by your healthcare provider. 

Selecting the right medication for OCD is not a straightforward decision. Each person’s journey with OCD is unique, influenced by various factors that impact their health. 

It’s essential to remember that there are alternative medications that are considered first-line treatments for OCD, which should be explored before opting for Mirtazapine. The choice of medication depends on a doctor’s evaluation of the patient’s responses to different treatments.

Just like we all have different tastes in music or food, our bodies and minds react differently to medications. Mirtazapine can be a promising choice for individuals who positively respond well to it and tolerate its effects without significant side effects.

This is why it’s best to stick to your doctor’s prescription and closely follow all the important instructions. This is the best way to achieve a safe and effective therapeutic response. 

What medications are approved for the treatment of OCD?

Following are the medications which are approved by the FDA for the management of OCD and are used as first-line agents (5):

  • Sertraline (Zoloft) – Approved for adults and children aged 6 and above.
  • Fluoxetine (Prozac) – Approved for adults and children aged 7 and above.
  • Paroxetine (Paxil, Pexeva) – Approved for adults.
  • Fluvoxamine – Approved for adults and children aged 8 and above.
  • Clomipramine (Anafranil) – Approved for adults and children aged 10 and above.

It is important to note that the best choice of medication is made by a doctor and you should never start taking any medication without having a proper diagnosis and prescription. If you’re not sure which medication to take, please reach out to your healthcare provider. 


In this article, we have discussed the therapeutic benefits of Mirtazapine for the management of OCD. we have also discussed what research has indicated and what drugs are used as first-line agents for OCD.

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The  Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. REMERON® (mirtazapine) tablets, for oral use. Available from:,%20021208s019lbl.pdf


Koran LM, Gamel NN, Choung HW, Smith EH, Aboujaoude EN. Mirtazapine for obsessive-compulsive disorder: an open trial followed by double-blind discontinuation. J Clin Psychiatry. 2005 Apr;66(4):515-20. PMID: 15816795.


Mowla A, Baniasadipour H. Is mirtazapine augmentation effective for patients with obsessive-compulsive disorder who failed to respond to sertraline monotherapy? A placebo-controlled, double-blind, clinical trial. Int Clin Psychopharmacol. 2023 Jan 1;38(1):4-8. doi: 10.1097/YIC.0000000000000415. Epub 2022 Jun 9. PMID: 35695582.


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