Mirtazapine and Bupropion – Test Prep and Practice Pearls
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist
4.9 • 773 Ratings
🗓️ 28 May 2026
⏱️ 15 minutes
🧾️ Download transcript
Summary
Mirtazapine is a unique antidepressant often chosen when depression occurs alongside insomnia or poor appetite. Its antihistamine activity makes it sedating, particularly at lower doses, and it commonly increases appetite and weight. Unlike many SSRIs, mirtazapine has a lower risk of sexual dysfunction and gastrointestinal side effects because it blocks 5-HT2 and 5-HT3 receptors. It is frequently dosed at bedtime and can be especially useful in older adults or medically ill patients who need both mood improvement and help with sleep or weight gain.
Bupropion is an activating antidepressant that works by increasing norepinephrine and dopamine activity rather than serotonin. It is often preferred in patients with fatigue, low motivation, hypersomnia, or concerns about sexual dysfunction and weight gain. Bupropion is also approved for smoking cessation. Common adverse effects include insomnia, anxiety, dry mouth, and headache. A major clinical pearl is its dose-related seizure risk, making it contraindicated in patients with seizure disorders or eating disorders such as anorexia nervosa or bulimia.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Resources!
Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)
Guide to Drug Food Interactions (Amazon Best Seller)
Transcript
Click on a timestamp to play from that location
| 0:00.0 | Hey, all welcome back to the Real Life Pharmacology podcast. I'm your host, |
| 0:03.9 | pharmacist Derek Christensen. Thank you so much for listening today. Today I'm going to cover |
| 0:09.0 | a couple of fairly commonly used antidepressants that can be used for multiple other things as well, |
| 0:17.3 | but I want to cover metasapine as well as buproprion on this podcast episode. |
| 0:24.1 | Before I get into that, go get your free 31 page PDF. |
| 0:28.7 | Absolutely a no-brainer. |
| 0:30.1 | Simply an email. |
| 0:30.9 | We'll get you access to that. |
| 0:32.0 | You can do that at real-life pharmacology.com. |
| 0:36.5 | It is on the top 200 drugs. Some of the most important things you're |
| 0:40.7 | going to see in practice as well as on board exams is on that free 31 page PDF. So go take |
| 0:47.7 | advantage of that. Simple an email. We'll get you access to that at real life pharmacology.com. |
| 0:57.3 | All right. Let's get into the two medications, |
| 1:02.8 | the two antidepressants I want to cover. Really going to hammer home the most important test prep pearls as well as things that actually occur out in practice. So myrtazapine first is Remeron. That's the |
| 1:10.8 | brand name. This has noradrenergic |
| 1:15.6 | mechanisms to it. So kind of that stimulatory effect. But it also has strong histamine blocking effects as well. |
| 1:27.3 | So that can kind of work on the flip side of sedation |
| 1:31.6 | and weight gain and things like that. We've also got some action on blocking some of the |
| 1:37.5 | serotonin receptors, 5HT2, 5HC3. And that can kind of shift serotonin activity around a little bit there. |
| 1:47.0 | So thinking about the mechanism, that really helps me understand the adverse effect profile. |
| 1:55.3 | So first off, the histamine effects or the antihistamine effects blockade, that is going to lend towards |
| 2:04.7 | sedation. And that tends to be more stronger than the noradrenergic effects or the alpha-2 |
... |
Transcript will be available on the free plan in 21 days. Upgrade to see the full transcript now.
Disclaimer: The podcast and artwork embedded on this page are from Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2026.