A synthetic derivative of piperazino-azepines, tetracyclic antidepressant Mirtazapine acts by an unknown mechanism that enhances central adrenergic and serotonergic transmission. Structurally unrelated to selective serotonin reuptake inhibitors, tricyclics, or monoamine oxidase inhibitors (MAOI), it also affects muscarinic transmission and has parasympatholytic properties. (NCI04)
