Antidepressants: mirtazapine: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antidepressants: mirtazapine

Sample item

An elderly underweight patient with depression, insomnia and poor appetite is started on an antidepressant that blocks alpha-2 and 5-HT2 and 5-HT3 receptors. Which is it?

AVenlafaxineBMirtazapineCBupropionDFluoxetine

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Mirtazapine

Mirtazapine is an alpha-2 antagonist that enhances noradrenaline and serotonin release and blocks H1 and 5-HT2/3 receptors, so sedation and weight gain are frequent, which helps in patients with poor sleep and appetite.

Option by option

A. Venlafaxine
Venlafaxine causes hypertension and is not sedating.
B. Mirtazapine (correct)
Correct. Mirtazapine is sedating and increases appetite.
C. Bupropion
Bupropion is stimulating and reduces appetite.
D. Fluoxetine
Fluoxetine tends to reduce appetite and cause insomnia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Mirtazapine. Mirtazapine is an alpha-2 antagonist that enhances noradrenaline and serotonin release and blocks H1 and 5-HT2/3 receptors, so sedation and weight gain are frequent, which helps in patients with poor sleep and appetite.

Why is "Venlafaxine" not the answer?

Venlafaxine causes hypertension and is not sedating.

Why is "Bupropion" not the answer?

Bupropion is stimulating and reduces appetite.

Why is "Fluoxetine" not the answer?

Fluoxetine tends to reduce appetite and cause insomnia.

What concept does this question test?

It tests Antidepressants: mirtazapine in Pharmacology. The correct option holds because: Correct. Mirtazapine is sedating and increases appetite.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidepressants: mirtazapine?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.