Antidepressants: mirtazapine: practice question

A Psychiatry 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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Psychiatry · Antidepressants: mirtazapine

Sample item

A thin elderly depressed patient with insomnia and poor appetite is prescribed an antidepressant that blocks alpha-2 receptors, 5-HT2 and 5-HT3 receptors and H1 receptors. This is:

AVenlafaxineBBupropionCMirtazapineDFluoxetine

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

The answer and the reasoning

C. Mirtazapine

Mirtazapine is a noradrenergic and specific serotonergic antidepressant (NaSSA), with sedation and appetite stimulation from H1 and 5-HT2C blockade, so it is useful when insomnia and anorexia are present. Weight gain is a common adverse effect.

Option by option

A. Venlafaxine
Venlafaxine is a reuptake inhibitor, not a receptor blocker.
B. Bupropion
Bupropion acts through reuptake inhibition and is activating.
C. Mirtazapine (correct)
Correct. Mirtazapine has this receptor profile with sedation and appetite increase.
D. Fluoxetine
Fluoxetine is an SSRI and may worsen insomnia and appetite.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Mirtazapine. Mirtazapine is a noradrenergic and specific serotonergic antidepressant (NaSSA), with sedation and appetite stimulation from H1 and 5-HT2C blockade, so it is useful when insomnia and anorexia are present.

Why is "Venlafaxine" not the answer?

Venlafaxine is a reuptake inhibitor, not a receptor blocker.

Why is "Bupropion" not the answer?

Bupropion acts through reuptake inhibition and is activating.

Why is "Fluoxetine" not the answer?

Fluoxetine is an SSRI and may worsen insomnia and appetite.

What concept does this question test?

It tests Antidepressants: mirtazapine in Psychiatry. Weight gain is a common adverse effect.

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 each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.