Two medicines, side by side
Escitalopram vs mirtazapine
Escitalopram and mirtazapine are both labeled for depression. Drugs@FDA records approvals of escitalopram since 2002 and of mirtazapine since 1996. Pharmacies paid $0.0632 per escitalopram 20 mg tablet and $0.063 per mirtazapine 15 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023); the mirtazapine FDA label on DailyMed (effective August 6, 2025).
Highlights of the escitalopram record
Escitalopram (Lexapro) · label of October 1, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsLexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]
On the market
- Earliest approval on file
- August 14, 2002
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0632 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the mirtazapine record
Mirtazapine (Remeron) · label of August 6, 2025
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1) ]. REMERON/REMERONSolTab is not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsREMERON/REMERONSolTab are indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies (14) ]. REMERON/REMERONSolTab is indicated for the treatment of major depressive disorder (MDD) in adults.
On the market
- Earliest approval on file
- June 14, 1996
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.063 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Escitalopram label of October 1, 2023, Mirtazapine label of August 6, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do escitalopram and mirtazapine differ on the record?
How each works, in its label's words: Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”; Mirtazapine, “The mechanism of action of mirtazapine for the treatment of major depressive disorder, is unclear.”
Half-life, in each label's words: Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”; Mirtazapine, “Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or …”
Both labels carry a boxed warning; the records quote them.
Generics: escitalopram since 2007; mirtazapine since 2003 (Drugs@FDA).
| Escitalopram | Mirtazapine | |
|---|---|---|
| Labeled for | Depression, Anxiety | Depression |
| Pharmacologic class | Serotonin Reuptake Inhibitor | n/a |
| How it works (label) | The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS … | The mechanism of action of mirtazapine for the treatment of major depressive disorder, is unclear. |
| Half-life (label) | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. | Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or REMERONSolTab. |
| Earliest approval on file (Drugs@FDA) | August 14, 2002 | June 14, 1996 |
| First generic approved | July 31, 2007 | January 24, 2003 |
| Generic labelers (NDC) | 43 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0632 per tablet (Escitalopram 20 mg tablet) | $0.063 per tablet (Mirtazapine 15 mg tablet) |
| 12-month price change | -12% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 139,519 | 91,057 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Escitalopram label, drug interactionsConcomitant use of Lexapro and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Mirtazapine label, warnings and precautionsIncreased risk when co-administered with other serotonergic drugs (e.g., SSRI, SNRI, triptans), but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to escitalopram
- every medicine labeled for the same conditions