Two medicines, side by side
Mirtazapine vs paroxetine
Mirtazapine and paroxetine are both labeled for depression. Drugs@FDA records approvals of mirtazapine since 1996 and of paroxetine since 1992. Pharmacies paid $0.063 per mirtazapine 15 mg tablet and $0.0611 per paroxetine HCl 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the mirtazapine FDA label on DailyMed (effective August 6, 2025); the paroxetine FDA label on DailyMed (effective February 12, 2026).
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
Highlights of the paroxetine record
Paroxetine (Paxil) · label of February 12, 2026
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) ]. Paroxetine tablets are not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsParoxetine tablets are indicated in adults for the treatment of: • Major depressive disorder (MDD) • Obsessive compulsive disorder (OCD) • Panic disorder (PD) • Social anxiety disorder (SAD) • Generalized anxiety disorder (GAD) • Posttraumatic stress disorder (PTSD) Paroxetine tablets are a selective serotonin reuptake inhibitor (SSRI) indicated in adults for the treatment of ( 1 ): • Major Depressive Disorder (MDD) • Obsessive Compulsive Disorder (OCD) • Panic Disorder (PD) • Social Anxiety Disorder (SAD) • Generalized Anxiety Disorder (GAD) • Posttraumatic Stress Disorder (PTSD) […]
On the market
- Earliest approval on file
- December 29, 1992
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.0611 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Source: FDA drug labels via openFDA (Mirtazapine label of August 6, 2025, Paroxetine label of February 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do mirtazapine and paroxetine differ on the record?
How each works, in its label's words: Mirtazapine, “The mechanism of action of mirtazapine for the treatment of major depressive disorder, is unclear.”; Paroxetine, “The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central …”
Half-life, in each label's words: Mirtazapine, “Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or …”; Paroxetine, “Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg …”
Both labels carry a boxed warning; the records quote them.
Generics: mirtazapine since 2003; paroxetine since 2003 (Drugs@FDA).
| Mirtazapine | Paroxetine | |
|---|---|---|
| Labeled for | Depression | Depression, Anxiety, Menopause symptoms |
| Pharmacologic class | n/a | Serotonin Reuptake Inhibitor |
| How it works (label) | The mechanism of action of mirtazapine for the treatment of major depressive disorder, is unclear. | The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of … |
| Half-life (label) | Elimination Mirtazapine has a half-life of about 20 to 40 hours following oral administration of REMERON or REMERONSolTab. | Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg tablets daily for 30 days of paroxetine tablets. |
| Earliest approval on file (Drugs@FDA) | June 14, 1996 | December 29, 1992 |
| First generic approved | January 24, 2003 | July 30, 2003 |
| Generic labelers (NDC) | 36 labelers | 45 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.063 per tablet (Mirtazapine 15 mg tablet) | $0.0611 per tablet (Paroxetine HCl 20 mg tablet) |
| 12-month price change | -12% | -16% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 91,057 | 41,809 |
| 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?
Mirtazapine label, warnings and precautionsIncreased risk when co-administered with other serotonergic drugs (e.g., SSRI, SNRI, triptans), but also when taken alone.
Paroxetine label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to mirtazapine
- every medicine labeled for the same conditions