Major depression is a severe mental disorder with a lifetime prevalence of∼ 17%[1], and is among the most disabling of all medical disorders. In most cases it appears early in life, can take a chronic course and worsens the prognosis of other medical illnesses, such as cardiovascular disease. Despite efficacious treatment options, the burden of depression is still increasing. A World Health Organization (WHO) study has reported that, at present, depression is the fourth leading cause of disability-adjusted life years. This WHO study predicts that by 2020, depression will be a leading cause of disability, second only to cardiovascular disease [2, 3]. Antidepressant drug treatment is an effective treatment option in depressive disorders. Due to the magnitude of the problem of treating a large number of depressed patients adequately, there is a need for the development of effective and safe antidepressant drugs. Mirtazapine is an antidepressant drug with a unique pharmacological profile. Although many currently available antidepressants have antagonistic effects on serotoninergic transporters (eg, selective serotonin reuptake inhibitors) and/or noradrenalinergic transporters (such as venlafaxine, reboxetine and various tetracyclic antidepressants), mirtazapine does not affect these structures in a significant manner. Nevertheless, serotonergic and noradrenalinergic neurotransmission is enhanced, most probably via presynaptic α2-auto-and heteroreceptor antagonistic effects on noradrenergic and serotonergic neurons, thus increasing their firing rates. Mirtazapine was developed by Organon and first approved for the treatment of major depression in 1994.