Remission of Panic Disorder With Mirtazapine Augmentation of Paroxetine: A Case Report

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Sir: Paroxetine is a selective serotonin reuptake inhibitor(SSRI) antidepressant with proven efficacy in the short- andlong-term treatment of panic attacks with or without agoraphobia.¹ Mirtazapine is a noradrenergic and specific serotonergicantidepressant that acts by antagonizing the adrenergic α₂-autoreceptorsand α₂-heteroreceptors, as well as by blocking serotonin5-HT₂ and 5-HT₃ receptors. It enhances, therefore, therelease of norepinephrine and 5-HT_1A-mediated serotonergictransmission.