American Board of Psychiatry and Neurology (ABPN) Practice Exam

Disable ads (and more) with a membership for a one time $2.99 payment

Prepare for the American Board of Psychiatry and Neurology Exam. Practice with questions and detailed explanations to boost your confidence. Ensure your readiness for the big day!

Each practice test/flash card set has 50 randomly selected questions from a bank of over 500. You'll get a new set of questions each time!

Practice this question and more.


How does mirtazapine primarily function as an antidepressant?

  1. Serotonin reuptake inhibition

  2. NE reuptake inhibition

  3. α2 Adrenergic receptor antagonism

  4. Partial dopamine antagonism

The correct answer is: α2 Adrenergic receptor antagonism

Mirtazapine primarily functions as an antidepressant through its action as an alpha-2 adrenergic receptor antagonist. This mechanism enhances norepinephrine and serotonin neurotransmission by blocking presynaptic alpha-2 receptors, which normally inhibit the release of these neurotransmitters. By antagonizing these receptors, mirtazapine increases the availability of norepinephrine and serotonin in the synaptic cleft, which is believed to contribute to its antidepressant effects. In addition to its action on alpha-2 receptors, mirtazapine also antagonizes specific serotonin receptors (specifically 5-HT2 and 5-HT3), further balancing the serotonergic system. This unique dual action is what differentiates it from other traditional antidepressants, as it can produce fewer side effects associated with increased serotonin levels, such as anxiety or gastrointestinal issues. The other mechanisms mentioned in the other options are not the primary actions of mirtazapine. For example, serotonin reuptake inhibition and norepinephrine reuptake inhibition are more characteristic of other classes of antidepressants, such as SSRIs and SNRIs, respectively. Partial dopamine antagonism is more relevant to atypical antipsychotic medications than to mirtaz