Mirtazapine is increasingly used in the treatment of depression and other psychiatric conditions. The incidence of seizures associated with Mirtazapine use is low. This is a case of a patient who developed seizures shortly after the initiation of treatment of Mirtazapine.

To highlight the rare occurrence of Mirtazapine associated seizures as well as review the relevant literature.

A middle aged Chinese man who was admitted to the hospital for deterioration in physical function was referred to the consultation liaison psychiatric team for low mood. He was diagnosed to be suffering from a depressive disorder and was started on Mirtazapine 15mg at night. He developed generalised tonic clonic seizures which aborted spontaneously. All subsequent investigations to look into possible causes were normal.

A search was performed in several biomedical databases and the relevant studies were reviewed.

Mirtazapine was discontinued in the patient with no recurrence of seizures. A review of the literature revealed that seizures associated with Mirtazapine are exceedingly rare. In fact, Mirtazapine is recommended for use in patients with epilepsy due to its low epileptogenic potential.

It is prudent to exercise caution in the prescription of Mirtazapine in patients who may be predisposed to developing seizures.