- Mirtazapine reduced methamphetamine use by approximately 2 fewer days over 12 weeks compared with placebo.
- No significant differences were observed in depression, insomnia, quality of life, or biologic measures of abstinence.
- Adverse events were more common with mirtazapine, including drowsiness and weight gain, with higher discontinuation rates.
- Treatment effects were consistent across subgroups, including sex and baseline depression status.
- Findings support a modest role for mirtazapine in reducing use, though without broader functional or psychiatric benefit.
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