Esmirtazapine

ID: esmirtazapine

Aliases: Org 50081

Type: compound

Route/form: oral or route depends on studied product

Status: investigational_or_discontinued

Evidence level: human RCT

Best data tier: human controlled/review

Support scope: human

Source types: human_rct

Linked sources: 2

Broad outcomes: Brain / mood / sleep

Reading note: These are curation notes anchored to linked sources, not a clinical recommendation or protocol.

Targets / mechanism

• histamine H1 receptor antagonist
• 5-HT2A receptor antagonist

Optimization domains

• insomnia
• sleep
• histamine

Research basis

• Human insomnia trials exist and H1 antagonism is a clear hypnotic mechanism.
• Useful as a cleaner pharmacology comparator for mirtazapine-family sedation.

Limits, risks, and missing evidence

• Development/availability limits practical use.
• Next-day sedation, appetite/weight, and anticholinergic-like burden need evaluation by compound.

Risk flags

• sedation
• CNS
• limited availability

Linked papers, labels, and reviews

1. Esmirtazapine in non-elderly adult patients with primary insomnia
   human_rct / pubmed_esmirtazapine_insomnia_2015
   Randomized outpatient insomnia trial.
2. Esmirtazapine for the Treatment of Chronic Primary Insomnia: A Randomized Long-Term Safety Study in Elderly Outpatients
   human_rct / kci_esmirtazapine_elderly_safety_2020
   Long-term randomized elderly insomnia safety study; relevant to esmirtazapine tolerability and sleep endpoints, not current approved use.