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Objective Mirtazapine,an antagonist for central α2-adrenergic autoreceptors and heteroreceptors,and postsynaptic 5-hydroxytryptamine2 (5-HT2) and 5-HT3 receptors,achieves its unique therapeutic effect by enhancing noradrenaline and serotonin release,and is effective for the treatment of various anxiety disorders,in addition to depressive disorders.Though preclinical and clinical studies have shown that mirtazapine exerts anxiolytic action,its precise brain target sites remain unclear.Lithium has been mainly used in the treatment of bipolar disorder,but recently,evidence from animal and clinical studies has shown that lithium has an effect on monoamine systems to potentiate the antidepressant action of tricyclic antidepressants,selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors.However,few studies have investigated the effect of lithium with mirtazapine.Previous studies have shown that both lithium and mirtazapine influence serotonergic systems and anxiety.These suggest the possibility that the combination of lithium and mirtazapine may have better efficacies for anxiety disorders.