Mirtazapine (Remeron™) is a newly approved medication for the treatment of depression. It is an alpha 2-adrenergic antagonist that causes increased levels of neuronal norepinephrine and serotonin. It is also believed to be an antagonist at the serotonin receptors 5-HT 2 and 5-HT 3. Little is known about isolated mirtazapine ingestions. We conducted a retrospective chart review of mirtazapine ingestions reported to our Poison Center during 2004. A standardized data sheet was completed collecting information regarding standard demographic data along with co-ingestants, neurologic and cardiovascular symptoms, and disposition. Data collection was reviewed by a second investigator, and a kappa score was calculated. Of 71 patients identified with mirtazapine ingestions, there were 33 isolated exposures that were further reviewed. A kappa score for inter-reviewer reliability was calculated and at 0.61, 95% confidence interval 56–70. The average age of these patients was 27 years (range 6–82 years), with the mean ingestion of 343 mg (range 15–1500 mg). The most common neurologic symptom was drowsiness seen in 8/23 patients, 1 patient became agitated, and 14 patients had no abnormal neurologic findings. Cardiovascular effects were recorded in 4/23 patients, with 3 patients exhibiting tachycardia and 1 patient with bradycardia and hypotension. Seven of 23 patients required admission; there were no deaths. Mirtazapine overdoses are generally very well tolerated, with the most common symptoms being drowsiness and lethargy. This study is limited by being a retrospective chart review.