Mirtazapine is an atypical antidepressant with tetracyclic structure that acts as an antagonist at central presynaptic α2-adrenergic receptors and 5-HT2 and 5-HT3 serotonin receptors. In the context of tinnitus management, it may modulate neural plasticity and neurotransmitter activity, potentially reducing the perception and distress associated with phantom sound perception. Its effects on central nervous system serotonergic and noradrenergic pathways are believed to contribute to its potential therapeutic benefit in tinnitus management.