Pilot Study of Mirtazapine for the Dual Tx of Depression and CINV in High-Grade Glioma Pts on TMZ

Inclusion Criteria: * Understand and voluntarily sign and date an informed consent document prior to any study related assessments/procedures are conducted. * Histologically confirmed diagnosis of glioma * No prior treatment with temozolomide TMZ * Patient will receive temozolomide TMZ therapy as part of their standard treatment. * Males and Females ≥18 years of age at the time of signing the informed consent document. Able to understand consent forms and study materials in English * Willing to use approved methods of contraception for duration of study * Karnofsy Performance Score (KPS) of at least 60 * Patients should have stopped any anti-depressant medications by standard of care at least a month before enrolling in the trial * Willing and able to adhere to the study visit schedule and other protocol requirements. Exclusion Criteria: * Prior treatment with other chemotherapy drugs for glioma * Known hypersensitivity to Mirtazapine and 5-HT3 receptor antagonists * Life expectancy of less than three months * Pregnancy or breastfeeding.