Sleep deprivation is well documented to result in physiologic stress and mood disorders (depression, irritability and anxiety), and sleep disturbances are among the most prevalent clinical problems and physical signs of depression.[1] Nonspecific pharmacotherapy available for sleep disorders currently falls into four categories: GABA receptor agonists, over-the-counter antihistamines, melatonin receptor agonists and sedating antidepressants. However, benzodiazepine and non-benzodiazepine GABA A receptor agonists all share a common adverse effect profile related to the drug class, including daytime somnolence, dizziness, headache and memory impairment.[2] Hence, there is still a medical need for the development of new drugs with improved efficacy for the treatment of sleep disorders.It has been suggested that brain histamine is involved in the regulation of the sleep/awake cycle, arousal, cognition and memory, mainly through the histamine H 1 receptor, producing a reduction of sleep latency both in preclinical [3] and clinical studies.[4] In parallel, selective blockade of the serotonin 5-HT 2A receptor has been proved in both preclinical [5] and clinical studies [6] to be efficacious in reducing wake after sleep onset, increasing slow-wave sleep and total sleep time, therefore, providing consolidation of sleep. On the other hand, pharmacological studies have shown that mirtazapine (1) and mianserin (2), two noradrenergic and specific serotonergic antidepressants (NaSSAs), act by blocking 5-HT 2A receptors, [7] and their broad pharmacological profile is characterized by a potent H 1 antagonistic activity. [8] As part of a program aimed at discovering novel chemical entities useful for the treatment of various sleep disorders, the model compounds mirtazapine (1) and mianserin (2) were used to design novel tetracyclic derivatives (see general template 3-4; Figure 1). This template is characterized by the presence of a spiro junction connecting the classical tricyclic core, suitably substituted, to a fourth exocycle ring with the nitrogen atom that can either be endo (3, X= N, W = H) or exo (4, X = CH, W = NH(CH 3 ) and N(CH 3 ) 2 ) with respect to that ring.To the best of our knowledge, the synthesis of compounds 3 has never been described, while the synthetic route to prepare compounds 4 has recently been reported by us in a patent application. [9] In particular, the preparation of compounds 3 a (X = N, W = H, Y = CH 2 , Z= CH 2 , R and R 1 = H) and2 is respectively CH 3 and H, R 3 = CH 3 , Z = CH 2 , R and R 1 = H) is described in detail. The tetracyclic derivative 3 a was synthesized as shown in Scheme 1. Starting from the known [10] 5-oxo-10,11-dihydro-5H-dibenzo[a,d]cycloheptene-10-carbonitrile (5), the alkylation reaction was performed with lithium bis(trimethylsilyl)amide in the presence of 1,3-dimethyl-2-imidazolidinone and ethylbromoacetate to afford racemic a-alkylated nitrile 6 in moderate yield. The reduction of both the nitrile and ketone functionalities via catalytic hydrogenation, followed by spo...