Mirtazapine is a prescription antidepressant introduced by Organon International in 1996. It is marketed under the tradenames:
- Remeron® (United States, Finland, Russia)
- Avanza® (Australia)
- Zispin® (United Kingdom)
- Norset® (France)
- Remergil® (Germany)
- Mirtabene® (Austria)
It is used mainly for treating clinical depression in adults. It's available in tablets of 15mg, 30mg, and 45mg, with the usual dose being 15 to 30mg.
Mirtazapine is chemically unrelated to other antidepressants. It is thought to work by blocking presynaptic alpha-2 adrenergic receptors that normally inhibit the release of the neurotransmitters norepinephrine and serotonin. This increases the active levels of these neurotransmitters in the synapse. Mirtazapine also blocks post-synaptic 5-HT2 and 5-HT3 receptors - an action which is thought to enhance serotonergic neurotransmission while causing a low incidence of side effects. The side effects that do occur are thought to be primarily related to the blockage of histamine receptors, which decreases with higher dosages.
The side effects from this drug may include:
- Drowsiness, especially at lower doses
- Increased weight and appetite
- Dry mouth
- Upset stomach
- Vivid, unusual, and often times frightening dreams or nightmares
Because sleep and appetite problems are common in people with depression, mirtazapine's side effects can sometimes be useful to counteract these issues. In particular, the drowsiness, increased appetite, and weight gain it can cause may counteract these effects in depression. However, for people that don't have this pattern of symptoms, the side effects can be more distressing.
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