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Mirtazapine, an antidepressant

T Puzantian1

  • 1San Francisco General Hospital, CA, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|January 23, 1998
PubMed
Summary

Mirtazapine is an effective antidepressant that works by blocking specific receptors. Clinical trials show it improves depression scores and is well-tolerated, with potential benefits for anxiety.

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Area of Science:

  • Pharmacology and Clinical Therapeutics
  • Neuroscience
  • Psychiatry

Background:

  • Mirtazapine is a novel antidepressant agent.
  • It functions by antagonizing presynaptic alpha 2-adrenergic autoreceptors and heteroreceptors, as well as postsynaptic serotonin 5-HT2 and 5-HT3 receptors.
  • The drug is FDA-approved for treating depression and shows potential for anxiolytic and sedative effects.

Purpose of the Study:

  • To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosing of mirtazapine.
  • To evaluate its effectiveness in treating depression and potential comorbid anxiety disorders.

Main Methods:

  • Review of existing pharmacological data, pharmacokinetic studies, and clinical trial results.
  • Assessment of efficacy using depression rating scales, such as the Hamilton Rating Scale for Depression (HAM-D).
  • Analysis of reported adverse effects and drug interactions.

Main Results:

  • Mirtazapine is rapidly absorbed orally and suitable for once-daily dosing due to hepatic biotransformation.
  • Clinical trials demonstrated significantly greater improvement in depression scores for mirtazapine compared to placebo.
  • Efficacy was comparable to established antidepressants like amitriptyline, clomipramine, and doxepin.

Conclusions:

  • Mirtazapine is an effective and well-tolerated antidepressant.
  • Common side effects include somnolence, increased appetite, weight gain, and dizziness.
  • The drug shows promise for treating depression, with potential benefits for co-occurring anxiety disorders.

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