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Mirtazapine is sometimes described as a noradrenergic and specific serotonergic antidepressant (NaSSA), [11] although the actual evidence in support of this label has been regarded as poor. [17] It is a tetracyclic piperazine-azepine. [85] Mirtazapine has antihistamine, α 2-blocker, and antiserotonergic activity.
The main indication for SSRIs is major depressive disorder; however, they are frequently prescribed for anxiety disorders, such as social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive–compulsive disorder (OCD), eating disorders, chronic pain, and, in some cases, for posttraumatic stress disorder (PTSD).
Chemical structure of the prototypical NaSSA mirtazapine (original brand name Remeron). Noradrenergic and specific serotonergic antidepressants (NaSSAs) are a class of psychiatric drugs used primarily as antidepressants. [1]
Changes in appetite or weight are common among antidepressants but are largely drug-dependent and related to which neurotransmitters they affect. Mirtazapine and paroxetine, for example, may be associated with weight gain and/or increased appetite, [178] [179] [180] while others (such as bupropion and venlafaxine) achieve the opposite effect ...
Remeron (mirtazapine) – an atypical antidepressant, used off-label as a sleep aid; Restoril – a benzodiazepine used to treat insomnia; Risperdal (risperidone) – atypical antipsychotic used to treat schizophrenia, bipolar disorder and irritability associated with autism; Ritalin (methylphenidate) – a stimulant used to treat ADHD
GLP-1 drugs may protect the brain from inflammation, some studies say, but others warn they may increase depression risk. Image credit: James Manning – PA Images/Getty Images.
Besides mirtazapine, they also block the α 1-adrenergic receptor [citation needed]. Conversely, whereas TCAs have relatively low affinity for the α 2 -adrenergic receptor , mianserin and mirtazapine potently antagonize this receptor, and this action is thought to be involved in their antidepressant effects [ citation needed ] .
The tetracyclic antidepressants mianserin and mirtazapine are α 2 blockers, although their efficacy as antidepressants may come from their activity at other receptor sites. [citation needed] Mechanistically, α 2 blockers increase adrenergic, dopaminergic and serotonergic neurotransmitters and induce insulin secretion, decreasing blood sugar ...
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