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Clonidine's blood pressure lowering effects are due to stimulation of presynaptic α 2 autoreceptors in the CNS which suppress sympathetic outflow. Mirtazapine itself blocks these same α 2 autoreceptors, so the effect of adding mirtazapine to a patient stabilized on clonidine may precipitate withdrawal symptoms. [75]
Noradrenergic and specific serotonergic antidepressants (NaSSAs) are a class of psychiatric drugs used primarily as antidepressants. [1] They act by antagonizing the α 2 -adrenergic receptor and certain serotonin receptors such as 5-HT 2A and 5-HT 2C , [ 1 ] but also 5-HT 3 , [ 1 ] 5-HT 6 , and/or 5-HT 7 in some cases.
Chlorthalidone is the thiazide drug that is most strongly supported by the evidence as providing a mortality benefit; in the ALLHAT study, a chlorthalidone dose of 12.5 mg was used, with titration up to 25 mg for those subjects who did not achieve blood pressure control at 12.5 mg. Chlorthalidone has repeatedly been found to have a stronger ...
Alpha-blockers, like prazosin (Minipress®), are typically used to manage high blood pressure. These medications work by blocking the norepinephrine to help prevent blood vessels from tightening ...
A number of non-SSRI drugs are not associated with sexual side effects (such as bupropion, mirtazapine, tianeptine, agomelatine, tranylcypromine, and moclobemide [57] [58] [59]). Several studies have suggested that SSRIs may adversely affect semen quality. [60] [61]
Elevation of norepinephrine levels can sometimes cause anxiety, mildly elevated pulse, and elevated blood pressure. However, norepinephrine-selective antidepressants, such as reboxetine and desipramine, have successfully treated anxiety disorders. [70] People at risk for hypertension and heart disease should monitor their blood pressure.
Side effects may also be less troublesome if treatment is initiated with low doses and then gradually increased, although this may also delay the beneficial effects. TCAs can behave like class 1A antiarrhythmics , as such, they can theoretically terminate ventricular fibrillation, decrease cardiac contractility and increase collateral blood ...
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