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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.
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.
A typical SSRI dosage alone won’t cause serotonin syndrome, but taking this type of antidepressant with other medications that increase serotonin levels can. SSRIs and pregnancy.
Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft, Lustral), escitalopram (Lexapro, Cipralex), fluoxetine (Prozac), paroxetine (Seroxat), and citalopram, are the primary medications considered, due to their relatively mild side effects and broad effect on the symptoms of depression and anxiety, as well as reduced risk ...
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.
Benzodiazepines may improve treatment-resistant depression by decreasing the adverse side effects caused by some antidepressants and therefore increasing patient compliance. [24] Atypical antipsychotics such as aripiprazole, quetiapine or olanzapine can be added to anti-depressants as part of augmentation of treatment. [23]
Tetracyclic antidepressants include: Maprotiline (Ludiomil) Mianserin (Tolvon) Mirtazapine (Remeron) Setiptiline (Tecipul) Mianserin, mirtazapine, and setiptiline are also sometimes described as noradrenergic and specific serotonergic antidepressants (NaSSAs).
Among the patients who were switched to a different antidepressant, there was no significant difference among the different antidepressants. For level three, the remission rates based on the HAM-D symptom scale were 12.3% for mirtazapine and 19.8% for nortriptyline, although the difference was not large enough for statistical significance. [5]
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