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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.
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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. By blocking α 2 -adrenergic autoreceptors and heteroreceptors , NaSSAs enhance adrenergic and serotonergic neurotransmission in the brain involved in mood regulation ...
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 ] .
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An atypical antidepressant is any antidepressant medication that acts in a manner that is different from that of most other antidepressants. Atypical antidepressants include agomelatine, bupropion, iprindole, mianserin, mirtazapine, nefazodone, opipramol, tianeptine, and trazodone.