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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.
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]
Approximately 3% of healthy elderly persons living in the community have major depression. Recurrence may be as high as 40%. Suicide rates are nearly twice as high in depressed patients as in the general population. Major depression is more common in medically ill patients who are older than 70 years and hospitalized or institutionalized.
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
Notably, esmirtazapine has a shorter half life of around 10 hours, compared to R-mirtazapine and racemic mixture, which has a half-life of 18–40 hours. [1] Merck has run several studies on low dose (3–4.5 mg) esmirtazapine for the treatment of insomnia.
According to a new study published in Neurology, poor sleep is linked to a higher risk of dementia. Neurologists explain the link—and how to prevent dementia.
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 ] .
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.