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Mirtazapine, sold under the brand name Remeron among others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression. [11] [12] Its effects may take up to four weeks but can also manifest as early as one to two weeks. [12] [13] It is often used in cases of depression complicated by anxiety or insomnia.
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]
In modern times, depression, more often severe cases, is more noted as an absence of pleasure, with feelings of emptiness and flatness. [4] In the United States and Canada, the costs associated with major depression are comparable to those related to heart disease, diabetes, and back problems and are greater than the costs of hypertension. [5]
To maintain consistency the ICD-10 used the same criteria, with only minor alterations, but using the DSM diagnostic threshold to mark a mild depressive episode, adding higher threshold categories for moderate and severe episodes. [113] [314] The ancient idea of melancholia still survives in the notion of a melancholic subtype.
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.
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
The World Health Organization's ICD-10 describes Mixed anxiety and depressive disorder: "...when symptoms of anxiety and depression are both present, but neither is clearly predominant, and neither type of symptom is present to the extent that justifies a diagnosis if considered separately. When both anxiety and depressive symptoms are present ...
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 ] .