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Mirtazapine is a very strong H 1 receptor antagonist and, as a result, it can cause powerful sedative and hypnotic effects. [11] A single 15 mg dose of mirtazapine to healthy volunteers has been found to result in over 80% occupancy of the H 1 receptor and to induce intense sleepiness. [92]
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
amitriptyline – tricyclic antidepressant used to treat separation anxiety, excessive grooming dogs and cats; amlodipine – calcium channel blocker used to decrease blood pressure; amoxicillin – antibacterial; apomorphine – emetic (used to induce vomiting) artificial tears – lubricant eye drops used as a tear supplement
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]
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.
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.
Mianserin is closely related to mirtazapine, both chemically and in terms of its actions and effects, although there are significant differences between the two drugs (for example, its higher noradrenergic activity and lower 5-HT3 receptor antagonism). [7]