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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]
In addition, due to their blockade of certain serotonin receptors, serotonergic neurotransmission is not facilitated in unwanted areas, which prevents the incidence of many side effects often associated with selective serotonin reuptake inhibitor (SSRI) antidepressants; [1] [3] hence, in part, the "specific serotonergic" label of NaSSAs. [2]
However, many are associated with an infamous side effect: weight gain. Luckily, some antidepressants are less likely to cause weight gain than others. In fact, there are even some antidepressants ...
Although usually reversible, these sexual side-effects can, in rare cases, continue after the drug has been completely withdrawn. [158] [159] In a study of 1,022 outpatients, overall sexual dysfunction with all antidepressants averaged 59.1% [160] with SSRI values between 57% and 73%, mirtazapine 24%, nefazodone 8%, amineptine 7%, and ...
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 ] .
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. [60] [61]
[3] [7] 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.
25 mg 2–3 hours 10–12 hours CYP2D6, others Yes Hydroxyzine: 25–100 mg 2 hours 20 hours ADH, CYP3A4, others No Doxepin: 3–6 mg 2–3 hours 17 hours c: CYP2D6, others No (at low doses) Mirtazapine: 7.5–15 mg 2 hours 20–40 hours CYP2D6, others No Quetiapine e: 25–200 mg 1.5 hours 7 hours d: CYP3A4 No (at low doses) Footnotes: a = For ...
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