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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.
In the process, metabolites, or byproducts, of the drug are produced, which can linger in our blood, urine (and even in our hair) for long after the initial effects of the drug are felt.
Occasionally symptoms can last up to one year. [3] They typically resolve within a day of restoring the medication. [ 20 ] Paroxetine and venlafaxine seem to be particularly difficult to discontinue, and prolonged withdrawal syndrome (post-acute-withdrawal syndrome, or PAWS) lasting over 18 months has been reported with paroxetine.
Symptoms typically persist for a longer time frame in patients taking drugs which have a long elimination half-life, active metabolites, or a protracted duration of action. [ 6 ] Cases have reported persisting chronic symptoms, [ 75 ] and antidepressant discontinuation may contribute to ongoing features. [ 76 ]
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]
Changes in appetite or weight are common among antidepressants but are largely drug-dependent and related to which neurotransmitters they affect. Mirtazapine and paroxetine, for example, may be associated with weight gain and/or increased appetite, [178] [179] [180] while others (such as bupropion and venlafaxine) achieve the opposite effect ...
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 last year has seen remarkable progress on the policy front. Lawmakers from both parties are becoming more open to less punitive approaches to the nation’s opioid epidemic, like making sure that drug courts are receptive to medication-assisted treatment. The federal government funded MAT programs and encouraged states to do the same.
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