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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.
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 ] .
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
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A dose of doxepin as low as 1 mg/day was found to significantly improve most of the assessed sleep measures, but unlike the 3 and 6 mg/day doses, was not able to improve wake time during sleep. [12] This, along with greater effect sizes with the higher doses, was likely the basis for the approval of the 3 and 6 mg doses of doxepin for insomnia ...
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Mirtazapine was developed by the same team of organic chemists and differs via addition of a nitrogen atom in one of the rings. [ 43 ] [ 44 ] ( S )-(+)-Mianserin is approximately 200–300 times more active than its enantiomer ( R )-(−)-mianserin; hence, the activity of mianserin lies in the ( S )-(+) isomer .
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