drug: mirtazapine
- Clinical class: anti-depressant
- Chemical class: tetracyclic piperazinoazepine
- Action: noradrenergic and specific serotonergic antidepressant (NaSSA)
- CSA schedule: none
- DEA number: none
- MEDLINEplus® Drug Information
U.S. Preparations:
- Remeron® (Organon) FDA approved: for treatment of depression 6.14.1996
- Remeron Soltab® (Organon) FDA approved: for treatment of depression
1.12.2001
U.S. Prescribing information
Preparations Outside U.S.:
- Norset, Promyrtil, Remergil, Rexer, Zispin
Stephen Stahl's Clinical Pearls* (Consult your physician before making any change in your treatment.)
- Sedation may be INVERSELY related to dose.
- Lowering dose may thus increase sedation.
- Two mechanisms (NE plus 5-HT) may be better than one (5HT alone) for severe or refractory depression.
- Consider for panic disorder.
- Consider for mixed anxiety depression.
- Low likelihood of drug interactions (except MAOI)
- Adding alpha-2 antagonism to agents which act as reuptake blockers may be useful for refractory depression.
- Adding mirtazapine's 5-HT2 antagonism may reduce SSRI- or venlafaxine-induced anxiety or insomnia.
- Adding mirtazapine's 5-HT3 antagonism may reduce SSRI- or venlafaxine-induced nausea.
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*Reprinted with permission from: Stahl, Stephen M Psychopharmacology of Antidepressants Paperback 1997 Martin Dunitz, Ltd & Blackwell Science You cannot fully appreciate this book until you have seen the extraordinary illustrations of every aspect of this area of psychopharmacology and neurochemistry. Loaded with practical clinical "pearls."