Depression Symptoms Treatment
Archive for the ‘Remeron (Mirtazapine)’ Category
Mirtazapine (Remeron / Organon) was approved by the U.S. Food and Drug Administration in 1996 for the treatment of depression. Structurally unrelated to any antidepressants currently available in the United States, it is a tetracyclic piperazinoazepine and is an analog of mianserin (available outside the U.S.).
Mechanism of Action Mirtazapine (Remeron) appears to exert its antidepressant effect in a unique way. It blocks central presynaptic alpha2-adrenergic receptors, which results in an increased release of norepinephrine and serotonin. In addition, it strongly blocks serotonergic 5-hydroxytryptamine (5-HT2 and 5-HT3) and histaminic H1 receptors and weakly blocks peripheral alpha1-adrenergic and muscarinic receptors.
Pharmacokinetics Mirtazapine (Remeron) Following oral absorption, mirtazapine is rapidly and completely absorbed, with peak plasma levels achieved within about two hours; neither the rate nor extent of absorption is significantly affected by food. It is extensively metabolized in the liver, by the cytochrome P450 isoenzymes 2D6, 1A2, and 3A4, primarily to inactive metabolites, Read more [...]
The first of a new class of antidepressants - the alpha2-receptor antagonists - has received FDA approval for the treatment of depression. Mirtazapine (Remeron / Akzo Nobel, Organon) is a long-acting tetracyclic compound unrelated to the tricyclic antidepressants. It is a potent antagonist of central pre- and post-synaptic alpha2-adrenergic receptors and also serotonin (5-HT2 and 5-HT3) and histamine (H1) receptors, and has a moderate effect on peripheral alpha1 adrenergic receptors. Antagonizing histamine receptors explains its prominent sedative effect, and antagonizing peripheral adrenergic receptors explains its tendency to cause orthostatic hypotension.
In clinical trials involving 4,562 patients with major depression (2,796 on mirtazapine (Remeron), 605 on placebo, and 1,161 on other antidepressants), mirtazapine (Remeron) was superior to placebo and at least as effective as other antidepressants for relieving symptoms of depression: dysphoric mood, loss of interest in daily activities, weight change, insomnia or hypersomnia, agitation or retardation, impaired Read more [...]