What is mirtizapine for?

Answer 1

MIRTAZAPINE (brand name Remeron) is a tetra-cyclic antidepressant. Though it is usually prescribed for major depression, there are many off-label uses, most notably to improve sleep-architecture in those with severe and/or chronic insomnia. It also posses anti-nausea, appetite-stimulating, antihistamine, anti-anxiety and strongly sedating properties, et al., though these become less noticeable with time. A notable irony is that at lower doses (<30mg) the sedative properties are greater than at higher doses (>45mg). The reason for this is, at low doses mirtazapine binds mostly with the brain's H1 receptor (the same receptor for which the sedating antihistamines have a strong affinity). At higher doses, however, mirtazapine begins to have a stimulating effect (due to the antagonizing of the alpha-2 adrenergic receptor) which partially offsets the sedative properties.

The initial dose is usually 30mg, and is adjusted based upon the patient's response to therapy; 90mg is the usually the highest recommended dose, although in severe cases, doses as high as 120mg have been found most efficacious.

Treatment for major depression with mirtazapine is recommended to continue for at least four months to gain maximum benefit. Stopping the medicine too soon can cause a return to the depressive state. If side effects are bothering you, do not stop taking mirtazapine; contact your doctor, the dose likely needs adjustment.

Mirtazapine must be discontinued very gradually and under close doctor supervision, as physical dependence will develop over time; this is especially important for patients who have used the drug at high doses and/or for long periods of time. Suddenly stopping mirtazapine may cause severe depression, insomnia, anxiety, panic attacks, (all dysphoric states) loss of appetite, worsening of Allergies and rarely, manic episodes.

PJF

Answer 2

Mirtazapine is an antidepressant introduced by Organon International in 1994 used for the treatment of moderate to severe depression. Mirtazapine has a tetracyclic chemical structure and is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA). Mirtazapine and Maprotiline are the only tetracyclic antidepressants that have been approved by the U.S. Food and Drug Administration to treat depression. Because of its unique structure, mirtazapine has less anticholinergic effects, serotonin-related side effects[1] and adrenergic side effects (such as orthostatic hypotension and sexual dysfunction) compared to other antidepressants. Antihistaminic side effects of drowsiness and weight gain are prominent. It is most useful as an add-on medication to enhance the effectiveness of agents such as duloxetine, bupropion and venlafaxine in severe and treatment-resistant depression. Mirtazapine is relatively safe if an overdose is taken.

Mirtazapine is marketed under the tradenames: * Avanza, Axit and Mirtazon in Australia * Míron in Iceland * Mirtabene in Austria * Mirtaz in India and Srilanka * Mirtazapin in Finland and Denmark * Mirzaten , Mizapin Sol and Remeron in Hungary, Poland and Slovakia * Norset in France * Noxibel in Bolivia * Promyrtil in Chile * Psidep in Portugal * Remergil in Germany * Remergon in Belgium * Remeron in Brazil, Canada, Czech Republic, Denmark, Estonia, Finland, Greece, Israel, Italy, Malaysia, Mexico, Netherlands, New Zealand, Norway, Pakistan, Romania, Sweden, Switzerland, Turkey and the United States. * Rexer in Spain * Zispin in Ireland and the United Kingdom