Tags

Type your tag names separated by a space and hit enter

A review of the pharmacological and clinical profile of mirtazapine.
CNS Drug Rev. 2001 Fall; 7(3):249-64.CD

Abstract

The novel antidepressant mirtazapine has a dual mode of action. It is a noradrenergic and specific serotonergic antidepressant (NaSSA) that acts by antagonizing the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors as well as by blocking 5-HT2 and 5-HT3 receptors. It enhances, therefore, the release of norepinephrine and 5-HT1A-mediated serotonergic transmission. This dual mode of action may conceivably be responsible for mirtazapine's rapid onset of action. Mirtazapine is extensively metabolized in the liver. The cytochrome (CYP) P450 isoenzymes CYP1A2, CYP2D6, and CYP3A4 are mainly responsible for its metabolism. Using once daily dosing, steady-state concentrations are reached after 4 days in adults and 6 days in the elderly. In vitro studies suggest that mirtazapine is unlikely to cause clinically significant drug-drug interactions. Dry mouth, sedation, and increases in appetite and body weight are the most common adverse effects. In contrast to selective serotonin reuptake inhibitors (SSRIs), mirtazapine has no sexual side effects. The antidepressant efficacy of mirtazapine was established in several placebo-controlled trials. In major depression, its efficacy is comparable to that of amitriptyline, clomipramine, doxepin, fluoxetine, paroxetine, citalopram, or venlafaxine. Mirtazapine also appears to be useful in patients suffering from depression comorbid with anxiety symptoms and sleep disturbance. It seems to be safe and effective during long-term use.

Authors+Show Affiliations

Department of Psychogeriatrics, Tampere University Hospital, FIN-33380 Pitkäniemi, Finland. samia@koti.tpo.fiNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11607047

Citation

Anttila, S A., and E V. Leinonen. "A Review of the Pharmacological and Clinical Profile of Mirtazapine." CNS Drug Reviews, vol. 7, no. 3, 2001, pp. 249-64.
Anttila SA, Leinonen EV. A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev. 2001;7(3):249-64.
Anttila, S. A., & Leinonen, E. V. (2001). A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Reviews, 7(3), 249-64.
Anttila SA, Leinonen EV. A Review of the Pharmacological and Clinical Profile of Mirtazapine. CNS Drug Rev. 2001;7(3):249-64. PubMed PMID: 11607047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of the pharmacological and clinical profile of mirtazapine. AU - Anttila,S A, AU - Leinonen,E V, PY - 2001/10/19/pubmed PY - 2002/1/15/medline PY - 2001/10/19/entrez SP - 249 EP - 64 JF - CNS drug reviews JO - CNS Drug Rev VL - 7 IS - 3 N2 - The novel antidepressant mirtazapine has a dual mode of action. It is a noradrenergic and specific serotonergic antidepressant (NaSSA) that acts by antagonizing the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors as well as by blocking 5-HT2 and 5-HT3 receptors. It enhances, therefore, the release of norepinephrine and 5-HT1A-mediated serotonergic transmission. This dual mode of action may conceivably be responsible for mirtazapine's rapid onset of action. Mirtazapine is extensively metabolized in the liver. The cytochrome (CYP) P450 isoenzymes CYP1A2, CYP2D6, and CYP3A4 are mainly responsible for its metabolism. Using once daily dosing, steady-state concentrations are reached after 4 days in adults and 6 days in the elderly. In vitro studies suggest that mirtazapine is unlikely to cause clinically significant drug-drug interactions. Dry mouth, sedation, and increases in appetite and body weight are the most common adverse effects. In contrast to selective serotonin reuptake inhibitors (SSRIs), mirtazapine has no sexual side effects. The antidepressant efficacy of mirtazapine was established in several placebo-controlled trials. In major depression, its efficacy is comparable to that of amitriptyline, clomipramine, doxepin, fluoxetine, paroxetine, citalopram, or venlafaxine. Mirtazapine also appears to be useful in patients suffering from depression comorbid with anxiety symptoms and sleep disturbance. It seems to be safe and effective during long-term use. SN - 1080-563X UR - https://www.unboundmedicine.com/medline/citation/11607047/A_review_of_the_pharmacological_and_clinical_profile_of_mirtazapine_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1080-563X&date=2001&volume=7&issue=3&spage=249 DB - PRIME DP - Unbound Medicine ER -