Mirtazapine
Mirtazapine is a tetracyclic antidepressant with a somewhat unique mechanism of action.
Liver safety of Mirtazapine
Mirtazapine therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.
Mechanism of action of Mirtazapine
Mirtazapine (mir taz' a peen) is a tetracyclic derivative with a somewhat unique antidepressant activity in comparison to the selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. Its mechanism of action is not well defined, but it is a potent antagonist of serotonin 5-HT2 and 5-HT3 receptors and appears to enhance central noradrenergic and serotonergic (5-HT1A) activity with less activity against peripheral receptors.
FDA approval information for Mirtazapine
Mirtazapine was approved for use in moderate and severe depression in the United States in 1996 and remains in wide use, with more than 5 million prescriptions being filled yearly.
Brand name for Mirtazapine
The major indication for mirtazapine therapy is major depressive disorder. Mirtazapine is available as regular and oral disintegrating tablets of 15, 30 and 45 mg in multiple generic forms and under the brand name Remeron.
Dosage and administration for Mirtazapine
The recommended dosage in adults is 15 mg once daily at bedtime, which can be increased to a maximum of 45 mg daily.
Side effects of Mirtazapine
Common side effects are drowsiness, fatigue, blurred vision, dry mouth, increased appetite and weight gain.
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Contributors: Prab R. Tumpati, MD