WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. The mean elimination half-life of mirtazapine after oral administration ranges from approximately 20 to 40 hours across age and gender subgroups, with females of all ages exhibiting significantly longer elimination half-lives than males mean half-life of 37 hours for females vs. There is no FDA guidance on the use of Mirtazapine in women of reproductive potentials and males. Mirtazapine has a tetracyclic chemical structure and belongs to the piperazino-azepine group of compounds. Its molecular weight is Mirtazapine is a white to creamy white crystalline powder which is slightly soluble in water.

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Mirtazapine belongs to the group of medications known as tetracyclic antidepressants. Antidepressants are used to help relieve the symptoms of depression such as feeling low, sleeping problems, loss of appetite, and loss of interest in activities that you would normally enjoy doing. When you have depression, certain chemicals in the brain are out of their normal balance. Antidepressants such as mirtazapine work by helping to bring the chemicals back into balance. Antidepressants usually take at least a few weeks to achieve their beneficial effect, so it is important to have patience and take the medication exactly as prescribed by your doctor. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

In the first study to compare the efficacy and tolerability of mirtazapine Remeron and fluoxetine Prozac in patients with major depression, David Wheatley, M. The study comprised male and female inpatients and outpatients between the ages of 18 and 75 who fulfilled the DSM-III-R criteria for a major depressive episode. At the end of the study, Wheatley and colleagues found that remeron 40 mg from baseline in group mean HAM-D scores were evident in both treatment groups throughout the study period. The difference between the mirtazapine-treated group compared to the fluoxetine group reached statistical significance days 21 and Common complaints were headache and nausea fluoxetine, and dry mouth and blurred vision mirtazapine.

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Mirtazapine 45 mg tablets are White, biconvex, capsule shaped film coated tablets with '10' debossed on one side and 'A' on the other side. Patients with depression should be treated for a sufficient period of at least 6 months to ensure that they are free from symptoms. It is recommended to discontinue treatment with mirtazapine gradually to avoid withdrawal symptoms see section 4. The recommended dose is the same as that for adults. Mirtazapine should not be used in children and adolescents under the age of 18 years as efficacy was not demonstrated in two short-term clinical trials see section 5. The clearance of mirtazapine may be decreased in patients with hepatic impairment.

Common side effects include increased weight, sleepiness, and dizziness. In NICE recommended generic SSRIs as first line choices, as they are equally effective as other antidepressants and have a favourable risk—benefit ratio. After one week of usage, mirtazapine was found to have an earlier onset of action compared to SSRIs. Mirtazapine is not considered to have a risk of many of the side effects often associated with other antidepressants like the SSRIs, and may actually improve certain ones when taken in conjunction with them. Mirtazapine and other antidepressants may cause a discontinuation syndrome upon cessation.

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Geriatric patients may have reduced clearance of mirtazapine and, as a result, may have increased plasma levels of the drug. In children and young adults, risks must be weighed against the benefits of taking antidepressants. Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies. Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy. Akathisia, characterized by subjectively unpleasant or distressing restlessness and need to move, often accompanied by an inability to sit or stand still; most likely to occur within first few weeks; increasing dose may be detrimental. Tetracyclic structure different from SSRIs, TCAs and MAOIs; through its central presynaptic alpha2-adrenergic antagonist effects, stimulates norepinephrine and serotonin release; potent antagonist of 5-HT2 and 5-HT3 serotonin and histamine receptors; is a moderate alpha1 remeron 40 mg and muscarinic antagonist.

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Mirtazapine is a tetracyclic antidepressant with noradrenergic and specific serotonergic antidepressant effects that is used for the treatment of depression. Mirtazapine is rapidly absorbed after either single or multiple doses oral administration with peak plasma concentration C max reached in 1—2. The rate of absorption was slightly slower after the drug was administered with food, but the extent of absorption was not affected by food. Van der Vorstenbosch and Delbressine studied the in vitro binding of mirtazapine to human plasma proteins over a concentration range of 0. The 8-hydroxy metabolites are conjugated with glucuronic acid or, to a slight amount, with sulfuric acid.

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