Internal restlessness and sleep disorders are symptoms of depression. Mirtazapine can alleviate this: It helps to calm down and sleep well restorative. Therefore, this antidepressant is mainly used in depressives with nocturnal restlessness (agitation). Since it has a sleep-promoting effect, it is usually taken before bedtime. Sleep disorders with thought circles and very early awakenings are thereby reduced. Nevertheless, side effects are to be considered.
Effect of mirtazapine
Mirtazapine belongs to the class of dual antidepressants: In particular it influences the messenger substances norepinephrine and serotonin. That is why it is called NaSSA antidepressant (Noradrenergic specific serotonergic antidepressant). It belongs to the so-called new generation of antidepressants, a still relatively young but proven group of medications.
Mirtazapine potentiates the action of both serotonin and norepinephrine receptors in the brain by binding to alpha2 receptors. This blocks the medication and acts antagonistic, so contrary to the effect of the substances that usually start there.
Normally, or without the activity of mirtazapine, the alpha2 receptor signaling pathway would inhibit the release of serotonin and norepinephrine. As with most other antidepressants, the effects of mirtazapine increase the supply of nadrenaline and serotonin. A deficiency of these substances is, among other things, blamed for the symptoms and development of depression.
Mirtazapine helps with depression
Psychiatrists often use the antidepressant mirtazapine because it has done well in various international studies. For example, a meta-analysis compared twelve different antidepressants in terms of their effects and tolerability, and showed that mirtazapine was especially effective and relatively well tolerated by most patients.
Citalopram, an antidepressant that could be used for another form of depression as a drug with other side effects, also achieved good results. It is given because of its drive-enhancing effect in those depressions characterized primarily by sadness and lack of drive.
Dosage of mirtazapine
The drug mirtazapine is usually taken orally in the form of orodispersible tablets. Alternatively, it is in solution for administration in drop form and as a concentrate for intravenous infusions on the market.
Preferably one should use the antidepressant late night because mirtazapine has a sleep-inducing effect. The preparation is in Germany pharmacy and prescription. The daily dose of maintenance therapy for depression is included 30 to 45 milligrams per day.
Side effects of mirtazapine
The most important and most common side effects of Mirtazapine are:
- a headache
Ingestion of the drug may generally lead to a feeling of light-headedness, which may be due to the antihistaminergic activity of mirtazapine. It also often causes side effects such as increased appetite and weight gain, as well as water retention (edema).
Rare it comes in patients with appropriate predisposition to side effects such as
- Circulatory problems with low blood pressure
- involuntary tremor (tremor)
- Rashes (rash)
- Muscle and joint pain
- a reduced blood formation
- Increase in liver enzymes
Interactions of mirtazapine
In general, mirtazapine has little interaction with other drugs.
In combination with the likewise antidepressive lithium, however, it may lead to an increase in the effects and side effects. In addition, mirtazapine can intensify the sleep-inducing effects of other concomitant drugs such as benzodiazepines or alcohol.
In combination with carbamazepine and phenytoin there may be an accelerated degradation of mirtazapine in the body and a possible dose adjustment may be necessary.
Information on the active substance mirtazapine
Here are some general guidelines to keep in mind when using mirtazapine.