5/24/2023 0 Comments Better blocker for panic attackesHowever, there is strong evidence that patients taking mirtazapine are less likely to leave treatment early because of side effects, although this is not the case for patients reporting side effects or leaving treatment early for any reason." Ī 2011 Cochrane review that compared mirtazapine to other antidepressants found that, while it appears to have a faster onset in people for whom it works (measured at two weeks), its efficacy is about the same as other antidepressants after six weeks' use. In addition, mirtazapine has a statistical advantage over selective serotonin reuptake inhibitors in terms of reducing symptoms of depression, but the difference is not clinically significant. In 2010, the National Institute for Health and Care Excellence recommended generic selective serotonin reuptake inhibitors as first line choices, as they are "equally effective as other antidepressants and have a favourable risk–benefit ratio." With respect to mirtazapine, it found: "There is no difference between mirtazapine and other antidepressants on any efficacy measure, although in terms of achieving remission mirtazapine appears to have a statistical though not clinical advantage. Onset of action appears faster than some selective serotonin reuptake inhibitors and similar to tricyclic antidepressants. Mirtazapine is primarily used for major depressive disorder and other mood disorders. Mirtazapine is approved by the United States Food and Drug Administration for the treatment of major depressive disorder in adults. In 2020, it was the 104th most commonly prescribed medication in the United States with more than 6 million prescriptions. The patent expired in 2004, and generic versions are available. Mirtazapine came into medical use in the United States in 1996. It also has strong antihistaminergic effects. Chemically, it is a tetracyclic antidepressant, and is closely related to mianserin. How it works is not clear, but it may involve blocking certain adrenergic and serotonin receptors. It is unclear if use during pregnancy is safe. It is not recommended together with a monoamine oxidase inhibitor, although evidence supporting the danger of this combination has been challenged. Withdrawal symptoms may occur with stopping. Serious side effects may include mania, low white blood cell count, and increased suicide among children. Ĭommon side effects include sleepiness, dizziness, increased appetite and weight gain. The effectiveness of mirtazapine is comparable to other commonly prescribed antidepressants. It is often used in cases of depression complicated by anxiety or insomnia. Its effects may take up to four weeks, but can also manifest as early as one to two weeks. Mirtazapine, sold under the brand name Remeron amongst others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression.
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