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Remeron (Mirtazapine) Medicine
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Basic information
- Generic name: Mirtazapine
- Brand/Trade names: Remeron
- Dosages: 15 mg, 30 mg, 45 mg tablets
- Pharmacologic category: Noradrenergic and specific
serotonergic antidepressants
- FDA approved: 1996
- Manufacturer: Organon International
- Habit forming? No
- Pregnancy risk factor: C
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Medical uses
Remeron is an antidepressant used for the treatment of mild to
severe depression. Remeron is effective in all levels of severity
of depressive illness, as well as is in a broad range of symptoms
associated with depression.
Although Remeron (mirtazapine) has a tetracyclic chemical structure
it is classified as a noradrenergic and specific serotonergic
antidepressant (NaSSA). This medication may be used in preference
to an SSRI due to the fact that it causes fewer sexual dysfunction
problems, that are a relatively common side effects of SSRIs.
Due to its unique pharmacologic profile, mirtazapine is virtually
devoid of anticholinergic, adrenolytic, and serotonin-related
side effects. Remeron is relatively safe if an overdose is taken.
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Pharmacological characteristics
- Elimination half-life: 20 to 40 h
- Metabolism: extensively metabolized by demethylation and hydroxylation followed by glucuronide conjugation. CYP2D6 and CYP1A2 are involved in formation of an 8-hydroxy metabolite. CYP3A is responsible for formation of N-desmethyl and N-oxide metabolites.
- Excretion: Primary route of elimination is urine (75%) and feces (15%).
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Benefits
- Effective for depression
- Possibly effective for anxiety at a low dose
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Concerns
- Approximately half of the patients who take Remeron (mirtazapine) develop sleepiness
- Increased appetite, cravings for sweets and carbohydrates
- Weight gain
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Unlabeled uses
- Anxiety
- Bipolar depression
- Fibromyalgia
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Mechanism of action
Although the precise mechanism of action of Remeron is not known, it increases the amount of norepinephrine and serotonin in the brain. Norepinephrine and serotonin are neurotransmitters, chemicals that nerves use to communicate with each other. Mirtazapine also acts as an antihistamine similar to diphenhydramine (Benadryl).
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References
- 1. U.S. Food and Drug Administration. Remeron (Mirtazapine)
U.S. Prescribing Information. Available at (PDF format): Prescribing
Information
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Interesting Remeron facts
- Remeron (mirtazapine) is a new antidepressant that enhances both
noradrenergic and serotonergic activity and is currently the only
member of the noradrenergic and specific serotonergic antidepressant
(NaSSA) class.
- There is eveidence that Remeron can be used to treat panic disorder,
generalized anxiety disorder (GAD), obsessive-compulsive disorder
(OCD), post traumatic stress disorder (PTSD).
- Remeron is thought to be effective in the prophylactic treatment
of chronic tension-type headache.
- Remeron, a dual-action antidepressant, has demonstrated an earlier
onset of action compared with SSRIs.
- Despite having good efficacy, Remeron has not become a first-line
treatment for depression in most clinical situations because of
2 limiting side effects in a number of patients: weight gain and
sedation.
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