User:Mr. Ibrahem/Mirtazapine

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Mr. Ibrahem/Mirtazapine
Clinical data
Trade namesRemeron, Mirataz, others
Other namesMepirzapine; 6-azamianserin; ORG-3770[1][2]
AHFS/Drugs.comMonograph
MedlinePlusa697009
License data
Pregnancy
category
Routes of
administration		By mouth (tablets), Topical
Drug classTetracyclic antidepressant (TeCA)[4]
Legal status
Legal status
Pharmacokinetic data
Bioavailability50%[5][6][7][8]
Protein binding85%[5][6][7][8]
MetabolismLiver (CYP1A2, CYP2D6, CYP3A4)[5][6][7][8][9]
MetabolitesDesmethylmirtazapine (contributes 3–10% of activity)[9]
Elimination half-life20–40 hours[5][6][7][8]
ExcretionUrine: 75%[5]
Feces: 15%[5][6][7][8]
Identifiers
  • (±)-2-Methyl-1,2,3,4,10,14b-hexahydropyrazino[2,1-a]pyrido[2,3-c][2]benzazepine
Chemical and physical data
FormulaC17H19N3
Molar mass265.360 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
Density1.22 g/cm3
Melting point114 to 116 °C (237 to 241 °F)
Boiling point432 °C (810 °F)
Solubility in waterSoluble in methanol and chloroform mg/mL (20 °C)
  • n1cccc3c1N4C(c2ccccc2C3)CN(C)CC4
  • InChI=1S/C17H19N3/c1-19-9-10-20-16(12-19)15-7-3-2-5-13(15)11-14-6-4-8-18-17(14)20/h2-8,16H,9-12H2,1H3 checkY
  • Key:RONZAEMNMFQXRA-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Mirtazapine, sold under the brand name Remeron among others, is an antidepressant primarily used to treat depression.[9][4] Its full effect may take more than four weeks to occur, with some benefit possibly as early as one to two weeks.[11][4] Often it is used in depression complicated by anxiety or trouble sleeping.[9][12] Effectiveness is similar to other antidepressants.[13] It is taken by mouth.[4]

Common side effects include increased weight, sleepiness, and dizziness.[4] Serious side effects may include mania, low white blood count, and increased suicide among children.[4] Withdrawal symptoms may occur with stopping.[14] It is not recommended together with an MAO inhibitor.[4] It is unclear if use during pregnancy is safe.[4] How it works is not clear, but it may involve blocking certain adrenergic and serotonin receptors.[9][4] Chemically, it is a tetracyclic antidepressant (TeCA).[4] It also has strong antihistamine effects.[9][4]

Mirtazapine came into medical use in the United States in 1996.[4] The patent expired in 2004, and generic versions are available.[15][4] In the United States the wholesale cost as of 2018 is about US$3 per month.[16] In the United Kingdom a month supply costs the NHS about £1.60 per month as of 2018.[17] In 2017, it was the 119th most commonly prescribed medication in the United States, with more than six million prescriptions.[18][19]

References[edit]

  1. ^ Index Nominum 2000: International Drug Directory. Taylor & Francis. 2000. pp. 696–. ISBN 978-3-88763-075-1.
  2. ^ "Mirtazapine - Drugs.com". Archived from the original on 17 November 2018. Retrieved 26 August 2016.
  3. ^ a b "Mirtazapine Use During Pregnancy". Drugs.com. 23 September 2019. Archived from the original on 22 August 2020. Retrieved 4 March 2020.
  4. ^ a b c d e f g h i j k l m n o "Mirtazapine Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 10 January 2021. Retrieved 20 November 2018.
  5. ^ a b c d e f Timmer CJ, Sitsen JM, Delbressine LP (June 2000). "Clinical pharmacokinetics of mirtazapine". Clinical Pharmacokinetics. 38 (6): 461–74. doi:10.2165/00003088-200038060-00001. PMID 10885584.
  6. ^ a b c d e "REMERON (mirtazapine) tablet, film coated [Organon Pharmaceuticals USA]". DailyMed. Organon Pharmaceuticals USA. October 2012. Archived from the original on 10 January 2021. Retrieved 24 October 2013.
  7. ^ a b c d e "Axit Mirtazapine PRODUCT INFORMATION". TGA eBusiness Services. alphapharm. 25 October 2011. Archived from the original on 20 September 2020. Retrieved 15 October 2013.
  8. ^ a b c d e "Mirtazapine 30 mg Tablets – Summary of Product Characteristics". electronic Medicines Compendium. Sandoz Limited. 20 March 2013. Archived from the original (PDF) on 31 July 2017. Retrieved 24 October 2013.
  9. ^ a b c d e f g Anttila SA, Leinonen EV (2001). "A review of the pharmacological and clinical profile of mirtazapine". CNS Drug Rev. 7 (3): 249–64. doi:10.1111/j.1527-3458.2001.tb00198.x. PMC 6494141. PMID 11607047.
  10. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 20 September 2020. Retrieved 9 September 2020.
  11. ^ Watanabe N, Omori IM, Nakagawa A, Cipriani A, Barbui C, Churchill R, Furukawa TA (December 2011). "Mirtazapine versus other antidepressive agents for depression". The Cochrane Database of Systematic Reviews (12): CD006528. doi:10.1002/14651858.CD006528.pub2. PMC 4158430. PMID 22161405.
  12. ^ Nutt DJ (2002). "Tolerability and safety aspects of mirtazapine". Hum Psychopharmacol. 17 Suppl 1: S37–41. doi:10.1002/hup.388. PMID 12404669.
  13. ^ "[129] Mirtazapine: Update on efficacy, safety, dose response". www.ti.ubc.ca. Archived from the original on 7 May 2021. Retrieved 8 May 2021.
  14. ^ British national formulary : BNF 74 (74 ed.). British Medical Association. 2017. p. 354. ISBN 978-0857112989.
  15. ^ Schatzberg AF, Cole JO, DeBattista C (2010). "3". Manual of Clinical Psychopharmacology (7th ed.). Arlington, VA: American Psychiatric Publishing. ISBN 978-1-58562-377-8.
  16. ^ "NADAC as of 2018-11-21". Centers for Medicare and Medicaid Services. Archived from the original on 1 June 2019. Retrieved 21 November 2018.
  17. ^ British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 369. ISBN 9780857113382.
  18. ^ "The Top 300 of 2020". ClinCalc. Archived from the original on 12 February 2021. Retrieved 11 April 2020.
  19. ^ "Mirtazapine - Drug Usage Statistics". ClinCalc. Archived from the original on 20 October 2020. Retrieved 11 April 2020.
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