Mirtazapine is used to treat symptoms of:
A. Depression
B. Parkinsonism
C. Gout
D. Petit mal epilepsy
E. None of the above.
Mirtazapine is a serotonergic and specific anti-serotonergic antidepressant (NaSSA) that has been primarily evaluated in the treatment of major depression.
The drug was as effective as tricyclic antidepressants and was at least as effective as trazodone in the majority of short-term clinical trials available in patients with moderate to severe depression, including those with symptoms of anxiety or of basic sleep disorders and the elderly.
A follow-up study also showed that sustained remission rates were higher with mirtazapine than with amitriptyline and that the drugs had similar efficacy for relapse prevention.
There is some evidence of a faster onset of action with mirtazapine than with selective serotonin reuptake inhibitors (5-hydroxytryptamine, 5-HT) (SSRIs).
Mirtazapine was more effective than SSRI fluoxetine at weeks 3 and 4 of treatment and was also more effective than paroxetine and citalopram at weeks 1 and 2, respectively, in short-term (6 or 8 weeks) evaluations).
Preliminary data suggest that the drug may be effective as an augmentation or combination therapy in patients with refractory depression.
Anticholinergic events and other events, including tremor and dyspepsia, are less common with mirtazapine than with tricyclic antidepressants.
Fluoxetine was more often associated with SSRIs than mirtazapine, but overall, mirtazapine had a similar safety profile to that of SSRIs.
An increase in appetite and body weight gain appear to be the only events reported more frequently with mirtazapine than with comparator antidepressants.
In vitro and in vivo data suggested that mirtazapine is unlikely to affect the metabolism of drugs metabolized by cytochrome P450 (CYP) 2D6, although few official data on drug interactions are available.
CONCLUSIONS:
Mirtazapine is effective and well tolerated for the treatment of patients with moderate to severe major depression.
Further research is needed to define the comparative efficacy of mirtazapine in specific patient groups, including the elderly and those with severe depression.
Clarification of its efficacy as an augmentation therapy and in patients with refractory depression and its role in improving the efficacy and reducing the extrapyramidal effects of antipsychotic drugs would also help to establish its clinical value.
The low potential for interaction with drugs metabolized by CYP2D6, including antipsychotics, tricyclic antidepressants and some SSRIs, may also make mirtazapine an important option for the treatment of major depression in patients requiring combination therapy.
Mirtazapine also appears to be useful in depressed patients with symptoms of anxiety and sleep disorders.
A. Depression
B. Parkinsonism
C. Gout
D. Petit mal epilepsy
E. None of the above.
Mirtazapine is a serotonergic and specific anti-serotonergic antidepressant (NaSSA) that has been primarily evaluated in the treatment of major depression.
The drug was as effective as tricyclic antidepressants and was at least as effective as trazodone in the majority of short-term clinical trials available in patients with moderate to severe depression, including those with symptoms of anxiety or of basic sleep disorders and the elderly.
A follow-up study also showed that sustained remission rates were higher with mirtazapine than with amitriptyline and that the drugs had similar efficacy for relapse prevention.
There is some evidence of a faster onset of action with mirtazapine than with selective serotonin reuptake inhibitors (5-hydroxytryptamine, 5-HT) (SSRIs).
Mirtazapine was more effective than SSRI fluoxetine at weeks 3 and 4 of treatment and was also more effective than paroxetine and citalopram at weeks 1 and 2, respectively, in short-term (6 or 8 weeks) evaluations).
Preliminary data suggest that the drug may be effective as an augmentation or combination therapy in patients with refractory depression.
Anticholinergic events and other events, including tremor and dyspepsia, are less common with mirtazapine than with tricyclic antidepressants.
Fluoxetine was more often associated with SSRIs than mirtazapine, but overall, mirtazapine had a similar safety profile to that of SSRIs.
An increase in appetite and body weight gain appear to be the only events reported more frequently with mirtazapine than with comparator antidepressants.
In vitro and in vivo data suggested that mirtazapine is unlikely to affect the metabolism of drugs metabolized by cytochrome P450 (CYP) 2D6, although few official data on drug interactions are available.
CONCLUSIONS:
Mirtazapine is effective and well tolerated for the treatment of patients with moderate to severe major depression.
Further research is needed to define the comparative efficacy of mirtazapine in specific patient groups, including the elderly and those with severe depression.
Clarification of its efficacy as an augmentation therapy and in patients with refractory depression and its role in improving the efficacy and reducing the extrapyramidal effects of antipsychotic drugs would also help to establish its clinical value.
The low potential for interaction with drugs metabolized by CYP2D6, including antipsychotics, tricyclic antidepressants and some SSRIs, may also make mirtazapine an important option for the treatment of major depression in patients requiring combination therapy.
Mirtazapine also appears to be useful in depressed patients with symptoms of anxiety and sleep disorders.
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