Jump to content

Mirtazapine: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
Line 65: Line 65:
== Side effects ==
== Side effects ==


Common [[adverse effect|side effect]]s of mirtazapine may include [[dizziness]], [[blurred vision]], [[sedation]], [[drowsiness]] or [[somnolence]], [[malaise]] or [[lassitude]], increased [[appetite]] or [[hyperphagia]] and subsequent [[weight gain]],<ref>Medications or Substances causing Excessive hunger http://www.wrongdiagnosis.com/symptoms/excessive_hunger/side-effects.htm</ref>, agitation or restlessness, [[irritability]] or [[aggression]], [[apathy]] or [[anhedonia]] or [[emotional blunting]], excessive mellowness or [[calmness]], [[dry mouth]] or [[xerostomia]], difficulty [[swallowing]] or [[dysphagia]], [[shallow breathing]] or [[hypoventilation]] or [[respiratory depression]], [[constipation]], decreased [[body temperature]] or [[hypothermia]], [[pupil]] [[constriction]] or [[miosis]], enhanced [[libido]] and [[sexual function]] or [[aphrodisiac|aphrodisia]], [[wet dream]]s or [[nocturnal emission]], spontaneous [[orgasm]], [[balance disorder|loss of balance]], [[vertigo (medical)|vertigo]], and [[restless legs syndrome]] (RLS).<ref name="pmid11607047"/><ref name="pmid18756499">{{cite journal | author = Kim SW, Shin IS, Kim JM, Park KH, Youn T, Yoon JS | title = Factors potentiating the risk of mirtazapine-associated restless legs syndrome | journal = Human Psychopharmacology | volume = 23 | issue = 7 | pages = 615–20 | year = 2008 | month = October | pmid = 18756499 | doi = 10.1002/hup.965 | url = http://dx.doi.org/10.1002/hup.965}}</ref><ref name="pmid8930008">{{cite journal | author = Montgomery SA | title = Safety of mirtazapine: a review | journal = International Clinical Psychopharmacology | volume = 10 Suppl 4 | issue = | pages = 37–45 | year = 1995 | month = December | pmid = 8930008 | doi = | url = }}</ref><ref name="pmid12680749">{{cite journal | author = Biswas PN, Wilton LV, Shakir SA | title = The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England | journal = Journal of Psychopharmacology (Oxford, England) | volume = 17 | issue = 1 | pages = 121–6 | year = 2003 | month = March | pmid = 12680749 | doi = | url = http://jop.sagepub.com/cgi/pmidlookup?view=long&pmid=12680749}}</ref> Mirtazapine has also occasionally been reported to cause mild [[psychedelic drug|psychedelic]] effects in some patients, including [[mental imagery]], [[auditory system|auditory]] and [[visual]] [[hallucination]]s, and particularly, vivid, bizarre, and even [[lucid dream|lucid]] [[dream]]s or [[nightmare]]s. Most of these side effects are generally mild and become less prominent with chronic dosing over time.<ref name="pmid11607047"/>
Common [[adverse effect|side effect]]s of mirtazapine include [[dizziness]], [[blurred vision]], [[sedation]], [[drowsiness]] or [[somnolence]], [[malaise]] or [[lassitude]], increased [[appetite]] or [[hyperphagia]] and subsequent [[weight gain]],<ref>Medications or Substances causing Excessive hunger http://www.wrongdiagnosis.com/symptoms/excessive_hunger/side-effects.htm</ref>, agitation or restlessness, [[irritability]] or [[aggression]], [[apathy]] or [[anhedonia]] or [[emotional blunting]], excessive mellowness or [[calmness]], [[dry mouth]] or [[xerostomia]], difficulty [[swallowing]] or [[dysphagia]], [[shallow breathing]] or [[hypoventilation]] or [[respiratory depression]], [[constipation]], decreased [[body temperature]] or [[hypothermia]], [[pupil]] [[constriction]] or [[miosis]], enhanced [[libido]] and [[sexual function]] or [[aphrodisiac|aphrodisia]], [[wet dream]]s or [[nocturnal emission]], spontaneous [[orgasm]], [[balance disorder|loss of balance]], [[vertigo (medical)|vertigo]], and [[restless legs syndrome]] (RLS).<ref name="pmid11607047"/><ref name="pmid18756499">{{cite journal | author = Kim SW, Shin IS, Kim JM, Park KH, Youn T, Yoon JS | title = Factors potentiating the risk of mirtazapine-associated restless legs syndrome | journal = Human Psychopharmacology | volume = 23 | issue = 7 | pages = 615–20 | year = 2008 | month = October | pmid = 18756499 | doi = 10.1002/hup.965 | url = http://dx.doi.org/10.1002/hup.965}}</ref><ref name="pmid8930008">{{cite journal | author = Montgomery SA | title = Safety of mirtazapine: a review | journal = International Clinical Psychopharmacology | volume = 10 Suppl 4 | issue = | pages = 37–45 | year = 1995 | month = December | pmid = 8930008 | doi = | url = }}</ref><ref name="pmid12680749">{{cite journal | author = Biswas PN, Wilton LV, Shakir SA | title = The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England | journal = Journal of Psychopharmacology (Oxford, England) | volume = 17 | issue = 1 | pages = 121–6 | year = 2003 | month = March | pmid = 12680749 | doi = | url = http://jop.sagepub.com/cgi/pmidlookup?view=long&pmid=12680749}}</ref> Mirtazapine has also occasionally been reported to cause mild [[psychedelic drug|psychedelic]] effects in some patients, including [[mental imagery]], [[auditory system|auditory]] and [[visual]] [[hallucination]]s, and particularly, vivid, bizarre, and even [[lucid dream|lucid]] [[dream]]s or [[nightmare]]s. Most of these side effects are generally mild and become less prominent with chronic dosing over time.<ref name="pmid11607047"/>
<br />
<br />
Another possible side effect is the heightened intensity of any feelings brought up by situations one would normally find to be "emotionally moving" in a positive sense of the phrase, especially a sense of redemption or being touched--becoming "choked up" or even tearful coming more readily--by a friend or family member's supportive words or by a song that is personal meaningful. This is not an induction of feeling that would not normally occur, but an amplification strictly of a very particular kind of emotion whenever that emotion ordinarily occurs. Or maybe this is just me.
Another possible side effect is the heightened intensity of any feelings brought up by situations one would normally find to be "emotionally moving" in a positive sense of the phrase, especially a sense of redemption or being touched--becoming "choked up" or even tearful coming more readily--by a friend or family member's supportive words or by a song that is personal meaningful. This is not an induction of feeling that would not normally occur, but an amplification strictly of a very particular kind of emotion whenever that emotion ordinarily occurs. Or maybe this is just me.

Revision as of 19:57, 29 October 2009

Mirtazapine
Clinical data
Pregnancy
category
  • C
Routes of
administration		Oral
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability50%
MetabolismLiver (enzymes CYP2D6 and CYP3A4)[2]
Elimination half-life20-40 hours
Excretion75% urine, 15% feces
Identifiers
  • (±)-1,2,3,4,10,14b-hexahydro-2-[11C]methylpyrazino(2,1-a)pyrido(2,3-c)(2)benzazepine
CAS Number
PubChem CID
DrugBank
ChemSpider
CompTox Dashboard (EPA)
ECHA InfoCard100.080.027 Edit this at Wikidata
Chemical and physical data
FormulaC17H19N3
Molar mass265.35 g/mol g·mol−1
3D model (JSmol)
Melting point114 to 116 °C (237 to 241 °F)
Solubility in waterSoluble in methanol and chloroform mg/mL (20 °C)
  • CN1CCN2C(C1)C3=CC=CC=C3CC4=C2N=CC=C4

Mirtazapine (Remeron) is a psychoactive drug of the benzazepine and tetracyclic antidepressant (TeCA) chemical classes which is used primarily as an antidepressant. It is sometimes also used as an anxiolytic, hypnotic, antiemetic, orexigenic, and antihistamine or antipruritic. Mirtazapine was introduced by Organon International in 1994. Along with its chemical analogue and predecessor mianserin (Bolvidon, Norval, Tolvon), mirtazapine is one of the few noradrenergic and specific serotonergic antidepressants (NaSSAs).

Indications

Mirtazapine's primary use is the treatment of moderate to severe clinical depression.[3] Mirtazapine has been found to be useful in the treatment of generalized anxiety disorder (GAD),[4][5] social anxiety disorder (SAD) or social phobia (SP),[6][7][8][9][10] obsessive-compulsive disorder (OCD),[11][12][13] panic disorder (PD),[14][15][16][17][18] post-traumatic stress disorder (PTSD),[19][20][21][22][23][24] seasonal affective disorder (SAD),[25] insomnia,[26][27][28] nausea and vomiting or emesis,[27][29][30][31][32][33][34] loss of appetite or anorexia and subsequent unintentional weight loss,[33][35][36], and itch or pruritus[37][38][39][40] as well, and it may be prescribed off-label for these conditions.

Mirtazapine has also been found to be efficient in the treatment of shallow breathing and pauses in respiration during sleep or sleep apnea/hypopnea (SAHS),[41][42][43][44][45] headaches such as migraine,[46][47] tension headache or chronic tension-type headache (CTTH),[48][49][50] post-dural puncture headache (PDPH)[51] and cluster headache,[52] severe morning sickness in pregnant women or hyperemesis gravidarum,[53][54][55] irritable bowel syndrome (IBS),[56][57] gastroparesis,[58] distortion or decrease in the sense of taste or dysgeusia, undifferentiated somatoform disorder (USD),[59] autism and other pervasive developmental disorders (PDDs),[60][61][62][63][64] and antipsychotic or neuroleptic-induced akathisia.[65][66][66][67][68][69][70]

Chemistry

The chemical synthesis of mirtazapine has been reviewed and can be found online.

Pharmacology

Mirtazapine is a potent antagonist at the following receptors: H1 (~0.75 nM) > 5-HT2A (~10 nM) = 5-HT2C (~10 nM) = 5-HT3 (~10 nM) > α2-adrenergic (~100 nM).[71][72][73][74][75] It also has weak but clinically negligible affinity as an antagonist for the following sites: 5-HT2B receptor (~350 nM) > α1-adrenergic receptor (~500 nM) > muscarinic acetylcholine receptors (mAChRs) (~1000 nM) > norepinephrine transporter (NET) (~1250 nM).[71][72][74]

Antagonization of the α2-adrenergic receptors which function largely as pre-synaptic autoreceptors and heteroreceptors enhances adrenergic and serotonergic neurotransmission, notably central 5-HT1A receptor-mediated transmission.[3][71][75][76][77] Because of this, mirtazapine has been said to be a functional "indirect agonist" of the 5-HT1A receptor.[76] Increased activation of the central 5-HT1A receptor is thought to be the primary mediator of efficacy of most antidepressant drugs.[78] Unlike most conventional antidepressants, however, mirtazapine is not a reuptake inhibitor and has no appreciable affinity for the serotonin, norepinephrine, or dopamine transporters, nor is it an MAOI or have any efficacy at inhibiting/inducing any other enzyme for that matter.

Despite its classification as a NaSSA based on its relatively weak actions at the α2-adrenergic receptor, mirtazapine's antidepressant properties are actually more likely to be mediated primarily by its far stronger blockade of various serotonin receptors, notably the 5-HT2C receptor.[79][80][81][81] This is probably why yohimbine (found in Pausinystalia yohimbe ("Yohimbe")) which is a similar-acting and even more potent α2-adrenergic receptor antagonist that lacks 5-HT2C receptor affinity has far lower antidepressant efficacy in comparison. The 5-HT2C receptor normally works to inhibit the release of the neurotransmitter dopamine in various parts of the brain, notably in the pleasure centers such as the ventral tegmental area (VTA).[82][83] By blocking it, mirtazapine disinhibits dopamine activity in these areas, causing a pronounced antidepressant and anxiolytic response.[84] Indeed, the novel antidepressant agomelatine (Valdoxan) acts primarily as a 5-HT2C receptor antagonist and has antidepressant efficacy at least comparable to that of the SSRIs and SNRIs.[85][86]

Antagonism of the 5-HT2A and 5-HT2C receptors has beneficial effects on anxiety, sleep and appetite, as well as sexual function regarding the latter.[71][73] Additionally, antagonism of the 5-HT3 receptor, the mechanism of action of the highly effective and popular antiemetic ondansetron (Zofran), significantly improves pre-existing symptoms of nausea, vomiting, diarrhea, and general irritable bowel syndrome in afflicted individuals.[87] Mirtazapine may be used as an inexpensive and possibly even superior antiemetic alternative to ondansetron.[30] Blockade of the 5-HT3 receptors has also shown to improve anxiety and drug addiction in several studies.[88] Mirtazapine appears to be nootropic via enhancing memory functioning as well.[89] In contrast to mirtazapine, the SSRIs, SNRIs, TCAs, and MAOIs all increase the general activity of the 5-HT2A, 5-HT2C, and 5-HT3 receptors, leading to a host of negative changes and side effects, the most prominent of which include anorexia, insomnia, sexual dysfunction (impaired libido and anorgasmia), nausea, and diarrhea, among others. As a result, mirtazapine is often used in conjunction with these drugs to reduce their side effect profile and to produce a stronger antidepressant effect.[73][90][91][92][93][94]

Mirtazapine is the strongest H1 receptor antagonist known to exist on the market and as a result, it can cause powerful sedative and hypnotic effects.[81] After a short period of chronic treatment, however, the H1 receptor tends to sensitize and the antihistamine effects become more tolerable. Many patients may also dose at night to avoid the effects and this appears to be an effective strategy for combating them. Blockade of the H1 receptor may improve pre-existing allergies, pruritus, nausea, and insomnia in afflicted individuals; hence, this may actually be a positive thing for some. It may also contribute to weight gain, however. Mirtazapine has very low affinity for the muscarinic acetylcholine receptors and therefore lacks any significant anticholinergic properties.

Mirtazapine's close chemical analogue mianserin (Bolvidon, Norval, Tolvon) has been demonstrated to be a potent 5-HT6 and 5-HT7 receptor antagonist.[95][96][97][98] Mirtazapine is not known to have ever been screened for binding affinity at these receptors, and may very well act on them as well. If mirtazapine does indeed bind to and act as an antagonist at these receptors, the effects induced by this action may contribute considerably to its antidepressant, anxiolytic, sleep-enhancing, and potential nootropic properties, as well as its utility in combating the side effects of pro-serotonergic antidepressants such as the SSRIs.[99][100][101][102][103][104]

Pharmacokinetics

Mirtazapine 30 mg tablets.

Mirtazapine is typically prescribed in doses ranging from 15 mg to 45 mg. However, in severely depressed individuals, doses as high as 120 mg have been used with success.[citation needed] Mirtazapine has a half-life of approximately 20–40 hours. Like most other antidepressants, because of the "therapeutic lag" mirtazapine may require as long as 2–4 weeks until the therapeutic benefits of the drug become manifest. Mirtazapine can be sedating at lower doses in the 15–30 mg range mainly because of its antihistamine action, but at higher doses in the 45–90 mg range the enhanced adrenergic activity partially counteracts these effects and it becomes more stimulating. If patients find mirtazapine to be too sedating, it is recommended that they contact their doctor and perhaps request a higher dose. If the patient is sensitive to medication constant monitoring should be taken.

Efficacy and tolerability

Mirtazapine has been found to be one of the most effective antidepressants available and has a generally tolerable side effect profile. In a major systematic review published in 2009 which compared the efficacy and tolerability of 12 popular antidepressants, mirtazapine, escitalopram (Lexapro, Cipralex), venlafaxine (Effexor), and sertraline (Zoloft, Lustral) were shown to be superior to all of the included SSRIs, all of the SNRIs, the norepinephrine reuptake inhibitor reboxetine (Edronax, Vestra), (NDRI) bupropion (Wellbutrin, Zyban), and the noradrenergic and specific serotonergic antidepressant (NaSSA) mianserin (Bolvidon, Norval, Tolvon) in terms of antidepressant efficacy, while mirtazapine was average in regards to tolerability.[71][105] Mirtazapine has been demonstrated to be superior to trazodone (Desyrel) as well.[106] Mirtazapine has also been shown to be equal in efficacy to many of the TCAs, including amitriptyline (Elavil), doxepin (Sinequan, Adapin), and clomipramine (Anafranil), but with a much improved tolerability profile.[71][73] However, two other studies found mirtazapine inferior to the TCA imipramine (Tofranil).[107][108] One study compared the combination of venlafaxine (Effexor) and mirtazapine versus the MAOI tranylcypromine (Parnate) and found them to be equally effective, though the MAOI was much less tolerable in terms of side effects and drug interactions.[90]

Side effects

Common side effects of mirtazapine include dizziness, blurred vision, sedation, drowsiness or somnolence, malaise or lassitude, increased appetite or hyperphagia and subsequent weight gain,[109], agitation or restlessness, irritability or aggression, apathy or anhedonia or emotional blunting, excessive mellowness or calmness, dry mouth or xerostomia, difficulty swallowing or dysphagia, shallow breathing or hypoventilation or respiratory depression, constipation, decreased body temperature or hypothermia, pupil constriction or miosis, enhanced libido and sexual function or aphrodisia, wet dreams or nocturnal emission, spontaneous orgasm, loss of balance, vertigo, and restless legs syndrome (RLS).[71][110][111][112] Mirtazapine has also occasionally been reported to cause mild psychedelic effects in some patients, including mental imagery, auditory and visual hallucinations, and particularly, vivid, bizarre, and even lucid dreams or nightmares. Most of these side effects are generally mild and become less prominent with chronic dosing over time.[71]
Another possible side effect is the heightened intensity of any feelings brought up by situations one would normally find to be "emotionally moving" in a positive sense of the phrase, especially a sense of redemption or being touched--becoming "choked up" or even tearful coming more readily--by a friend or family member's supportive words or by a song that is personal meaningful. This is not an induction of feeling that would not normally occur, but an amplification strictly of a very particular kind of emotion whenever that emotion ordinarily occurs. Or maybe this is just me.

Rare and potentially serious adverse reactions may include allergic reaction, abnormal fluid accumulation or edema, fainting or syncope, seizures or convulsions, bone marrow suppression or myelotoxicity, ineffective myeloid blood cell production or myelodysplasia, and white blood cell reduction or agranulocytosis (occurs in 1/1,000 patients).[112]

Mirtazapine seems to have lower risk of many of the side effects encountered with related antidepressants, such as decreased appetite or anorexia, insomnia, nausea and vomiting or emesis, diarrhea, urinary retention or ischuria, increased body temperature or hyperthermia, increased perspiration or sweating, pupil dilation or mydriasis, or sexual dysfunction (consisting of loss of libido and anorgasmia).[71][73]

In general, antidepressants may have the capacity to exacerbate some patients' depression or anxiety or cause suicidal ideation, particularly when first starting treatment, and although this is rare, patient should be aware of these risks. As of 2001, there was no evidence that mirtazapine differs from other antidepressants in this regard,[71][73] but studies of such rare effects need to follow a larger number of participants over a longer time to give a clearer picture either way.

Discontinuation

Mirtazapine and other antidepressants generally produce a degree of physical dependence and may cause a withdrawal upon discontinuation, though such effects are usually much less severe with mirtazapine in comparison to the SSRIs and related drugs.[71][113][114][115] It should be noted that the withdrawal effects of antidepressants are typically nowhere near as strong as those of the benzodiazepines.[116] A gradual and slow reduction in dose is recommended in order to minimize withdrawal symptoms.[117] Effects of sudden cessation of treatment with mirtazapine may include depression, anxiety, panic attacks, vertigo, restlessness, irritability, decreased appetite or anorexia, insomnia, diarrhea, nausea and vomiting, flu-like symptoms such as allergies or pruritus, headache or migraine, and sometimes hypomania or mania.[113][114][118][119][120]

Interactions

The potential for dangerous drug interactions with mirtazapine is considered to be very low, if not completely negligible. As a serotonin receptor antagonist, mirtazapine will not cause serotonin syndrome at any dose, nor is it capable of causing tyramine-induced hypertensive crisis, unlike the SSRIs and MAOIs, respectively. In fact, mirtazapine can actually be used to treat serotonin syndrome.[121] The only notable interactions are that mirtazapine may increase the sedative effects of certain drugs such as alcohol and the benzodiazepines, and it has also been reported to reduce or block the effects of some street drugs, including entactogens like MDMA (ecstasy) and psychedelics such as LSD (acid) and psilocybe mushrooms (magic mushrooms).[citation needed]

Mirtazapine in combination with an SSRI, SNRI, or TCA as an augmentation strategy is perfectly safe and is often used therapeutically.[73][90][91][92][94] Mirtazapine and MAOIs are said to be contraindicated by some sources; however, there is no true indication that this is actually the case, and there is no proper literature on the subject warning against the combination whatsoever. Only a single study has mentioned anything significantly important regarding the combination, and they reported that it does not result in any incidence of serotonin-related toxicity.[122] However, mirtazapine has been associated with inducing hypertension in clonidine-treated patients[123], and due to MAOIs' similar action to clonidine via octopamine, this combination may be expected to disinhibit adrenergic effects of MAOIs (possibly to the point of hypertension).

Overdose

Mirtazapine is relatively safe if an overdose is taken.[124] Unlike the TCAs, mirtazapine shows no significant cardiovascular adverse effects at 7 to 22 times the maximum recommended dose.[73] Overdose with as much as 30 to 50 times the standard dose has shown to be relatively non-toxic.[125] One case in which 1,200 mg was ingested proved non-fatal.[126] There are no known reports of anyone ever having died as a consequence of mirtazapine use, combination, or overdose.[71]

Trade names

Mirtazapine is marketed under many different brand names in various parts of the world, including:

  • In Chile: Amirel, Divaril, Promyrtil and Zuleptan.
  • In Finland: Alphamirt, Alphazagen, Finmirtaza, Finpharma, Finscope, Genamirt, Hexazipin, Loxozapin, Medizapin, Mirtacur, Mirtamerck, Mirtapharm, Mirtalphagen, Mirtamed, Mirtapin, Mirtaratio, Mirtaril, Mirtascope, Mirtasole, Mirtastada, Mirtatifi, Mirtatsapiini, Mirtazon, Mirtoral, Mirzaten, Pharmasole, Pharmazepine, Tarzapine, Tazascope and Tirzamed.
  • In Germany: Loxozapin, Mirta, Mirtagamma, Mirtapin, Mirtazepin, Mirtazelon and Mirtazza.
  • In the Republic of Ireland: Bexzis, Mirap, Tazamel, Zismirt and Zistap.

Mirtazapine was also formerly known as 6-Azamianserin and ORG-3770 while it was in early clinical development.

See also

General classification
Effects classification
Pharmacological classification
Similar or related compounds

References

  1. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
  2. ^ http://biopsychiatry.com/mirtazpharmok.html
  3. ^ a b Gorman JM (1999). "Mirtazapine: clinical overview". The Journal of Clinical Psychiatry. 60 Suppl 17: 9–13, discussion 46–8. PMID 10446735.
  4. ^ Gambi F, De Berardis D, Campanella D; et al. (2005). "Mirtazapine treatment of generalized anxiety disorder: a fixed dose, open label study". Journal of Psychopharmacology (Oxford, England). 19 (5): 483–7. doi:10.1177/0269881105056527. PMID 16166185. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ Goodnick PJ, Puig A, DeVane CL, Freund BV (1999). "Mirtazapine in major depression with comorbid generalized anxiety disorder". The Journal of Clinical Psychiatry. 60 (7): 446–8. PMID 10453798. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  6. ^ Van Veen JF, Van Vliet IM, Westenberg HG (2002). "Mirtazapine in social anxiety disorder: a pilot study". International Clinical Psychopharmacology. 17 (6): 315–7. PMID 12409686. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  7. ^ Muehlbacher M, Nickel MK, Nickel C; et al. (2005). "Mirtazapine treatment of social phobia in women: a randomized, double-blind, placebo-controlled study". Journal of Clinical Psychopharmacology. 25 (6): 580–3. PMID 16282842. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Mörtberg E (2006). "Mirtazapine reduces social anxiety and improves quality of life in women with social phobia". Evidence-based Mental Health. 9 (3): 75. PMID 16868194. {{cite journal}}: Unknown parameter |month= ignored (help)
  9. ^ Mrakotsky C, Masek B, Biederman J; et al. (2008). "Prospective open-label pilot trial of mirtazapine in children and adolescents with social phobia". Journal of Anxiety Disorders. 22 (1): 88–97. doi:10.1016/j.janxdis.2007.01.005. PMID 17419001. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  10. ^ Liappas J, Paparrigopoulos T, Tzavellas E, Christodoulou G (2003). "Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration". Journal of Affective Disorders. 76 (1–3): 279–84. PMID 12943960. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  11. ^ Koran LM, Gamel NN, Choung HW, Smith EH, Aboujaoude EN (2005). "Mirtazapine for obsessive-compulsive disorder: an open trial followed by double-blind discontinuation". The Journal of Clinical Psychiatry. 66 (4): 515–20. PMID 15816795. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  12. ^ Pallanti S, Quercioli L, Bruscoli M (2004). "Response acceleration with mirtazapine augmentation of citalopram in obsessive-compulsive disorder patients without comorbid depression: a pilot study". The Journal of Clinical Psychiatry. 65 (10): 1394–9. PMID 15491244. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  13. ^ Koran LM, Quirk T, Lorberbaum JP, Elliott M (2001). "Mirtazapine treatment of obsessive-compulsive disorder". Journal of Clinical Psychopharmacology. 21 (5): 537–9. PMID 11593084. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  14. ^ Sarchiapone M, Amore M, De Risio S; et al. (2003). "Mirtazapine in the treatment of panic disorder: an open-label trial". International Clinical Psychopharmacology. 18 (1): 35–8. doi:10.1097/01.yic.0000047780.24295.3e. PMID 12490773. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  15. ^ Boshuisen ML, Slaap BR, Vester-Blokland ED, den Boer JA (2001). "The effect of mirtazapine in panic disorder: an open label pilot study with a single-blind placebo run-in period". International Clinical Psychopharmacology. 16 (6): 363–8. PMID 11712626. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  16. ^ Carpenter LL, Leon Z, Yasmin S, Price LH (1999). "Clinical experience with mirtazapine in the treatment of panic disorder". Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists. 11 (2): 81–6. PMID 10440525. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  17. ^ Carli V, Sarchiapone M, Camardese G, Romano L, DeRisio S (2002). "Mirtazapine in the treatment of panic disorder". Archives of General Psychiatry. 59 (7): 661–2. PMID 12090820. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  18. ^ Ribeiro L, Busnello JV, Kauer-Sant'Anna M; et al. (2001). "Mirtazapine versus fluoxetine in the treatment of panic disorder". Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas / Sociedade Brasileira De Biofísica ... [Et Al.] 34 (10): 1303–7. PMID 11593305. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  19. ^ Davidson JR, Weisler RH, Butterfield MI; et al. (2003). "Mirtazapine vs. placebo in posttraumatic stress disorder: a pilot trial". Biological Psychiatry. 53 (2): 188–91. PMID 12547477. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  20. ^ Kim W, Pae CU, Chae JH, Jun TY, Bahk WM (2005). "The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: a 24-week continuation therapy". Psychiatry and Clinical Neurosciences. 59 (6): 743–7. doi:10.1111/j.1440-1819.2005.01447.x. PMID 16401254. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  21. ^ Bahk WM, Pae CU, Tsoh J; et al. (2002). "Effects of mirtazapine in patients with post-traumatic stress disorder in Korea: a pilot study". Human Psychopharmacology. 17 (7): 341–4. doi:10.1002/hup.426. PMID 12415552. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  22. ^ Chung MY, Min KH, Jun YJ, Kim SS, Kim WC, Jun EM (2004). "Efficacy and tolerability of mirtazapine and sertraline in Korean veterans with posttraumatic stress disorder: a randomized open label trial". Human Psychopharmacology. 19 (7): 489–94. doi:10.1002/hup.615. PMID 15378676. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  23. ^ Alderman CP, Condon JT, Gilbert AL (2009). "An Open-Label Study of Mirtazapine as Treatment for Combat-Related PTSD(July/August)". The Annals of Pharmacotherapy. doi:10.1345/aph.1M009. PMID 19584388. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  24. ^ Lewis JD (2002). "Mirtazapine for PTSD nightmares". The American Journal of Psychiatry. 159 (11): 1948–9. PMID 12411239. {{cite journal}}: Unknown parameter |month= ignored (help)
  25. ^ "Mirtazapine in seasonal affective disorder (SAD): a preliminary report".
  26. ^ Winokur A, DeMartinis NA, McNally DP, Gary EM, Cormier JL, Gary KA (2003). "Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia". The Journal of Clinical Psychiatry. 64 (10): 1224–9. PMID 14658972. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  27. ^ a b Kim SW, Shin IS, Kim JM; et al. (2008). "Effectiveness of mirtazapine for nausea and insomnia in cancer patients with depression". Psychiatry and Clinical Neurosciences. 62 (1): 75–83. doi:10.1111/j.1440-1819.2007.01778.x. PMID 18289144. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  28. ^ Cankurtaran ES, Ozalp E, Soygur H, Akbiyik DI, Turhan L, Alkis N (2008). "Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: superiority over imipramine". Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 16 (11): 1291–8. doi:10.1007/s00520-008-0425-1. PMID 18299900. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  29. ^ Pae CU (2006). "Low-dose mirtazapine may be successful treatment option for severe nausea and vomiting". Progress in Neuro-psychopharmacology & Biological Psychiatry. 30 (6): 1143–5. doi:10.1016/j.pnpbp.2006.03.015. PMID 16632163. {{cite journal}}: Unknown parameter |month= ignored (help)
  30. ^ a b Kast RE, Foley KF (2007). "Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects". European Journal of Cancer Care. 16 (4): 351–4. doi:10.1111/j.1365-2354.2006.00760.x. PMID 17587360. {{cite journal}}: Unknown parameter |month= ignored (help)
  31. ^ Chen CC, Lin CS, Ko YP, Hung YC, Lao HC, Hsu YW (2008). "Premedication with mirtazapine reduces preoperative anxiety and postoperative nausea and vomiting". Anesthesia and Analgesia. 106 (1): 109–13, table of contents. doi:10.1213/01.ane.0000289636.09841.bc. PMID 18165563. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  32. ^ Teixeira FV, Novaretti TM, Pilon B, Pereira PG, Breda MF (2005). "Mirtazapine (Remeron) as treatment for non-mechanical vomiting after gastric bypass". Obesity Surgery. 15 (5): 707–9. doi:10.1381/0960892053923923. PMID 15946465. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  33. ^ a b Ito T, Okubo Y, Roth A (2009). "[Efficacy of mirtazapine for appetite loss and nausea of the cancer patient--from clinical experience in Memorial Sloan-Kettering Cancer Center]". Gan to Kagaku Ryoho. Cancer & Chemotherapy (in Japanese). 36 (4): 623–6. PMID 19381036. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  34. ^ Thompson DS (2000). "Mirtazapine for the treatment of depression and nausea in breast and gynecological oncology". Psychosomatics. 41 (4): 356–9. PMID 10906359.
  35. ^ Mattox TW (2005). "Treatment of unintentional weight loss in patients with cancer". Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition. 20 (4): 400–10. PMID 16207680. {{cite journal}}: Unknown parameter |month= ignored (help)
  36. ^ Fox CB, Treadway AK, Blaszczyk AT, Sleeper RB (2009). "Megestrol acetate and mirtazapine for the treatment of unplanned weight loss in the elderly". Pharmacotherapy. 29 (4): 383–97. doi:10.1592/phco.29.4.383. PMID 19323618. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  37. ^ Davis MP, Frandsen JL, Walsh D, Andresen S, Taylor S (2003). "Mirtazapine for pruritus". Journal of Pain and Symptom Management. 25 (3): 288–91. PMID 12614964. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  38. ^ Hundley JL, Yosipovitch G (2004). "Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study". Journal of the American Academy of Dermatology. 50 (6): 889–91. doi:10.1016/j.jaad.2004.01.045. PMID 15153889. {{cite journal}}: Unknown parameter |month= ignored (help)
  39. ^ Demierre MF, Taverna J (2006). "Mirtazapine and gabapentin for reducing pruritus in cutaneous T-cell lymphoma". Journal of the American Academy of Dermatology. 55 (3): 543–4. doi:10.1016/j.jaad.2006.04.025. PMID 16908377. {{cite journal}}: Unknown parameter |month= ignored (help)
  40. ^ Sheen MJ, Ho ST, Lee CH, Tsung YC, Chang FL, Huang ST (2008). "Prophylactic mirtazapine reduces intrathecal morphine-induced pruritus". British Journal of Anaesthesia. 101 (5): 711–5. doi:10.1093/bja/aen241. PMID 18713761. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  41. ^ Castillo JL, Menendez P, Segovia L, Guilleminault C (2004). "Effectiveness of mirtazapine in the treatment of sleep apnea/hypopnea syndrome (SAHS)". Sleep Medicine. 5 (5): 507–8. doi:10.1016/j.sleep.2004.06.004. PMID 15341898. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  42. ^ Carley DW, Olopade C, Ruigt GS, Radulovacki M (2007). "Efficacy of mirtazapine in obstructive sleep apnea syndrome". Sleep. 30 (1): 35–41. PMID 17310863. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  43. ^ Marshall NS, Yee BJ, Desai AV; et al. (2008). "Two randomized placebo-controlled trials to evaluate the efficacy and tolerability of mirtazapine for the treatment of obstructive sleep apnea". Sleep. 31 (6): 824–31. PMC 2442407. PMID 18548827. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  44. ^ Brunner H (2008). "Success and failure of mirtazapine as alternative treatment in elderly stroke patients with sleep apnea-a preliminary open trial". Sleep & Breathing = Schlaf & Atmung. 12 (3): 281–5. doi:10.1007/s11325-008-0177-7. PMID 18369672. {{cite journal}}: Unknown parameter |month= ignored (help)
  45. ^ Carley DW, Radulovacki M (1999). "Mirtazapine, a mixed-profile serotonin agonist/antagonist, suppresses sleep apnea in the rat". American Journal of Respiratory and Critical Care Medicine. 160 (6): 1824–9. PMID 10588592. {{cite journal}}: Unknown parameter |month= ignored (help)
  46. ^ Lévy E, Margolese HC (2003). "Migraine headache prophylaxis and treatment with low-dose mirtazapine". International Clinical Psychopharmacology. 18 (5): 301–3. doi:10.1097/01.yic.0000080803.87368.01. PMID 12920393. {{cite journal}}: Unknown parameter |month= ignored (help)
  47. ^ Brannon GE, Rolland PD, Gary JM (2000). "Use of mirtazapine as prophylactic treatment for migraine headache". Psychosomatics. 41 (2): 153–4. PMID 10749956.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  48. ^ Bendtsen L, Jensen R (2004). "Mirtazapine is effective in the prophylactic treatment of chronic tension-type headache". Neurology. 62 (10): 1706–11. PMID 15159466. {{cite journal}}: Unknown parameter |month= ignored (help)
  49. ^ Bendtsen L, Buchgreitz L, Ashina S, Jensen R (2007). "Combination of low-dose mirtazapine and ibuprofen for prophylaxis of chronic tension-type headache". European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 14 (2): 187–93. doi:10.1111/j.1468-1331.2006.01607.x. PMID 17250728. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  50. ^ Martín-Araguz A, Bustamante-Martínez C, de Pedro-Pijoán JM (2003). "[Treatment of chronic tension type headache with mirtazapine and amitriptyline]". Revista De Neurologia (in Spanish; Castilian). 37 (2): 101–5. PMID 12938066.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unrecognized language (link)
  51. ^ Sheen MJ, Ho ST (2008). "Mirtazapine relieves postdural puncture headache". Anesthesia and Analgesia. 107 (1): 346. doi:10.1213/ane.0b013e3181771074. PMID 18635514. {{cite journal}}: Unknown parameter |month= ignored (help)
  52. ^ Nutt D, Law J (1999). "Treatment of cluster headache with mirtazapine". Headache. 39 (8): 586–7. PMID 11279976. {{cite journal}}: Unknown parameter |month= ignored (help)
  53. ^ Guclu S, Gol M, Dogan E, Saygili U (2005). "Mirtazapine use in resistant hyperemesis gravidarum: report of three cases and review of the literature". Archives of Gynecology and Obstetrics. 272 (4): 298–300. doi:10.1007/s00404-005-0007-0. PMID 16007504. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  54. ^ Rohde A, Dembinski J, Dorn C (2003). "Mirtazapine (Remergil) for treatment resistant hyperemesis gravidarum: rescue of a twin pregnancy". Archives of Gynecology and Obstetrics. 268 (3): 219–21. doi:10.1007/s00404-003-0502-0. PMID 12819986. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  55. ^ Schwarzer V, Heep A, Gembruch U, Rohde A (2008). "Treatment resistant hyperemesis gravidarum in a patient with type 1 diabetes mellitus: neonatal withdrawal symptoms after successful antiemetic therapy with mirtazapine". Archives of Gynecology and Obstetrics. 277 (1): 67–9. doi:10.1007/s00404-007-0406-5. PMID 17628816. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  56. ^ "Irritable Bowel Syndrome and Mirtazapine -- THOMAS 157 (8): 1341 -- Am J Psychiatry".
  57. ^ Thomas SG (2000). "Irritable bowel syndrome and mirtazapine". The American Journal of Psychiatry. 157 (8): 1341–2. PMID 10910804. {{cite journal}}: Unknown parameter |month= ignored (help)
  58. ^ Kim SW, Shin IS, Kim JM; et al. (2006). "Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment". Psychosomatics. 47 (5): 440–2. doi:10.1176/appi.psy.47.5.440. PMID 16959934. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  59. ^ Han C, Pae CU, Lee BH; et al. (2008). "Venlafaxine versus mirtazapine in the treatment of undifferentiated somatoform disorder: a 12-week prospective, open-label, randomized, parallel-group trial". Clinical Drug Investigation. 28 (4): 251–61. PMID 18345715. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  60. ^ Posey DJ, Guenin KD, Kohn AE, Swiezy NB, McDougle CJ (2001). "A naturalistic open-label study of mirtazapine in autistic and other pervasive developmental disorders". Journal of Child and Adolescent Psychopharmacology. 11 (3): 267–77. doi:10.1089/10445460152595586. PMID 11642476.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  61. ^ Coskun M, Karakoc S, Kircelli F, Mukaddes NM (2009). "Effectiveness of mirtazapine in the treatment of inappropriate sexual behaviors in individuals with autistic disorder". Journal of Child and Adolescent Psychopharmacology. 19 (2): 203–6. doi:10.1089/cap.2008.020. PMID 19364298. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  62. ^ Coskun M, Mukaddes NM (2008). "Mirtazapine treatment in a subject with autistic disorder and fetishism". Journal of Child and Adolescent Psychopharmacology. 18 (2): 206–9. doi:10.1089/cap.2007.0014. PMID 18439117. {{cite journal}}: Unknown parameter |month= ignored (help)
  63. ^ Albertini G, Polito E, Sarà M, Di Gennaro G, Onorati P (2006). "Compulsive masturbation in infantile autism treated by mirtazapine". Pediatric Neurology. 34 (5): 417–8. doi:10.1016/j.pediatrneurol.2005.10.023. PMID 16648008. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  64. ^ Nguyen M, Murphy T (2001). "Mirtazapine for excessive masturbation in an adolescent with autism". Journal of the American Academy of Child and Adolescent Psychiatry. 40 (8): 868–9. PMID 11501682. {{cite journal}}: Unknown parameter |month= ignored (help)
  65. ^ "Mirtazapine for Neuroleptic-Induced Akathisia -- POYUROVSKY and WEIZMAN 158 (5): 819 -- Am J Psychiatry".
  66. ^ a b Poyurovsky M, Epshtein S, Fuchs C, Schneidman M, Weizman R, Weizman A (2003). "Efficacy of low-dose mirtazapine in neuroleptic-induced akathisia: a double-blind randomized placebo-controlled pilot study". Journal of Clinical Psychopharmacology. 23 (3): 305–8. doi:10.1097/01.jcp.0000084027.22282.16. PMID 12826992. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  67. ^ Poyurovsky M, Pashinian A, Weizman R, Fuchs C, Weizman A (2006). "Low-dose mirtazapine: a new option in the treatment of antipsychotic-induced akathisia. A randomized, double-blind, placebo- and propranolol-controlled trial". Biological Psychiatry. 59 (11): 1071–7. doi:10.1016/j.biopsych.2005.12.007. PMID 16497273. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  68. ^ Hieber R, Dellenbaugh T, Nelson LA (2008). "Role of mirtazapine in the treatment of antipsychotic-induced akathisia". The Annals of Pharmacotherapy. 42 (6): 841–6. doi:10.1345/aph.1K672. PMID 18460588. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  69. ^ Ranjan S, Chandra PS, Chaturvedi SK, Prabhu SC, Gupta A (2006). "Atypical antipsychotic-induced akathisia with depression: therapeutic role of mirtazapine". The Annals of Pharmacotherapy. 40 (4): 771–4. doi:10.1345/aph.1G561. PMID 16569791. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  70. ^ Poyurovsky M, Weizman A (2001). "Mirtazapine for neuroleptic-induced akathisia". The American Journal of Psychiatry. 158 (5): 819. PMID 11329417. {{cite journal}}: Unknown parameter |month= ignored (help)
  71. ^ a b c d e f g h i j k l Anttila SA, Leinonen EV (2001). "A review of the pharmacological and clinical profile of mirtazapine". CNS Drug Reviews. 7 (3): 249–64. PMID 11607047.
  72. ^ a b "Column - Imipramine, Mirtazapine, and Nefazodone: Multiple Targets".
  73. ^ a b c d e f g h Fawcett J, Barkin RL (1998). "Review of the results from clinical studies on the efficacy, safety and tolerability of mirtazapine for the treatment of patients with major depression". Journal of Affective Disorders. 51 (3): 267–85. PMID 10333982. {{cite journal}}: Unknown parameter |month= ignored (help)
  74. ^ a b de Boer TH, Maura G, Raiteri M, de Vos CJ, Wieringa J, Pinder RM (1988). "Neurochemical and autonomic pharmacological profiles of the 6-aza-analogue of mianserin, Org 3770 and its enantiomers". Neuropharmacology. 27 (4): 399–408. PMID 3419539. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  75. ^ a b "The α2-adrenoceptor antagonist Org 3770 enhances serotonin transmission in vivo". Cite error: The named reference "urlThe α2-adrenoceptor antagonist Org 3770 enhances serotonin transmission in vivo" was defined multiple times with different content (see the help page).
  76. ^ a b Berendsen HH, Broekkamp CL (1997). "Indirect in vivo 5-HT1A-agonistic effects of the new antidepressant mirtazapine". Psychopharmacology. 133 (3): 275–82. PMID 9361334. {{cite journal}}: Unknown parameter |month= ignored (help)
  77. ^ Nakayama K, Sakurai T, Katsu H (2004). "Mirtazapine increases dopamine release in prefrontal cortex by 5-HT1A receptor activation". Brain Research Bulletin. 63 (3): 237–41. doi:10.1016/j.brainresbull.2004.02.007. PMID 15145142. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  78. ^ Blier P, Abbott FV (2001). "Putative mechanisms of action of antidepressant drugs in affective and anxiety disorders and pain" (PDF). Journal of Psychiatry & Neuroscience : JPN. 26 (1): 37–43. PMC 1408043. PMID 11212592. {{cite journal}}: Unknown parameter |month= ignored (help)
  79. ^ Dekeyne A, Millan MJ (2009). "Discriminative stimulus properties of the atypical antidepressant, mirtazapine, in rats: a pharmacological characterization". Psychopharmacology. 203 (2): 329–41. doi:10.1007/s00213-008-1259-8. PMID 18709360. {{cite journal}}: Unknown parameter |month= ignored (help)
  80. ^ Millan MJ (2005). "Serotonin 5-HT2C receptors as a target for the treatment of depressive and anxious states: focus on novel therapeutic strategies". Thérapie. 60 (5): 441–60. PMID 16433010.
  81. ^ a b c "www.psychotropical.com". Cite error: The named reference "urlwww.psychotropical.com" was defined multiple times with different content (see the help page).
  82. ^ De Deurwaerdère P, Navailles S, Berg KA, Clarke WP, Spampinato U (2004). "Constitutive activity of the serotonin2C receptor inhibits in vivo dopamine release in the rat striatum and nucleus accumbens". The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 24 (13): 3235–41. doi:10.1523/JNEUROSCI.0112-04.2004. PMID 15056702. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  83. ^ Bubar MJ, Cunningham KA (2007). "Distribution of serotonin 5-HT2C receptors in the ventral tegmental area". Neuroscience. 146 (1): 286–97. doi:10.1016/j.neuroscience.2006.12.071. PMC 1939890. PMID 17367945. {{cite journal}}: Unknown parameter |month= ignored (help)
  84. ^ Millan MJ, Gobert A, Rivet JM; et al. (2000). "Mirtazapine enhances frontocortical dopaminergic and corticolimbic adrenergic, but not serotonergic, transmission by blockade of alpha2-adrenergic and serotonin2C receptors: a comparison with citalopram". The European Journal of Neuroscience. 12 (3): 1079–95. PMID 10762339. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  85. ^ Millan MJ, Gobert A, Lejeune F; et al. (2003). "The novel melatonin agonist agomelatine (S20098) is an antagonist at 5-hydroxytryptamine2C receptors, blockade of which enhances the activity of frontocortical dopaminergic and adrenergic pathways". The Journal of Pharmacology and Experimental Therapeutics. 306 (3): 954–64. doi:10.1124/jpet.103.051797. PMID 12750432. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  86. ^ "February 2009: agomelatine (Valdoxan) licensed in the EU to treat major depression".
  87. ^ Kast RE (2001). "Mirtazapine may be useful in treating nausea and insomnia of cancer chemotherapy". Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 9 (6): 469–70. PMID 11585276. {{cite journal}}: Unknown parameter |month= ignored (help)
  88. ^ "The psychopharmacology of 5-HT3 receptors".
  89. ^ Nowakowska E, Chodera A, Kus K (1999). "Behavioral and memory improving effects of mirtazapine in rats". Polish Journal of Pharmacology. 51 (6): 463–9. PMID 10817523.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  90. ^ a b c McGrath PJ, Stewart JW, Fava M; et al. (2006). "Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report". The American Journal of Psychiatry. 163 (9): 1531–41, quiz 1666. doi:10.1176/appi.ajp.163.9.1531. PMID 16946177. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  91. ^ a b Sennef C, Timmer CJ, Sitsen JM (2003). "Mirtazapine in combination with amitriptyline: a drug-drug interaction study in healthy subjects". Human Psychopharmacology. 18 (2): 91–101. doi:10.1002/hup.441. PMID 12590402. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  92. ^ a b Gándara Martín Jde L, Agüera Ortiz L, Ferre Navarrete F, Rojo Rodés E, Ros Montalbán S (2002). "[Tolerability and efficacy of combined antidepressant therapy]". Actas Españolas De Psiquiatría (in Spanish; Castilian). 30 (2): 75–84. PMID 12028939.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unrecognized language (link)
  93. ^ Caldis EV, Gair RD (2004). "Mirtazapine for treatment of nausea induced by selective serotonin reuptake inhibitors". Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 49 (10): 707. PMID 15560319. {{cite journal}}: Unknown parameter |month= ignored (help)
  94. ^ a b Ravindran LN, Eisfeld BS, Kennedy SH (2008). "Combining mirtazapine and duloxetine in treatment-resistant depression improves outcomes and sexual function". Journal of Clinical Psychopharmacology. 28 (1): 107–8. doi:10.1097/JCP.0b013e318160d609. PMID 18204355. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  95. ^ "Serotonin and Sleep: Molecular ... - Google Books".
  96. ^ "Basic neurochemistry: molecular ... - Google Books".
  97. ^ Crider JY, Williams GW, Drace CD, Katoli P, Senchyna M, Sharif NA (2003). "Pharmacological characterization of a serotonin receptor (5-HT7) stimulating cAMP production in human corneal epithelial cells". Investigative Ophthalmology & Visual Science. 44 (11): 4837–44. PMID 14578406. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  98. ^ "Foye's principles of medicinal chemistry - Google Books".
  99. ^ Wesołowska A, Nikiforuk A (2007). "Effects of the brain-penetrant and selective 5-HT6 receptor antagonist SB-399885 in animal models of anxiety and depression". Neuropharmacology. 52 (5): 1274–83. doi:10.1016/j.neuropharm.2007.01.007. PMID 17320917. {{cite journal}}: Unknown parameter |month= ignored (help)
  100. ^ Mnie-Filali O, Lambás-Señas L, Zimmer L, Haddjeri N (2007). "5-HT7 receptor antagonists as a new class of antidepressants". Drug News & Perspectives. 20 (10): 613–8. doi:10.1358/dnp.2007.20.10.1181354. PMID 18301795. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  101. ^ Abbas AI, Hedlund PB, Huang XP, Tran TB, Meltzer HY, Roth BL (2009). "Amisulpride is a potent 5-HT7 antagonist: relevance for antidepressant actions in vivo". Psychopharmacology. 205 (1): 119–28. doi:10.1007/s00213-009-1521-8. PMID 19337725. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  102. ^ Morairty SR, Hedley L, Flores J, Martin R, Kilduff TS (2008). "Selective 5HT2A and 5HT6 receptor antagonists promote sleep in rats". Sleep. 31 (1): 34–44. PMC 2225549. PMID 18220076. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  103. ^ Upton N, Chuang TT, Hunter AJ, Virley DJ (2008). "5-HT6 receptor antagonists as novel cognitive enhancing agents for Alzheimer's disease". Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics. 5 (3): 458–69. doi:10.1016/j.nurt.2008.05.008. PMID 18625457. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  104. ^ Hirano K, Piers TM, Searle KL, Miller ND, Rutter AR, Chapman PF (2009). "Procognitive 5-HT6 antagonists in the rat forced swimming test: potential therapeutic utility in mood disorders associated with Alzheimer's disease". Life Sciences. 84 (15–16): 558–62. doi:10.1016/j.lfs.2009.01.019. PMID 19302808. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  105. ^ Cipriani A, Furukawa TA, Salanti G; et al. (2009). "Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis". Lancet. 373 (9665): 746–58. doi:10.1016/S0140-6736(09)60046-5. PMID 19185342. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  106. ^ van Moffaert M, de Wilde J, Vereecken A; et al. (1995). "Mirtazapine is more effective than trazodone: a double-blind controlled study in hospitalized patients with major depression". International Clinical Psychopharmacology. 10 (1): 3–9. PMID 7622801. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  107. ^ Bruijn JA, Moleman P, Mulder PG; et al. (1996). "A double-blind, fixed blood-level study comparing mirtazapine with imipramine in depressed in-patients". Psychopharmacology. 127 (3): 231–7. PMID 8912401. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  108. ^ Bruijn JA, Moleman P, Mulder PG, van den Broek WW (1999). "Depressed in-patients respond differently to imipramine and mirtazapine". Pharmacopsychiatry. 32 (3): 87–92. PMID 10463374. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  109. ^ Medications or Substances causing Excessive hunger http://www.wrongdiagnosis.com/symptoms/excessive_hunger/side-effects.htm
  110. ^ Kim SW, Shin IS, Kim JM, Park KH, Youn T, Yoon JS (2008). "Factors potentiating the risk of mirtazapine-associated restless legs syndrome". Human Psychopharmacology. 23 (7): 615–20. doi:10.1002/hup.965. PMID 18756499. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  111. ^ Montgomery SA (1995). "Safety of mirtazapine: a review". International Clinical Psychopharmacology. 10 Suppl 4: 37–45. PMID 8930008. {{cite journal}}: Unknown parameter |month= ignored (help)
  112. ^ a b Biswas PN, Wilton LV, Shakir SA (2003). "The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England". Journal of Psychopharmacology (Oxford, England). 17 (1): 121–6. PMID 12680749. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  113. ^ a b Benazzi F (1998). "Mirtazapine withdrawal symptoms". Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 43 (5): 525. PMID 9653542. {{cite journal}}: Unknown parameter |month= ignored (help)
  114. ^ a b Berigan TR (2001). "Mirtazapine-Associated Withdrawal Symptoms: A Case Report". Primary Care Companion to the Journal of Clinical Psychiatry. 3 (3): 143. PMC 181176. PMID 15014614. {{cite journal}}: Unknown parameter |month= ignored (help)
  115. ^ Blier P (2001). "Pharmacology of rapid-onset antidepressant treatment strategies". The Journal of Clinical Psychiatry. 62 Suppl 15: 12–7. PMID 11444761.
  116. ^ van Broekhoven F, Kan CC, Zitman FG (2002). "Dependence potential of antidepressants compared to benzodiazepines". Progress in Neuro-psychopharmacology & Biological Psychiatry. 26 (5): 939–43. PMID 12369270. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  117. ^ Vlaminck JJ, van Vliet IM, Zitman FG (2005). "[Withdrawal symptoms of antidepressants]". Nederlands Tijdschrift Voor Geneeskunde (in Dutch; Flemish). 149 (13): 698–701. PMID 15819135. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) CS1 maint: unrecognized language (link)
  118. ^ Klesmer J, Sarcevic A, Fomari V (2000). "Panic attacks during discontinuation of mirtazepine". Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 45 (6): 570–1. PMID 10986577. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  119. ^ MacCall C, Callender J (1999). "Mirtazapine withdrawal causing hypomania". The British Journal of Psychiatry : the Journal of Mental Science. 175: 390. PMID 10789310. {{cite journal}}: Unknown parameter |month= ignored (help)
  120. ^ Ali S, Milev R (2003). "Switch to mania upon discontinuation of antidepressants in patients with mood disorders: a review of the literature". Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 48 (4): 258–64. PMID 12776393. {{cite journal}}: Unknown parameter |month= ignored (help)
  121. ^ Hoes MJ, Zeijpveld JH (1996). "Mirtazapine as treatment for serotonin syndrome". Pharmacopsychiatry. 29 (2): 81. PMID 8741027. {{cite journal}}: Unknown parameter |month= ignored (help)
  122. ^ Gillman PK (2006). "A review of serotonin toxicity data: implications for the mechanisms of antidepressant drug action". Biological Psychiatry. 59 (11): 1046–51. doi:10.1016/j.biopsych.2005.11.016. PMID 16460699. {{cite journal}}: Unknown parameter |month= ignored (help)
  123. ^ Abo-Zena RA, Bobek MB, Dweik RA (2000). "Hypertensive urgency induced by an interaction of mirtazapine and clonidine". Pharmacotherapy. 20 (4): 476–8. PMID 10772378. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  124. ^ Velazquez C, Carlson A, Stokes KA, Leikin JB (2001). "Relative safety of mirtazapine overdose". Veterinary and Human Toxicology. 43 (6): 342–4. PMID 11757992. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  125. ^ Holzbach R, Jahn H, Pajonk FG, Mähne C (1998). "Suicide attempts with mirtazapine overdose without complications". Biological Psychiatry. 44 (9): 925–6. PMID 9807651. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  126. ^ Retz W, Maier S, Maris F, Rösler M (1998). "Non-fatal mirtazapine overdose". International Clinical Psychopharmacology. 13 (6): 277–9. PMID 9861579. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Mirtazapine&oldid=322788766"