Tolerability and safety aspects of mirtazapine

Nutt, David

doi:10.1002/hup.388

Cited by 75 publications

(54 citation statements)

References 17 publications

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“…Although histaminergic blockage helps to rapid sleep onset, it is assumed that the effects on continuity is due to its 5HT2 and 5HT3 blocking effects (62,63).…”

Section: Mirtazapinementioning

confidence: 99%

Psychotropic medications affecting biological rhythm

Oral¹,

Özcan²,

Güleç³

et al. 2011

JMOOD

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Biyolojik ritmi etkileyen psikotrop ilaçlarBirçok canlı organizmada, omurgalı ve memeli canlıda olduğu gibi insanda da biyolojik işlevler çeşitli aralıklarla salınan ritimlerle yürür. Sirkadyen, ultradien ve infradian ya da daha uzun aralıklarla salınan iç ritimlerimiz kendi iç düzenlerini her şartta devam ettiren, bağımsız biyolojik organizasyonlardır. Biyolojik olarak kendiliğinden işleyen, istikrarlı bir yol varsa da, gerek psikiyatrik hastalıklar ve gerekse de psikotrop ilaçlar bu iç ritimleri değiştirebilir. Psikotrop ilaçlar, etki düzeneklerindeki nörotransmmitter ya da nöromediatörler vasıtasıyla doğrudan veya daha uzun vadede hormonal ya da genetik değişikliklere neden olarak da biyolojik ritimler üzerine etkili olabilir. Biyolojik ritim düzensizliklerinin duygudurum bozuklukları açısından hem neden hem de sonuç olarak önemine dikkat çeken birçok çalışma vardır. Duygudurum bozukluklarının takip ve tedavisinde psikofarmakolojik ajanların biyolojik ritimlere olan muhtemel etkisi de değerlendirilmesi önemlidir.

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“…Although histaminergic blockage helps to rapid sleep onset, it is assumed that the effects on continuity is due to its 5HT2 and 5HT3 blocking effects (62,63).…”

Section: Mirtazapinementioning

confidence: 99%

Psychotropic medications affecting biological rhythm

Oral¹,

Özcan²,

Güleç³

et al. 2011

JMOOD

View full text Add to dashboard Cite

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“…On the other hand, weight gain after antidepressants may override this beneficial effect and induce obesity as an unwanted side effect. Normalization of body weight and unwanted weight gain belong to the benefits and sequelae of treatment with mirtazapine (Nutt, 2002). Leptin morning levels were shown to increase during antidepressive treatment with mirtazapine (Kraus et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Schmid

Wichniak

Uhr

et al. 2005

Neuropsychopharmacol

143

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The noradrenergic and specific serotoninergic antidepressant mirtazapine improves sleep, modulates hormone secretion including blunting of hypothalamic-pituitary-adrenocortical (HPA) activity, and may prompt increased appetite and weight gain. The simultaneous investigation of sleep electroencephalogram (EEG) and hormone secretion during antidepressive treatment helps to further elucidate these effects. We examined sleep EEG (for later conventional and quantitative analyses) and the nocturnal concentrations of cortisol, adrenocorticotropin (ACTH), growth hormone (GH), prolactin, melatonin and the key factors of energy balance, ghrelin, and leptin before and after 28 days of treatment of depressed patients (seven women, three men, mean age 39.974.2 years) with mirtazapine. In addition, a sleep EEG was recorded at day 2 and the dexamethasone-corticotropin-releasing hormone (DEX-CRH) test was performed to assess HPA activity at days À3 and 26. Psychometry and mirtazapine plasma concentrations were measured weekly. Already at day 2, sleep continuity was improved. This effect persisted at day 28, when slow-wave sleep, low-delta, theta and alpha activity, leptin and (0300-0700) melatonin increased, and cortisol and ghrelin decreased. ACTH and prolactin remained unchanged. The first two specimens of GH collected after the start of quantitative EEG analysis were reduced at day 28. The DEX-CRH test showed, at day 26, a blunting of the overshoot of ACTH and cortisol found at day À3. The Hamilton Depression score decreased from 32.177.3 to 15.576.7 between days À1 and 28. A weight gain of approximately 3 kg was observed. This unique profile of changes is compatible with the action of mirtazapine at 5-HT-2 receptors, at presynaptic adrenergic alpha 2 receptors, at the HPA system, and on ghrelin and leptin.

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“…It also has anxiolytic and hypnotic properties. Side effects, such as increased appetite, weight gain, dry mouth, and somnolence, are relatively minor complaints (1)(2)(3)(4). Unlike other antidepressants, mirtazapine alone has not been involved as a cause of death by overdose.…”

Section: To the Editormentioning

confidence: 99%

“…Unlike other antidepressants, mirtazapine alone has not been involved as a cause of death by overdose. Numerous studies have shown that Mirtazapine overdose in patients resolves well (1)(2)(3)(4)(5)(6)(7). Therefore, mirtazapine is considered a drug with good tolerability and safety profile.…”

Section: To the Editormentioning

confidence: 99%

Letter to the Editor: A Suspicious Bathtub Death in a Suicidal Patienton Mirtazapine

Sauvageau¹

2006

Clinical Toxicology

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Tolerability and safety aspects of mirtazapine

Cited by 75 publications

References 17 publications

Psychotropic medications affecting biological rhythm

Psychotropic medications affecting biological rhythm

Changes of Sleep Architecture, Spectral Composition of Sleep EEG, the Nocturnal Secretion of Cortisol, ACTH, GH, Prolactin, Melatonin, Ghrelin, and Leptin, and the DEX-CRH Test in Depressed Patients during Treatment with Mirtazapine

Letter to the Editor: A Suspicious Bathtub Death in a Suicidal Patienton Mirtazapine

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