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Sedating antidepressants side effects


Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity. It is at least as effective as the older antidepressants for treating mild to severe depression. Sedation is the most common side effect.

Although agranulocytosis is the most serious side effect, it is rare approximately one in 1, and usually reversible when the medication is stopped. Mirtazapine is relatively safe in Sedating antidepressants side effects. Many clinicians consider mirtazapine a second-line or even third-line antidepressant, to be used when older antidepressants are not tolerated or are ineffective.

Physicians who are concerned about the risks of elevated lipid levels and agranulocytosis may choose to reserve mirtazapine as a third-line choice.

It is particularly useful in patients who experience sexual side effects from other antidepressants. Mirtazapine is also a good choice in depressed patients with significant anxiety or insomnia.

Although mirtazapine has been used successfully in Europe for a number of years, its place in the care of patients with depression in the United States has not yet been established. Sedating antidepressants side effects

Antidepressants remain the cornerstone of treatment of depression by primary care physicians. Table 1 compares selected antidepressants in terms of dosages and costs. A recent antidepressant introduced to the U. Medical Economics Data, Sedating antidepressants side effects to the patient will be higher, depending on prescription filling fee.

As with any new drug, mirtazapine's place in the treatment of depression is Sedating antidepressants side effects yet clear. Selective serotonin reuptake inhibitors SSRIs have become the drugs of choice in the treatment of depression. Mirtazapine is a tetracyclic piperazinoazepine, which has a different structure from any other currently used antidepressant.

It enhances central noradrenergic and serotonergic activity by blocking alpha 2 receptors and selectively antagonizing 5HT 2 and 5HT 3 receptors. Mirtazapine is well absorbed without regard to food intake. It demonstrates linear kinetics over its usual dosage range and reaches peak plasma level approximately two hours after an oral dose.

Mirtazapine is metabolized in the liver via the P cytochrome oxidase pathway, inhibiting cytochromes 2D6, 1A2 and 3A4. It is excreted in the urine.

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Clearance of the drug is diminished in the presence of liver or renal impairment. Therefore, a lower dosage is recommended in elderly patients and those with liver or renal dysfunction. Mirtazapine is currently approved for use in adults. Because it is unknown if mirtazapine is secreted in breast milk, it should be used with caution in breast-feeding mothers. Food and Drug Administration has labeled mirtazapine as a pregnancy category C drug. In the treatment of depression, as measured by Hamilton Depression rating scales, mirtazapine is clearly superior to placebo.

Mirtazapine is especially helpful in patients with depression "Sedating antidepressants side effects" are anxious; this drug has been shown to reduce anxiety and has even been used to relieve preoperative anxiety and insomnia in patients having gynecologic surgery. The most common side effects of mirtazapine are dose-dependent drowsiness 54 percentdry mouth 25 percentincreased appetite 17 percentweight gain 12 percent and dizziness 7 percent. These side effects tend to improve with time.

The most serious side effect is agranulocytosis, which occurs in approximately one in 1, patients. This incidence is no higher than the incidence of other antidepressants.

To date, all patients with this complication have recovered completely when the medication was stopped. A complete blood count and ALT measurement may be obtained if symptoms or signs suggest a need.

Mirtazapine has few, if any, cardiac effects and causes very little orthostatic hypotension.

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