Mirtazapina (REXER IN SPAIN)
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Before yesterday, mi doctor sichiyastrist recomended take 1/2 tablet of Mirtazipina (in Spain REXER), and I have been sleeping 36 hours. Someone know something about this antedepressant?. This is normal?.
Answer:
Mirtazapine's typical effect of causing sedation may actually be inversely related to the dose. Its alpha 2 auto-receptor antagonism means it increases the availability of noradrenaline (and, indirectly, serotonin). But it has antihistamine properties as well, which may lead to sleepiness. IMO it might be premature to write it off on the basis of its immediate side-effects. You might want to consider taking it for another two-to-three weeks to give your receptors the chance to re-regulate. If it doesn't work, however, there are certainly more activating mood-brighteners available: http://www.biopsychiatry.com This is what the manufacturer says, but think about it. If H1 antagonism per se caused sedation, then it follows that the development of "non-sedating antihistamines" would not be possible. But it is not only possible, it has been done (terfenadine and its followers). Therefore, sedation cannot be attributed to H1 antagonism. The sedation seen with first-generation antihistamines is most likely due to their anticholinergic activity -- they were not clean H1 antagonists. I am amazed that something so obvious entirely bypassed the Organon scientists, who actually attributed mirtazapine's sedating effects to its H1 antagonism in the package insert. The sedating properties of mirtazapine (which is 6-aza-mianserin, as you probably knew) are also subjectively different in character from those of antimuscarinic drugs or first generation antihistamines.
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