Date - 11 November 2004

Source- Drugs in Context 2004; 1E(9): Oseltamivir - Influenza p329

Author - Dr Eleanor Bull

Mirtazapine is a novel antidepressant drug that enhances both noradrenergic and serotonergic neurotransmission. Predominantly used for the treatment of major depression, particularly when associated with sleep disturbances, clinical evidence suggests that mirtazapine is at least as effective as the tricyclic antidepressants (TCAs) and has a more rapid onset of therapeutic action than the selective serotonin reuptake inhibitors (SSRIs). Mirtazapine may be particularly effective in the treatment of those patients with severe depression, comorbid anxiety, or those who have previously shown resistance to other pharmacological interventions. The efficacy of mirtazapine has also been proven in difficult-to-treat patient populations, including the elderly. Mirtazapine has a favourable adverse event profile, and in view of its metabolic pathway, a low propensity for drug-drug interactions. Weight gain and sedation represent the most common side-effects associated with mirtazapine, but in contrast to the other newly available antidepressants, sexual dysfunction and gastrointestinal effects are rarely reported. Patients may switch to mirtazapine directly from prior SSRI therapy, without experiencing clinically significant side-effects.

Keywords: Mirtazapine, Depression