Mirtaz 7.5mg

Description

Mirtazapine is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA). Its mechanism of action, while not fully understood, involves increasing the levels of certain natural chemical messengers in the brain, primarily serotonin and noradrenaline (norepinephrine). It achieves this by blocking specific receptors in the brain:

• Alpha-2 adrenergic autoreceptors: By blocking these receptors, mirtazapine disinhibits the release of noradrenaline and serotonin, leading to increased levels of these neurotransmitters in the synaptic cleft.
• Serotonin 5-HT2 and 5-HT3 receptors: Mirtazapine acts as a potent antagonist at these serotonin receptors. This is thought to redirect serotonin’s activity to other receptors (like 5-HT1A receptors), which are associated with the antidepressant effects, while potentially reducing some of the common side effects linked to 5-HT2 and 5-HT3 receptor activation (such as nausea, anxiety, and sexual dysfunction often seen with SSRIs).
• Histamine H1 receptors: Mirtazapine is a strong antagonist of histamine H1 receptors. This property is largely responsible for its significant sedative effect, which is why it’s often taken in the evening or before sleep.
• Moderate alpha-1 adrenergic and muscarinic receptor antagonism: These effects are generally weaker but can contribute to some side effects like orthostatic hypotension (a drop in blood pressure upon standing) and dry mouth.

The 7.5mg dose of Mirtazapine is typically a starting dose, especially for individuals who might be more sensitive to its sedative effects, or when a lower dose is desired to manage specific symptoms like insomnia or appetite stimulation, before potentially increasing for full antidepressant effect. Mirtazapine can be particularly beneficial for patients with depression who also experience insomnia or significant weight loss/poor appetite, due to its sedating and appetite-stimulating properties.

It’s important to note that like other antidepressants, the full antidepressant effects of mirtazapine may take several weeks (typically 1-4 weeks, sometimes longer) to become apparent, although some effects like improved sleep can be noticed sooner due to its sedative action.

Important considerations:

• Sedation: A very common and prominent side effect, especially at lower doses. This often leads to it being prescribed for evening administration.
• Weight gain and increased appetite: This is a common and often desired side effect for individuals with depression-related appetite loss, but it needs to be monitored.
• Withdrawal symptoms: Abrupt discontinuation can lead to withdrawal symptoms (e.g., dizziness, abnormal dreams, agitation), so the dose should be gradually reduced under medical supervision.
• Serotonin Syndrome: There’s a risk of serotonin syndrome, especially if taken with other serotonergic drugs (e.g., SSRIs, triptans, tramadol, St. John’s Wort).
• Contraindications: Should not be used with Monoamine Oxidase Inhibitors (MAOIs).
• Monitoring: Regular monitoring for side effects, including blood cell counts and liver function, may be necessary.