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Mirtazapine is a very strong H 1 receptor antagonist and, as a result, it can cause powerful sedative and hypnotic effects. [11] A single 15 mg dose of mirtazapine to healthy volunteers has been found to result in over 80% occupancy of the H 1 receptor and to induce intense sleepiness. [92]
In addition, due to their blockade of certain serotonin receptors, serotonergic neurotransmission is not facilitated in unwanted areas, which prevents the incidence of many side effects often associated with selective serotonin reuptake inhibitor (SSRI) antidepressants; [1] [3] hence, in part, the "specific serotonergic" label of NaSSAs. [2]
Mianserin is closely related to mirtazapine, both chemically and in terms of its actions and effects, although there are significant differences between the two drugs (for example, its higher noradrenergic activity and lower 5-HT3 receptor antagonism). [7]
Mirtazapine is reported to have fewer sexual side effects, most likely because it antagonizes 5-HT 2 and 5-HT 3 receptors and may, in some cases, reverse sexual dysfunction induced by SSRIs by the same mechanism.
50 mg 2–3 hours 2–9 hours CYP2D6, others Yes Doxylamine: 25 mg 2–3 hours 10–12 hours CYP2D6, others Yes Hydroxyzine: 25–100 mg 2 hours 20 hours ADH, CYP3A4, others No Doxepin: 3–6 mg 2–3 hours 17 hours c: CYP2D6, others No (at low doses) Mirtazapine: 7.5–15 mg 2 hours 20–40 hours CYP2D6, others No Quetiapine e: 25–200 mg 1.5 ...
A number of non-SSRI drugs are not associated with sexual side effects (such as bupropion, mirtazapine, tianeptine, agomelatine, tranylcypromine, and moclobemide [57] [58] [59]). Several studies have suggested that SSRIs may adversely affect semen quality. [60] [61]
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