Adding some fasted AM cardio, this can fire things up..
Depending on macro intake and goals..
AM fasted cardio is 100% the most effective thing IMO.. depending on what goals are, it can be light, moderate or dialed up a tad..
20mins speed 3 on 6% incline (no hands, no holding bar) is a perfect starting point.
Fires the metabolism up and ESPSIALLY helps with nutrition partitioning..
People hate cardio, and some people have the wrong idea about it, most assume its for fat loss only.. Only issue most have is time constraints being fasted AM. Thank goodness I have some equipment at home for that, I wake up and jump right on with head phones after I take my Modafinil and 1 small K-cup or black only. Only downfall its directly right under the air register, I get blasted with heat..
Its awful in that aspect.
Great for supporting appetite for the rest of the day.. Truly!
Other than that, There's a few things that can work, whether its GHRP6 peptide (injection),
or
Sarms like MK677 (this can make hunger pangs unbearable,
or Cyproheptadine which is an antihistamine, but it has been used for off label properties with treating conditions, syndromes in people that have little to no appetite due to whatever issues that may have trigger the appetite loss. Back in the late 90's early 2000's some pharma companies would in fact add this to their Dbol.
If orals suppress your appetite (dbol/drol)..
Cyproheptadine is a antihistamine, but it has been used for off label properties with treating conditions, syndroms in people that have little to no appetite due to whatever issues that may have trigger the appetite loss.
Back in the late 90's early 2000's some pharma companies would in fact add this to their Dbol, yup, that's right.. Guy's were blowing up like craziness..
I decided to add this once again due to my script meds interfering with my appetite , this will give me the added advantage with wanting to pound some food during difficult times..
2 x 4mg tabs is all you really need, take with your orals (dbol/drol).. take 1 in am and 1 in pm..
Also so more..
Older post I made -
Depression/appetite..Solution for those that suffer!
Depression/appetite..Solution for those that suffer!
As some of you know, well the mostly the members that speak to me on a personal level know that I have had my bouts with depression here and there, and trying medication after medication throughout the years..
Often at times when I have a low my appetite naturally takes a hit as well, and struggling to choke down food all the while trying to have a stable steady keel with my outlook..
Last summer I introduced a drug that I was kinda unfamiliar with
(just recently re-added it again,glad I did), but did some research on it, and it turned out to be the Swiss army knife of antidepressants... Its role is multi-functional, at the same time not effecting sex drive,libido, ability to cum, or anything that SSIR's do to people..
This drug has been a life saver, not only does it treat my depression like symptoms, but it knocks me the hell out like an ambien would (deep sleep wise)..Further more, its been used to treat people with wasting disorders where they cant eat, or lack of appetite, anorexia..In fact its one of the top 3 most prescribed for treating appetite stimulation.. Dosages will vary.. I started at 30mgs and I was blown away on how well I was sleeping, and the increase and desire to eat was out of this world, it actually became problematic at night lol... I now take the max dosage at 45mgs, sleep is sound, and appetite has been like that or a carnivore.
side effects? zero for me.... maybe a bit groggy upon waking up, but nothing a dark roast can't fix...
Its a great alternative to the other crap those Dr have pushed on me for years..Here's some info below, I hope this can assist anyone out there..
Mirtazapine, sold under the brand name Remeron among others, is an
atypical antidepressant which is used primarily in the treatment of
depression.[SUP]
[7][/SUP] In addition to its
antidepressant properties, mirtazapine has
anxiolytic,
sedative,
antiemetic, and
appetite stimulant effects and is sometimes used in the treatment of
anxiety disorders,
insomnia,
nausea and
vomiting, and to produce
weight gain when desirable.[SUP]
[7][/SUP][SUP]
[8][/SUP] It is taken
by mouth.
The drug acts as an
antagonist of certain
adrenergic and
serotonin receptors, and is also a strong
antihistamine.[SUP]
[7][/SUP] It is sometimes described as a
noradrenergic and specific serotonergic antidepressant (NaSSA),[SUP]
[7][/SUP] although the actual evidence in support of this label has been regarded as poor.[SUP]
[9][/SUP] Chemically, mirtazapine is a
tetracyclic antidepressant (TeCA), with four interconnected
rings of atoms, and is a relative of the TeCA
mianserin(Tolvon).[SUP]
[10][11][/SUP]
Mirtazapine was developed by
Organon International in the
Netherlands and was introduced in the
United States in 1996.[SUP]
[4][/SUP] Its patent expired in 2004, so
generic versions are available.[SUP]
[12]
[/SUP]
Approved and off-label[edit]
Mirtazapine's primary use is the
treatment of
major depressive disorder and other
mood disorders.[SUP]
[13][14][/SUP]
However, it has also been found useful in alleviating the following conditions and is sometimes prescribed off-label for their treatment:
Effectiveness and tolerability[edit]
In 2010
NICE published a guideline for treating depression that included a review of antidepressants. It recommended generic
SSRIs as first line choices, as they are "equally effective as other antidepressants and have a favourable risk–benefit ratio."[SUP]
[29][/SUP] With respect to mirtazapine, it found: "There is no difference between mirtazapine and other antidepressants on any efficacy measure, although in terms of achieving remission mirtazapine appears to have a statistical though not clinical advantage. In addition, mirtazapine has a statistical advantage over SSRIs in terms of reducing symptoms of depression, but the difference is not clinically important. However, there is strong evidence that patients taking mirtazapine are less likely to leave treatment early because of side effects, although this is not the case for patients reporting side effects or leaving treatment early for any reason."[SUP]
[30][/SUP]
A 2011 Cochrane review that compared mirtazapine to other antidepressants, found that while it appears to have a faster onset in people for whom it works (measured at 2 weeks), it is about the same as other antidepressants at 6 weeks.[SUP]
[31][/SUP]
A 2012 review focused on antidepressants and sleep found that in many people with sleep disorders caused by depression, mirtazapine reduces the time it takes to fall asleep and increases the quality of sleep, but that in some people it can disturb sleep, causing
restless leg syndrome in 8 to 28% of people, and in rare cases causes
REM sleep behavior disorder.[SUP]
[32][/SUP]
A 2018 systematic review and network meta-analysis comparing the efficacy and acceptability of 21 antidepressant drugs showed mirtazapine to be one of the most effective antidepressants in head-to-head studies.[SUP]
[33][/SUP]
In general, all antidepressants, including mirtazapine, require at least a week for their therapeutic benefits on depressive and anxious symptoms to become apparent.[SUP]
[34][35][/SUP]
Side effects[edit]
A 2011 Cochrane review found that compared with other antidepressants, it is more likely to cause weight gain and sleepiness, but it is less likely to cause tremor than tricyclic antidepressants, and less likely to cause nausea and sexual dysfunction than SSRIs.[SUP]
[31][/SUP]
Very common (≥10% incidence) adverse effects include constipation, dry mouth, sleepiness, increased appetite and weight gain.[SUP]
[4][/SUP][SUP]
[5][/SUP][SUP]
[6][/SUP][SUP]
[36][/SUP][SUP]
[37][/SUP][SUP]
[38][/SUP][SUP]
[39][/SUP][SUP]
[40][41][/SUP]
Common (1–10% incidence) adverse effects include weakness, confusion, dizziness,
peripheral edema, and negative lab results like
elevated transaminases, elevated serum
triglycerides, and elevated total
cholesterol.[SUP]
[6][/SUP]
Mirtazapine is not considered to have a risk of many of the side effects often associated with other antidepressants like the SSRIs, and may actually improve certain ones when taken in conjunction with them.[SUP]
[7][/SUP][SUP]
[42][/SUP] (Those adverse effects include
decreased appetite,
weight loss,
insomnia,
nausea and
vomiting,
diarrhoea,
urinary retention, increased
body temperature,
excessive sweating,
pupil dilation and
sexual dysfunction.[SUP]
[7][/SUP][SUP]
[42][/SUP])
In general, some antidepressants, especially SSRIs, can paradoxically exacerbate some peoples' depression or anxiety or cause
suicidal ideation.[SUP]
[43][/SUP] Despite its sedating action, mirtazapine is also believed to be capable of this, so in the United States and certain other countries, it carries a
black box label warning of these potential effects.
A case report published in 2000 noted an instance in which mirtazapine counteracted the action of
clonidine, causing a dangerous rise in blood pressure.[SUP]
[44][/SUP]
Discontinuation[edit]
Mirtazapine and other antidepressants may cause a
discontinuation syndrome upon cessation.[SUP]
[7][/SUP][SUP]
[45][/SUP][SUP]
[46][/SUP] A gradual and slow reduction in dose is recommended to minimize discontinuation symptoms.[SUP]
[47][/SUP] Effects of sudden cessation of treatment with mirtazapine may include depression,
anxiety,
panic attacks,
vertigo,
restlessness,
irritability,
decreased appetite,
insomnia,
diarrhea,
nausea,
vomiting,
flu-like symptoms such as
allergies and
pruritus,
headaches and sometimes
hypomania or
mania.[SUP]
[45][/SUP][SUP]
[48][/SUP][SUP]
[49][/SUP][SUP]
[50][51][/SUP]
Overdose[edit]
Mirtazapine is considered to be relatively safe in the event of an
overdose,[SUP]
[35][/SUP] although it is considered slightly more toxic in overdose than most of the SSRIs (except
citalopram).[SUP]
[52][/SUP] Unlike the tricyclic antidepressants, mirtazapine showed no significant
cardiovascularadverse effects at 7 to 22 times the maximum recommended dose.[SUP]
[42][/SUP] Case reports of overdose with as much as 30 to 50 times the standard dose described the drug as relatively nontoxic, compared to tricyclic antidepressants.[SUP]
[53][54][/SUP]
Twelve reported fatalities have been attributed to mirtazapine overdose.[SUP]
[55][/SUP][SUP]
[56][/SUP] The fatal toxicity index (deaths per million prescriptions) for mirtazapine is 3.1 (95% CI: 0.1 to 17.2). This is similar to that observed with SSRIs.[SUP]
[57][/SUP]
Interactions[edit]
Concurrent use with inhibitors or inducers of the
cytochrome (CYP) P450isoenzymesCYP1A2,
CYP2D6, and/or
CYP3A4 can result in altered concentrations of mirtazapine, as these are the main
enzymes responsible for its metabolism.[SUP]
[3][/SUP][SUP]
[7][/SUP] As examples,
fluoxetine and
paroxetine, inhibitors of these enzymes, are known to modestly increase mirtazapine levels, while
carbamazepine, an inducer, considerably decreases them.[SUP]
[3][/SUP]
Liver and moderate
renal impairment have been reported to decrease the oral clearance of mirtazapine by about 30%; severe renal impairment decreases it by 50%.[SUP]
[3][/SUP]
According to information from the manufacturers, mirtazapine should not be started within two weeks of any
monoamine oxidase inhibitor (MAOI) usage; likewise, MAOIs should not be administered within two weeks of discontinuing mirtazapine.[SUP]
[58][/SUP] Mirtazapine in combination with an SSRI, SNRI, or TCA as an
augmentation strategy is considered to be relatively safe and is often employed therapeutically,[SUP]
[42][/SUP] with a combination of
venlafaxine and mirtazapine, sometimes referred to as "California rocket fuel".[SUP]
[59][60][/SUP]
Pharmacology[edit]
Pharmacodynamics[edit]
See also: Pharmacology of antidepressants and Tetracyclic antidepressant § Pharmacology
| Site | K[SUB]i[/SUB] (nM) | Species | Ref |
|---|
| SERT | >10,000 | Human | [SUP][62][/SUP][SUP][63][/SUP] |
| NET | ≥4,600 | Human | [SUP][10][/SUP][SUP][62][/SUP] |
| DAT | >10,000 | Human | [SUP][62][/SUP][SUP][63][/SUP] |
| 5-HT[SUB]1A[/SUB] | 3,330–5,010 | Human | [SUP][63][/SUP][SUP][7][/SUP] |
| 5-HT[SUB]1B[/SUB] | 3,534–12,600 | Human | [SUP][63][/SUP][SUP][7][/SUP] |
| 5-HT[SUB]1D[/SUB] | 794–5,010 | Human | [SUP][63][/SUP][SUP][7][/SUP] |
| 5-HT[SUB]1E[/SUB] | 728 | Human | [SUP][63][/SUP] |
| 5-HT[SUB]1F[/SUB] | 583 | Human | [SUP][63][/SUP] |
| 5-HT[SUB]2A[/SUB] | 6.3–69 | Human | [SUP][7][/SUP][SUP][64][/SUP][SUP][63][/SUP] |
| 5-HT[SUB]2B[/SUB] | 200 | Human | [SUP][7][/SUP] |
| 5-HT[SUB]2C[/SUB] | 8.9–39 | Human | [SUP][64][/SUP][SUP][7][/SUP][SUP][63][/SUP] |
| 5-HT[SUB]3[/SUB] | 7.9 | Human | [SUP][7][/SUP] |
| 5-HT[SUB]4L[/SUB] | >10,000 | Human | [SUP][63][/SUP] |
| 5-HT[SUB]5A[/SUB] | 670 | Human | [SUP][63][/SUP] |
| 5-HT[SUB]6[/SUB] | ND | ND | ND[SUP][63][/SUP] |
| 5-HT[SUB]7[/SUB] | 265 | Human | [SUP][64][/SUP][SUP][63][/SUP] |
| α[SUB]1A[/SUB] | 316–1,815 | Human | [SUP][63][/SUP][SUP][63][/SUP] |
| α[SUB]2A[/SUB] | 20 | Human | [SUP][64][/SUP][SUP][63][/SUP] |
| α[SUB]2B[/SUB] | 88 | Human | [SUP][63][/SUP] |
| α[SUB]2C[/SUB] | 18 | Human | [SUP][64][/SUP][SUP][63][/SUP] |
| β | >10,000 | Human | [SUP][63][/SUP] |
| D[SUB]1[/SUB] | 4,167 | Rat | [SUP][64][/SUP] |
| D[SUB]2[/SUB] | >5,454 | Human | [SUP][64][/SUP][SUP][63][/SUP] |
| D[SUB]3[/SUB] | 5,723 | Human | [SUP][64][/SUP][SUP][63][/SUP] |
| D[SUB]4[/SUB] | 2,518 | Human | [SUP][63][/SUP] |
| H[SUB]1[/SUB] | 0.14–1.6 | Human | [SUP][65][/SUP][SUP][64][/SUP][SUP][7][/SUP][SUP][63][/SUP] |
| H[SUB]2[/SUB] | >10,000 | Rat | [SUP][66][/SUP][SUP][65][/SUP] |
| H[SUB]3[/SUB] | 83,200 | Human | [SUP][65][/SUP] |
| H[SUB]4[/SUB] | >100,000 | Human | [SUP][65][/SUP] |
| mACh | 670 | Human | [SUP][7][/SUP][SUP][10][/SUP] |
| VGSC | 6,905 | Rat | [SUP][63][/SUP] |
| VDCC | >10,000 | Rat | [SUP][63][/SUP] |
| Values are K[SUB]i[/SUB] (nM). The smaller the value, the more strongly the drug binds to the site. | | | |
Mirtazapine has
antihistamine,
α[SUB]2[/SUB]-blocker, and
antiserotonergic activity.[SUP]
[7][/SUP][SUP]
[67][/SUP] It is specifically a potent
antagonist or
inverse agonist of the
α[SUB]2A[/SUB]-,
α[SUB]2B[/SUB]-, and
α[SUB]2C[/SUB]-adrenergic receptors, the
serotonin5-HT[SUB]2A[/SUB],
5-HT[SUB]2C[/SUB], and
5-HT[SUB]3[/SUB]receptors, and the
histamineH[SUB]1[/SUB] receptor.[SUP]
[7][/SUP][SUP]
[67][/SUP] Unlike many other antidepressants, it does not
inhibit the
reuptake of
serotonin,
norepinephrine, or
dopamine,[SUP]
[7][/SUP][SUP]
[67][/SUP] nor does it inhibit
monoamine oxidase.[SUP]
[68][/SUP] Similarly, mirtazapine has weak or no activity as an
anticholinergic or
blocker of
sodium or
calcium channels, in contrast to most TCAs.[SUP]
[7][/SUP][SUP]
[67][/SUP][SUP]
[63][/SUP] In accordance, it has better
tolerability and low
toxicity in
overdose.[SUP]
[7][/SUP][SUP]
[69][/SUP] As an H[SUB]1[/SUB] receptor antagonist, mirtazapine is extremely potent, and is in fact the most potent of all the TCAs and TeCAs.[SUP]
[10][/SUP][SUP]
[70][/SUP][SUP]
[71][/SUP] Antagonism of the H[SUB]1[/SUB] receptor is by far the strongest activity of mirtazapine, with the drug acting as a selective H[SUB]1[/SUB]receptor antagonist at low concentrations.[SUP]
[7][63][/SUP]
The (
S)-(+) enantiomer of mirtazapine is responsible for antagonism of the serotonin 5-HT[SUB]2A[/SUB] and 5-HT[SUB]2C[/SUB] receptors,[SUP]
[11][/SUP] while the (
R)-(–) enantiomer is responsible for antagonism of the 5-HT[SUB]3[/SUB] receptor.[SUP]
[11][/SUP] Both enantiomers are involved in antagonism of the H[SUB]1[/SUB] and α[SUB]2[/SUB]-adrenergic receptors,[SUP]
[11][/SUP][SUP]
[5][/SUP] although the (
S)-(+) enantiomer is the stronger antihistamine.[SUP]
[72][/SUP]
Although not clinically relevant, mirtazapine has been found to act as a
partial agonist of the
κ-opioid receptor at high concentrations (
EC[SUB]50[/SUB] = 7.2 μM).[SUP]
[73][/SUP]
α[SUB]2[/SUB]-Adrenergic receptor[edit]
Antagonism of the α[SUB]2[/SUB]-adrenergic receptors, which function largely as
inhibitoryautoreceptors and
heteroreceptors, enhances
adrenergic and
serotonergicneurotransmission, notably
central5-HT[SUB]1A[/SUB] receptor mediated transmission in the
dorsal raphe nucleus and
hippocampus; hence, mirtazapine's classification as a NaSSA. Indirect α[SUB]1[/SUB] adrenoceptor-mediated enhancement of serotonin cell firing and direct blockade of inhibitory α[SUB]2[/SUB]heteroreceptors located on serotonin terminals are held responsible for the increase in extracellular serotonin.[SUP]
[7][/SUP][SUP]
[13][/SUP][SUP]
[74][/SUP][SUP]
[75][/SUP][SUP]
[76][/SUP] Because of this, mirtazapine has been said to be a functional "
indirect agonist" of the 5-HT[SUB]1A[/SUB]receptor.[SUP]
[75][/SUP] Increased activation of the central 5-HT[SUB]1A[/SUB] receptor is thought to be a major mediator of efficacy of most antidepressant drugs.[SUP]
[77][/SUP]
5-HT[SUB]2[/SUB] and 5-HT[SUB]3[/SUB] receptors[edit]
Antagonism of the 5-HT[SUB]2[/SUB] subfamily of receptors and inverse agonism of the 5-HT[SUB]2C[/SUB] receptor appears to be in part responsible for mirtazapine's efficacy in the treatment of depressive states.[SUP]
[78][/SUP][SUP]
[79][/SUP] Mirtazapine increases dopamine release in the prefrontal cortex.[SUP]
[80][/SUP][SUP]
[81][/SUP] Accordingly, it was shown that by blocking the α[SUB]2[/SUB]-adrenergic receptors and 5-HT[SUB]2C[/SUB] receptors mirtazapine disinhibited dopamine and norepinephrine activity in these areas in rats.[SUP]
[82][/SUP] In addition, mirtazapine's antagonism of 5-HT[SUB]2A[/SUB] receptors has beneficial effects on
anxiety,
sleep and
appetite, as well as sexual function regarding the latter receptor.[SUP]
[7][/SUP][SUP]
[42][/SUP] Mirtazapine has been shown to lower drug seeking behaviour in various human and animal studies.[SUP]
[83][/SUP][SUP]
[84][/SUP][SUP]
[85][/SUP] It is also being investigated in substance abuse disorders to reduce withdrawal effects and improve remission rates.[SUP]
[83][/SUP][SUP]
[86][/SUP][SUP]
[87][88][/SUP]
Antagonism of the 5-HT[SUB]3[/SUB] receptor, an action mirtazapine shares with the approved antiemetic
ondansetron, significantly improves pre-existing symptoms of nausea, vomiting, diarrhea, and
irritable bowel syndrome in afflicted individuals.[SUP]
[89][/SUP] Mirtazapine may be used as an inexpensive antiemetic alternative to ondansetron.[SUP]
[24][/SUP] Blockade of the 5-HT[SUB]3[/SUB] receptors has also shown to improve anxiety and to be effective in the treatment of
drug addiction in several studies.[SUP]
[90][/SUP] In conjunction with
substance abuse counseling, mirtazapine has been investigated for the purpose of reducing
methamphetamine use in dependent individuals with success.[SUP]
[84][/SUP] In contrast to mirtazapine, the SSRIs, SNRIs, MAOIs, and some TCAs increase the general activity of the 5-HT[SUB]2A[/SUB], 5-HT[SUB]2C[/SUB], and 5-HT[SUB]3[/SUB] receptors leading to a host of negative changes and side effects, the most prominent of which including anorexia, insomnia, sexual dysfunction (loss of
libido and
anorgasmia), nausea, and diarrhea, among others. As a result, it is often combined with these drugs to reduce their side-effect profile and to produce a stronger antidepressant effect.
Mirtazapine does not have
serotonergic activity and does not cause serotonergic side effects or
serotonin syndrome. This is in accordance with the fact that it is not a
serotonin reuptake inhibitor or MAOI, nor a
serotonin receptor agonist.[SUP]
[9][/SUP][SUP]
[92][/SUP] There are no reports of serotonin syndrome in association with mirtazapine alone, and mirtazapine has not been found to cause serotonin syndrome in overdose.[SUP]
[9][/SUP][SUP]
[92][/SUP][SUP]
[93][/SUP] However, there are a handful of
case reports of serotonin syndrome occurring with mirtazapine in combination with serotonergic drugs like SSRIs, although such reports are unusual, very rare, and do not necessarily implicate mirtazapine as causative.[SUP]
[9][/SUP][SUP]
[94][/SUP][SUP]
[95][/SUP][SUP]
[96][/SUP][SUP]
[97][/SUP][SUP]
[98][/SUP] The addition of mirtazapine to an MAOI does not cause serotonin syndrome, and has been considered to be a safe combination.[SUP]
[9][/SUP][SUP]
[92][/SUP] Moreover, mirtazapine may actually be useful in the treatment of serotonin syndrome, with at least one publication finding it to be effective in resolving the syndrome.[SUP]
[9][/SUP][SUP]
[99][/SUP][SUP]
[100][/SUP] This is in accordance with the fact that the 5-HT[SUB]2A[/SUB] receptor is the predominant serotonin receptor thought to be involved in the
pathophysiology of serotonin syndrome (with the 1A[/SUB] receptor seeming to be protective). Mirtazapine is a potent 5-HT receptor antagonist, and
cyproheptadine, a drug that shares this property, mediates recovery from serotonin syndrome and is well-established clinically as an
antidote against it.
Mirtazapine is a very strong H[SUB]1[/SUB] receptor inverse agonist and, as a result, it can cause powerful
sedative and
hypnotic effects.[SUP]
[7][/SUP] A single 15 mg dose of mirtazapine to healthy volunteers has been found to result in over 80% occupancy of the H[SUB]1[/SUB] receptor and to induce intense sleepiness.[SUP]
[72][/SUP] After a short period of chronic treatment, however, the H[SUB]1[/SUB] receptor tends to
desensitize and the antihistamine effects become more tolerable. Many patients may also dose at night to avoid the effects, and this appears to be an effective strategy for combating them. Blockade of the H[SUB]1[/SUB] receptor may improve pre-existing
allergies,
pruritus, nausea, and insomnia in afflicted individuals. It may also contribute to weight gain, however. In contrast to the H[SUB]1[/SUB] receptor, mirtazapine has only low affinity for the
muscarinic acetylcholine receptors, although anticholinergic side effects like dry mouth, constipation, and mydriasis are still sometimes seen in clinical practice.[SUP]
[102][/SUP]
Pharmacokinetics[edit]
The
oralbioavailability of mirtazapine is about 50%. It is found mostly
bound to
plasma proteins, about 85%. It is
metabolized primarily in the
liver by
demethylation and
hydroxylation via
cytochrome P450enzymes. One of its major
metabolites is desmethylmirtazapine. The overall elimination half-life is 20–40 hours. About 15% is
eliminated in
feces and 75% in
urine.[SUP]
[103]:430[/SUP]
History[edit]
Mirtazapine was first synthesized at
Organon and published in 1989, was first approved for use in major depressive disorder in the Netherlands in 1994, and was introduced in the United States in 1996 under the brand name Remeron.[SUP]
[103][/SUP][SUP]:429[/SUP][SUP]
[104][105][/SUP]
Society and culture[edit]
A 15 mg tablet of generic mirtazapine.
Generic names[edit]
Mirtazapine is the
English and
Frenchgeneric name of the drug and its INN, USAN, USP, BAN, DCF, and JAN.[SUP]
[1][/SUP][SUP]
[2][/SUP][SUP]
[106][/SUP] Its generic name in
Spanish is
mirtazapina, in
German is
Mirtazapin, and in
Latin is
mirtazapinum.[SUP]
[1][2][/SUP]
Brand names[edit]
Mirtazapine is marketed under many brand names worldwide, including Adco-Mirteron, Afloyan, Amirel, Arintapin Smelt, Avanza, Azapin, Beron, Bilanz, Calixta, Ciblex, Combar, Comenter, Depreram, Divaril, Esprital, Maz, Menelat, Mepirzapine, Merdaten, Meronin, Mi Er Ning, Milivin, Minelza, Minivane, Mirastad, Mirazep, Miro, Miron, Mirrador, Mirt, Mirta, Mirtabene, Mirtadepi, Mirtagamma, Mirtagen, Mirtalan, Mirtamor, Mirtamylan, Mirtan, Mirtaneo, Mirtapax, Mirtapil, Mirtapine, Mirtaron, Mirtastad, Mirtax, Mirtaz, Mirtazap, Mirtazapin, Mirtazapina, Mirtazapine, Mirtazapinum, Mirtazelon, Mirtazon, Mirtazonal, Mirtel, Mirtimash, Mirtin, Mirtine, Mirzapine, Mirzaten, Mirzest, Mitaprex, Mitaxind, Mitocent, Mitrazin, Mizapin, Motofen, Mytra, Norset, Noxibel, Pharmataz, Promyrtil, Ramure, Redepra, Reflex, Remergil, Remergon, Remeron, Remirta, Rexer, Saxib, Sinmaron, Smilon, Tazepin, Tazimed, Tetrazic, Tifona, U-Mirtaron, U-zepine, Valdren, Vastat, Velorin, Yarocen, Zania, Zapex, Zestat, Zismirt, Zispin, Zuleptan, and Zulin.[SUP]
[2][/SUP]
Chemistry[edit]
Mirtazapine is a
tetracyclic piperazinoazepine;
mianserin was developed by the same team of organic chemists and mirtazapine differs from it via addition of a nitrogen atom in one of the rings.[SUP]
[103][/SUP][SUP]:429[/SUP][SUP]
[107][/SUP][SUP]
[108][/SUP] It is a
racemic mixture of
enantiomers. The (
S)-(+)-enantiomer is known as
esmirtazapine.
Analogues of mirtazapine include mianserin,
setiptiline, and
aptazapine.
Synthesis[edit]
A
chemical synthesis of mirtazapine has been published.[SUP]
[109][/SUP]
Research[edit]
The use of mirtazapine has been explored in several additional conditions:
Veterinary use[edit]
