Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity.It is at least as effective as the older antidepressants for treating mild to severe depression. Although agranulocytosis is the most serious side effect, it is rare (approximately one in 1,000) and usually reversible when the medication is stopped. Many clinicians consider mirtazapine a second-line or even third-line antidepressant, to be used when older antidepressants are not tolerated or are ineffective.Mirtazapine is metabolized in the liver via the P450 cytochrome oxidase pathway, inhibiting cytochromes 2D6, 1A2 and 3A4. Clearance of the drug is diminished in the presence of liver or renal impairment.Therefore, a lower dosage is recommended in elderly patients and those with liver or renal dysfunction.I was actually hoping for a better answer to be true did you notice less sedation on the higher dosage ? It's quite weird your were unemotional as mirtazapine blocks serotonin receptors so it should have let dopamine flow into various areas of the brain and give back emotions . I was on 2 ssri's that persistently desensitized the serotonin receptor even after quitting it so now more serotonin is flowing into various other area's of the brain and so my libido was gone and still is after 2 years ....and also my dopamine is downregulated that gave me ahnedonia (excessive porn and after ejactuation 3 times in a row - everything swtiched off) I am looking to block Most serotonin receptor esp the 5htia , 5ht2c and 5ht2a so that it can get to pre ssri state and let other major transmitter like dopamine flow freely ... For me, 30 mgs actually increased my anxiety so I couldn't use it as a stand alone AD. It's really not all that great as a 5ht antagonist, except on the 5ht1a receptor, probably one of the reasons it made me more anxious.General Bucky Turgeson in the Stanley Kubrick movie, Dr.Strangelove, was mighty proud of his aerial warriors and their B-52s.
I took it 15 mg for a week then moved up to 30 then eventually 45mg.Physicians who are concerned about the risks of elevated lipid levels and agranulocytosis may choose to reserve mirtazapine as a third-line choice.It is particularly useful in patients who experience sexual side effects from other antidepressants. Cost to the patient will be higher, depending on prescription filling fee As with any new drug, mirtazapine's place in the treatment of depression is not yet clear.It enhances central noradrenergic and serotonergic activity by blocking alpha10Mirtazapine is well absorbed without regard to food intake.It demonstrates linear kinetics over its usual dosage range and reaches peak plasma level approximately two hours after an oral dose.11 The elimination half-life is 20 to 40 hours, so a steady state is reached in approximately five days.