The Pharmacologic Rationale for the Clinical Use of Antidepressants

Trond Aarre, M.D.; Otto Benkert, M.D.; Jonathan R. T. Davidson, M.D.; Elias Eriksson, Ph.D.; Siegfried Kasper, M.D.; John Kogeorgos, M.D., M.R.C.Psych; Charlotte Kremer, M.D.; Stuart Montgomery, M.D.; Andrew Nierenberg, M.D.; Philip Ninan, M.D.; Arthur Prange, M.D.; Elliott Richelson, M.D.; Donald C. Dayton, ; Lucy J. Dayton, ; Michael E. Thase, M.D.; Andrew Winokur, M.D., Ph.D.

J Clin Psychiatry 1997;58(11):501-508

Article Abstract

Click to enlarge page

Mirtazapine is the latest in a line of drugs that have recently been introduced for the treatment of depression. It is now available worldwide and has been used in more than 170,000 patients (May 1997). The novelty of this drug over other antidepressants lies particularly in its unique mechanism of action.

Mirtazapine inhibits neither the reuptake of norepinephrine (NE), serotonin (5-HT), or dopamine (DA) nor the activity of monoamine oxidase, thereby clearly being distinguished from the tricyclic antidepressants (TCAs), newer reuptake inhibitors of either serotonin and/or norepinephrine (SSRI/SNRI), and the monoamine oxidase inhibitors (MAOIs).