Mirtazapine - Revision history

MDElliottMD: parser-claude: Mirtazapine MedTemplate refill, Top 300 stub upgrade

2026-05-23T06:55:44Z

parser-claude: Mirtazapine MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 06:55, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Mirtazapine		\| generic = Mirtazapine
	\| brand = Remeron		\| brand = Remeron (US brand discontinued; generic widely available), Remeron SolTab (ODT)
	\| structure =		\| structure =
	\| classes = ~~NaSSA~~, Antidepressant, ~~Sedative~~-~~Hypnotic~~		\| classes = [[:Category:Tetracyclic antidepressants\|Tetracyclic antidepressant]], [[:Category:Antidepressants\|Antidepressant]], [[:Category:Sleep aids\|Sleep aid (off-label)]]
	\| ~~mechanism~~ = ~~Alpha~~-~~2 antagonist~~; H1/5-~~HT2~~/5-~~HT3 antagonist~~		\| uses = <vote slug="major-depressive-disorder-use">Major depressive disorder (FDA)</vote>, <vote slug="insomnia-mirtazapine-use">Insomnia adjunct (off-label; particularly with concurrent depression)</vote>, <vote slug="anxiety-adjunct-mirtazapine-use">Anxiety disorder adjunct (off-label)</vote>, <vote slug="chemotherapy-induced-nausea-use">Chemotherapy-induced nausea (off-label)</vote>, <vote slug="appetite-stimulation-cachexia-use">Appetite stimulation in cancer or HIV cachexia (off-label, leveraging weight-gain side effect)</vote>, <vote slug="ptsd-sleep-disturbance-use">PTSD-related sleep disturbance (off-label)</vote>
	\| ~~uses~~ =		\| starting_dose = 15 mg PO at bedtime, titrate to 30-45 mg/day after 1-2 weeks. '''Counterintuitive dose paradox''': lower doses (7.5-15 mg) are more sedating than higher doses because H1 antihistamine effect dominates at low dose
	\| ~~starting_dose~~ =		\| preparations = Tablets 7.5, 15, 30, 45 mg; orally disintegrating tablets (SolTab) 15, 30, 45 mg
	\| ~~preparations~~ =		\| fda_max = 45 mg/day
	\| ~~fda_max~~ =		\| pill_id =
	\| routes =		\| routes = Oral
	\| onset =		\| onset = Sleep effect from first dose; antidepressant effect over 1-4 weeks
	\| duration =		\| duration = 24 hours (HS dosing)
	\| halflife =		\| halflife = 20-40 hours<ref name="remeron-label">FDA Prescribing Information, Remeron (mirtazapine), Organon/Merck, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020415s029,021208s019lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~50% (oral; substantial first-pass)<ref name="remeron-label" />
	~~\| pregnancy~~ =		\| pregnancy = Limited human data; some observational signals reassuring relative to other antidepressants.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="remeron-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="mirtazapine-mech-claim">Atypical antidepressant with a multi-receptor mechanism: central α2-adrenergic autoreceptor antagonism (disinhibiting noradrenergic and serotonergic neuron firing), 5-HT2A and 5-HT2C antagonism (the antidepressant rationale and the side-effect-favorable profile), 5-HT3 antagonism (antiemetic and pro-appetite), and strong H1 antihistamine activity (the sedation and weight-gain mediators). Net effect raises synaptic serotonin and norepinephrine indirectly without reuptake inhibition.</vote> Lacks the sexual dysfunction, discontinuation syndrome, and nausea associated with SSRIs and SNRIs, the principal selling points. Weight gain and sedation are the dose-limiting features. Rare but recognized '''agranulocytosis''' warrants monitoring for sore throat, fever, and infection during the first months of therapy<ref name="remeron-label" />.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	\| ~~interactions~~ = <~~pharmaInteractions~~/>
	~~\| pregnancy_details =~~
	\| monitoring =
	~~\| counseling =~~
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

			[[Category:Tetracyclic antidepressants]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]
	[[Category:~~Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)~~]]		[[Category:Sleep aids]]

MDElliottMD: Comprehensive categorization: +Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)

2026-05-15T18:42:07Z

Comprehensive categorization: +Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Antidepressants]]		[[Category:Antidepressants]]
			[[Category:Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:00Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:42Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:38Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Mirtazapine
+| generic            = Mirtazapine
-| brand             = Remeron
+| brand              = Remeron
-| classes           = NaSSA, Antidepressant, Sedative-Hypnotic
+| structure          =
-| mechanism         = Alpha-2 antagonist; H1/5-HT2/5-HT3 antagonist
+| classes            = NaSSA, Antidepressant, Sedative-Hypnotic
 }}
 [[Category:Antidepressants]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Mirtazapine
| brand = Remeron
| classes = NaSSA, Antidepressant, Sedative-Hypnotic
| mechanism = Alpha-2 antagonist; H1/5-HT2/5-HT3 antagonist
}}
[[Category:Antidepressants]]