The Sound of Evolution
Mirtazapine
Mechanism of action:
Mirtazapine is a noradrenergic and specific serotonergic antidepressant. Mirtazapine blocks central α₂ autoreceptors and heteroreceptors. α₂ autoreceptors normally inhibit norepinephrine release, whereas α₂ heteroreceptors inhibit serotonin (5-HT) release. By blocking these α₂ receptors, mirtazapine increases the release of both norepinephrine and serotonin. In addition, mirtazapine also blocks 5-HT₂ and 5-HT₃ receptors, shifting serotonergic activity toward the 5-HT₁A receptor.
Reference(s):
1. Gillman PK et al. (2006). A systematic review of the serotonergic effects of mirtazapine in humans: implications for its dual action status. Hum Psychopharmacol.
2. Burrows GD et al. (1997). Mirtazapine: clinical advantages in the treatment of depression. J Clin Psychopharmacol.
3. Velazquez C et al. (2001). Relative safety of mirtazapine overdose. Vet Hum Toxicol.