Drug info - Mirtazapine Drug Info

Discussion in 'Antidepressants' started by fehs, Mar 2, 2012.

  1. fehs

    fehs Silver Member

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    I can't believe there isn't an actual mirtazapine drug info thread yet, so I think it's about time to make one.

    Can anyone add information about:
    • names / synonyms
    • molecule
    • dose
    • duration
    side effects
    • legal status
    • have there been any reported incidents with this compound?
    • stability of the molecule / compound

    Name: Mirtazapine

    General description: First introduced by Organon International in the United States in 1990 for the treatment of depression, Mirtazapine (brand names include at least Remeron) is a tetracyclic antidepressant (TeCA). It's also used for its antiemetic (anti-nausea), appetite raising and strong hypnotic properties, and for the treatment of anxiety among other indications. Mirtazapine is one of the few noradrenergic and specific serotonergic antidepressants (NaSSas) among with its close analogues mianserin and setiptiline. Esmirtazapine, the (S)-(+)-enantiomer of mirtazapine, is currently under development for the treatment of insomnia and menopausal symptoms by the same company that produced mirtazapine.
    [​IMG]Synonyms: Mirtazapin, "Mirtsari" in finnish (roughly equivalent to "Mirzie" or "Mirzy" in english)

    Formula: C17H19N3 (the same molecular formula (molar mass 265.35g/mol) is shared with Acridine orange and Antazoline)

    Systematic (IUPAC) name: (±)-1,2,3,4,10,14b-hexahydro-2-[11C]methylpyrazino(2,1-a)pyrido(2,3-c)(2)benzazepine

    Dosage: Initially often started as 15 mg orally once per day before sleep, then raised to maintenance dose which is usually 15-45 mg per day. More than 45 mg is very rarely prescribed. Paradoxically, the hypnotic effect does not get stronger when dose is raised, quite the opposite actually. According to large amount of experience reports, subjective of course, 15-30 mg is enough to achieve the maximum hypnotic effect, while an increase to 45 mg does not add anything to that aspect. On the other hand, for antidepressant purposes 15 mg is often considered too low and 30-45 mg is favored.

    Half-life: 20-40 hours according to a popular online encyclopedia. Another, (even) more unreliable source claims an average of 37 hours for females and 26 hours for males. The (−) enantiomer half-life is about twice as long as the (+) enantiomer.

    Duration: It takes about 45 minutes orally for the hypnotic effect to kick in and peak, making the subject usually fall asleep. If one fights against the tiredness, it takes a couple, perhaps 3-4 hours for one to feel back on baseline again.

    Bioavailability: 50% (orally)

    Interactions and combinations: According to the official prescription information, mirtazapine should not be started within two weeks of any MAOI usage and Vice Versa; MAOI's shouldn't be taken within two weeks of mirtazapine use. However, there is one study which reported that it actually does NOT result in any serotonin-related toxicity. Another report actually suggests that mirtazapine can be used to treat serotonin syndrome.

    The amount of mirtazapine in your system may be heightened or lowered by concurrent usage of CYP1A2, CYP2D6, or CYP3A4 -inhibitors or inducers, respectively.

    Mirtazapine in often therapeutically combined with an SSRI, SNRI or a TCA as an augmentation strategy and is said to be a safe practice. A combination of venlafaxine and mirtazapine is sometimes referred to as "California rocket fuel".

    One report has described mirtazapine causing hypertension in a clonidine-treated patient.

    Incidents: 12 fatalities have been attributed to mirtazapine overdose in literature. However, the fatal toxicity index (FTI: deaths per million prescriptions) for mirtazapine is only 3.1 (95% CI: 0.1 to 17.2). This is similar to that observed with SSRIs.

    Stability, storage: Store at 59° to 86° F. Protect from light and moisture. Store orally disintegrating tablets in tablet blister and use immediately upon opening tablet blister.


    [Note: Quite some information in this post was taken from Wikipedia (I know...), but other sources as well, and it's all double-checked and rewritten in a nicer (in my personal opinion) way. Part of the info is from my personal 10+ years of experience with the substance.]
     
    Last edited: Mar 4, 2012
  2. chibi curmudgeon

    chibi curmudgeon Gold Digger Gold Member Donating Member

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    Now that you mention it, there isn't a wiki either, and that's kind of where all this info should go. I forget if silver members can add to wiki articles; if not, I'll move this to the mirtazapine wiki and credit you.
     
  3. fehs

    fehs Silver Member

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    Oh, I almost forgot this thread. No, I'm afraid I can not create or edit wiki articles. I would greatly appreciate if you could move it for me.
     
  4. mkultra5979

    mkultra5979 Silver Member

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    Well writen.
    Mirtazapine is an axcellent AD. Sedating, as it should be and working during night. And it helps keeping your feelings off the edge next day also combined with an SSRI at morning. It's a drug with many pros.
     
  5. RecoverySucks

    RecoverySucks Silver Member

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    Im bout to take this for the first time tonight and was kinda worried bout.it voming off a two day A-PVP binge...You think thats ok!!
     
  6. fehs

    fehs Silver Member

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    It's alright, the first few days may be very tiresome but the downer effect balances quite soon after you've taken it for a while (some days, two weeks max maybe, dunno?)

    You'll probably sleep like a baby if you have A-PVP binge just behind you. Don't be surprised though if the first few days are quite annoying and you wake up at evening or so. It'll pass, I promise.

    The hypnotic/downer effects of Mirtazapine seem to have an interesting paradox; many anecdotal reports (and myself) suggest that the less you take the better it knocks you out! Yes, you read it right, 15 mg often makes you sleep better than 45 mg would. Under 7,5 mg is probably a bit too little though.

    What mg are you taking? What's the purpose you've been prescribed them for? If you seek just sleep assistance, a small dose (~7,5 mg - 15 mg) is recommended. For antidepressant purposes bigger doses are used, usually around 30-45 mg per night. In some extreme cases even 120 mg has been used.
     
  7. RecoverySucks

    RecoverySucks Silver Member

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    Only 7.5 mg...i'm ill be fine, they just switch me off risperdal and cogenton to this. They have me on it from when i went to rehab for being highly addicted to MDPV, did the shit everyday for over a year and it drove me crazy...did to trips to the psyche ward and 30 days in rehab...relapes right outta rehab to A-PVP from bout a month...been clean since last july...I been doing drugs since high and alot of them daily...but nothing an i mean nothing grabed like MDPV and A-PVP im bo gonna deny that i dont love it but i just cant fucking control it...don't stop till its gone...and MDPV was so dit cheap for a while a 5-8 a grams i was getting 20 grams a shot....i read in a post once when i started on the gas station cut up bath salt crap that u should NEVER purchase more that u can do in a sitting...and i found out exactly why

    I really went crazy cuz after my first trip to the psyche ward, (went in off a 8 day bindge and came out to 14 outa 20grams left) but they had me start seeing a psyciatrist... And knowing the drugs i was using and daily...go a put me on selexa and buspar...not a good combo...MDPV, selexa and buspar...i washearing voice all the time was insanely paranoid and thought everyone was out to get me and i wanted to kill myself....the dr when i told her, said so stop using drugs...ya tell that to an addict....it seriously took me 4 different Psyche Doctors to get one that actually had knowledge of drugs anc daily use...i was told everything i was experiencing was from MDPV and had noting to do with the selexa and buspar combo...i was diagnose bi-polar and they put me on all this shit in the hospital and didnt think i had a clue about anything and didnt listen to a word i said. (first time, was for suicidal thoughts...they insisted all week that was homicidal and wanted to/almost tried to kill my, parent, then at discharge when my dad cameth dr. Asked him why he thought i wanted to killnand my was just like...what?!?...he wanted to kill himself) walked in to Rehab first day...talked to the Dr...he was well ur definitly not bi-polar and are right bout the drugs also...selexa and buspar combo alone can do that...and u dont MDPV for over a year straight and all of a sudden go nuts when u throw completly opposite chems into the mix...nuf said


    So u think i could get high if i snorted the mirtazapine
     
  8. fehs

    fehs Silver Member

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    Yeah I experimented with IV MDPV a couple years ago too and for me it seemed to have really high potential in causing lots of mental damage... to lots of people. Nasty, nasty stimulant.

    I'm not sure, mirtazapine isn't water soluble though but I'm not 100% sure if that means that you can't snort it, however my insticts say no. Someone correct me please if I'm wrong.
     
  9. out_there

    out_there Titanium Member

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    I certainly wouldn't snort it. I took 30mg orally and it knocked me out for 14 hours. The next day I was vomiting and extremely disoriented. So unless you want an extremely bad and potentially dangerous experience, DO NOT snort mitrazapine.
     
    Last edited: Feb 3, 2013