Mirtazapine Mechanism of Action

Instructor: April Banks

April has taught a pharmacy technician certification course. She is a Registered Pharmacist and educator who holds a MPH and a Master of Education in Teaching and Learning.

Depression is a serious condition that can greatly affect the life and productivity of those that suffer from it. Treatment is imperative. In this lesson you will learn about mirtazapine, one of the many medications used to treat major depressive disorders.

Are you feeling a little blue? Does studying have you down in the dumps? Everyone feels sad at some point in their lives. It's normal. But some people deal with a more perpetual and serious sadness that requires treatment.


Major Depressive Disorder

There is a distinctive difference between general sadness and a major depressive disorder. According to the Diagnostic and Statistical Manual of Mental Disorders-- aka the psychiatrist's bible, major depressive disorder (MDD) is characterized by an unrelenting feeling of overwhelming sadness that lasts for more than two weeks. To be considered MDD, the dysphoric mood must affect daily functioning and be accompanied by at least five of the following symptoms: changes in appetite, sleep disturbances--difficulty falling asleep or excessive sleeping, increased fatigue, poor concentration, loss of interest in activities that previously produced joy, and suicidal thoughts or attempts at suicide.

According to National Health and Nutrition Survey 2009-2012, 7.8% of Americans 12 years of age and older suffer from depression. Women tend to present with a higher prevalence than men and people below the poverty line experience more episodes of depression than their counterparts.

Treatment of Major Depressive Disorder

Psychotherapy and medication are the mainstays of treatment for clinical depression. Currently, the drug market is saturated with a variety of drugs to treat MDD. These antidepressants, as they are commonly known, differ in structure and side effects, but are similar in their mechanism of action. Mirtazapine, sold under the brand name Remeron, is an antidepressant approved for the treatment of major depressive disorders.

What's happening in the brain of a depressed person?

To better understand how mirtazapine works, it is important to understand the pathophysiology of depression. In other words, we need to know what biologic and or chemical processes are taking place in the body that produce the state of depression. Believe it or not, the exact cause of depression has yet to be determined. However, researchers believe that depression is a brain issue. The dysfunction begins in the brain with chemicals called neurotransmitters. Norepinephrine and serotonin are the two chemicals believed to be involved in the pathophysiology of depression. An imbalance in these chemicals seems to be the culprit. Although questions still remain, a deficiency in the levels of serotonin, norepinephrine and, sometimes, dopamine is widely accepted among mental health medical professionals as the main cause of depression. Consequently, these chemicals are targeted by drugs that are indicated for the treatment of depression.

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