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Pharmacological principles of antidepressant efficacy
Author(s) -
Schatzberg Alan F.
Publication year - 2002
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.399
Subject(s) - mirtazapine , antidepressant , tricyclic , serotonergic , monoamine neurotransmitter , serotonin , pharmacology , mianserin , onset of action , medicine , reuptake inhibitor , psychology , psychiatry , receptor , anxiety
Abstract Both noradrenaline (NA) and serotonin (5‐HT) appear to be involved in depression. Evidence suggests that dual‐acting antidepressants, i.e. those that affect both monoamine systems, such as tricyclic antidepressants and the noradrenergic and specific serotonergic antidepressant mirtazapine, may have greater efficacy and a faster onset of action than drugs that act on a single monoamine system only, such as the selective serotonin reuptake inhibitors (SSRIs). Cell firing is reduced by SSRIs in the short‐term, but is increased by mirtazapine, probably due to its actions on both NA (via α 2 antagonism) and 5‐HT (via α 1 ‐stimulation by NA). This may help to explain clinical evidence suggesting that mirtazapine has a faster onset of action than the more selective antidepressants. Copyright © 2002 John Wiley & Sons, Ltd.