Mirtazapin
Mirtazapin (Remeron, Avanza, Zispin) je noradrenergički i specifični serotonergički antidepresiv (NaSSA) koji je razvila kompanija Organon International u Sjedinjenim Državama 1990. godine. On se prvenstveno koristi za lečenje depresije. On isto takao nalazi primenu kao anksiolitik, hipnotik, antiemetik i stimulant apetita. On je strukturno sličan sa mianserinom, i klasifikuje se kao tetraciklični antidepresant (TeCA).
IUPAC ime | |
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(±)-2-metil-1,2,3,4,10,14b-heksahidropirazino[2,1-a]pirido[2,3-c][2]benzazepin | |
Klinički podaci | |
Prodajno ime | Remeron, Avanza, Zispin |
Drugs.com | Monografija |
MedlinePlus | a697009 |
Kategorija trudnoće |
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Način primene | Oralno |
Pravni status | |
Pravni status |
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Farmakokinetički podaci | |
Bioraspoloživost | 50%[1] |
Vezivanje proteina | 85%[1] |
Metabolizam | Hepatički (CYP1A2, CYP2D6, i CYP3A4)[1][2] |
Poluvreme eliminacije | 20–40 sata[1] |
Izlučivanje | Urin (75%)[1] Izmet (15%)[1] |
Identifikatori | |
CAS broj | 61337-67-5 |
ATC kod | N06AX11 (WHO) |
PubChem | CID 4205 |
DrugBank | DB00370 |
ChemSpider | 4060 |
UNII | A051Q2099Q |
KEGG | D00563 |
ChEBI | CHEBI:6950 |
ChEMBL | CHEMBL654 |
Sinonimi | 6-Azamianserin, Org 3770 |
Hemijski podaci | |
Formula | C17H19N3 |
Molarna masa | 265,35 g/mol |
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Fizički podaci | |
Gustina | 1,22 g/cm3 |
Tačka topljenja | 114 to 116 °C (237 to 241 °F) |
Tačka ključanja | 432 °C (810 °F) |
Rastvorljivost u vodi | Rastvoran u metanolu i hloroformu mg/mL (20 °C) |
Medicinska upotreba
уредиMirtazapin se prvenstveno koristi za tretiranje kliničke depresije i drugih poremećaja raspoloženja.[3][4]
On isto tako može da bude koristan u tretiranju sledećih oboljenja, mada nije odobren za te primene:
- Generalizovani anksiozni poremećaj[2][5]
- Socijalna fobija[6][7]
- Opsesivno-kompulzivni poremećaj[6][8]
- Panični poremećaj[6][9][10]
- Posttraumatski stresni poremećaj[6]
- Anoreksija[11]
- Insomnija[12][13]
- Mučnina/povraćanje[14][15][16]
- Umanjeni apetit/nedovoljna telesna težina[17][18][19]
- Svrabež[20][21]
- Glavobolje i migrena[15][22][23]
Reference
уреди- ^ а б в г д ђ Timmer CJ, Sitsen JM, Delbressine LP (2000). „Clinical pharmacokinetics of mirtazapine”. Clinical Pharmacokinetics. 38 (6): 461—74. PMID 10885584. doi:10.2165/00003088-200038060-00001.[мртва веза]
- ^ а б Anttila SA, Leinonen EV (2001). „A review of the pharmacological and clinical profile of mirtazapine”. CNS Drug Reviews. 7 (3): 249—64. PMID 11607047. doi:10.1111/j.1527-3458.2001.tb00198.x.
- ^ Gorman JM (1999). „Mirtazapine: clinical overview”. J Clin Psychiatry. 60 Suppl 17: 9—13; discussion 46—8. PMID 10446735.
- ^ Benjamin S, Doraiswamy PM (2011). „Review of the use of mirtazapine in the treatment of depression”. Expert Opinion on Pharmacotherapy. 12 (10): 1623—32. PMID 21644844. doi:10.1517/14656566.2011.585459.
- ^ Goodnick PJ, Puig A, DeVane CL, Freund BV (1999). „Mirtazapine in major depression with comorbid generalized anxiety disorder”. J Clin Psychiatry. 60 (7): 446—8. PMID 10453798. doi:10.4088/JCP.v60n0705.
- ^ а б в г Croom KF, Perry CM, Plosker GL (2009). „Mirtazapine: a review of its use in major depression and other psychiatric disorders”. CNS Drugs. 23 (5): 427—52. PMID 19453203. doi:10.2165/00023210-200923050-00006. Архивирано из оригинала 09. 02. 2013. г. Приступљено 18. 08. 2012.
- ^ Muehlbacher M; Nickel MK; Nickel C; et al. (2005). „Mirtazapine treatment of social phobia in women: a randomized, double-blind, placebo-controlled study”. Journal of Clinical Psychopharmacology. 25 (6): 580—3. PMID 16282842. doi:10.1097/01.jcp.0000186871.04984.8d. Архивирано из оригинала 27. 11. 2015. г. Приступљено 18. 08. 2012.
- ^ Koran LM, Quirk T, Lorberbaum JP, Elliott M (2001). „Mirtazapine treatment of obsessive-compulsive disorder”. J Clin Psychopharmacol. 21 (5): 537—9. PMID 11593084. doi:10.1097/00004714-200110000-00016.
- ^ Carpenter LL, Leon Z, Yasmin S, Price LH (1999). „Clinical experience with mirtazapine in the treatment of panic disorder”. Ann Clin Psychiatry. 11 (2): 81—6. PMID 10440525. doi:10.3109/10401239909147053.
- ^ Carli V, Sarchiapone M, Camardese G, Romano L, DeRisio S (2002). „Mirtazapine in the treatment of panic disorder”. Arch. Gen. Psychiatry. 59 (7): 661—2. PMID 12090820. doi:10.1001/archpsyc.59.7.661.
- ^ Hrdlicka M, Beranova I, Zamecnikova R, Urbanek T (2008). „Mirtazapine in the treatment of adolescent anorexia nervosa. Case-control study”. European Child & Adolescent Psychiatry. 17 (3): 187—9. PMID 18357426. doi:10.1007/s00787-007-0670-8.
- ^ Hartmann PM (1999). „Mirtazapine: a newer antidepressant”. Am Fam Physician. 59 (1): 159—61. PMID 9917581.
- ^ Jindal RD (2009). „Insomnia in patients with depression: some pathophysiological and treatment considerations”. CNS Drugs. 23 (4): 309—29. PMID 19374460. Архивирано из оригинала 09. 02. 2013. г. Приступљено 18. 08. 2012.
- ^ Nutt DJ (2002). „Tolerability and safety aspects of mirtazapine”. Human Psychopharmacology. 17 Suppl 1: S37—41. PMID 12404669. doi:10.1002/hup.388.
- ^ а б Li TC, Shiah IS, Sun CJ, Tzang RF, Huang KC, Lee WK (2011). „Mirtazapine relieves post-electroconvulsive therapy headaches and nausea: a case series and review of the literature”. The Journal of ECT. 27 (2): 165—7. PMID 21602639. doi:10.1097/YCT.0b013e3181e63346. Архивирано из оригинала 09. 05. 2013. г. Приступљено 18. 08. 2012.
- ^ Kast RE, Foley KF (2007). „Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects”. Eur J Cancer Care (Engl). 16 (4): 351—4. PMID 17587360. doi:10.1111/j.1365-2354.2006.00760.x.
- ^ Landowski J (2002). „[Mirtazapine--an antidepressant]”. Psychiatria Polska (на језику: Polish). 36 (6 Suppl): 125—30. PMID 12647431.
- ^ Chinuck RS, Fortnum H, Baldwin DR (2007). „Appetite stimulants in cystic fibrosis: a systematic review”. Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association. 20 (6): 526—37. PMID 18001374. doi:10.1111/j.1365-277X.2007.00824.x.
- ^ Davis MP, Khawam E, Pozuelo L, Lagman R (2002). „Management of symptoms associated with advanced cancer: olanzapine and mirtazapine. A World Health Organization project”. Expert Review of Anticancer Therapy. 2 (4): 365—76. PMID 12647979. doi:10.1586/14737140.2.4.365.
- ^ Twycross R; Greaves MW; Handwerker H; et al. (2003). „Itch: scratching more than the surface”. QJM : Monthly Journal of the Association of Physicians. 96 (1): 7—26. PMID 12509645. doi:10.1093/qjmed/hcg002.
- ^ Greaves MW (2005). „Itch in systemic disease: therapeutic options”. Dermatologic Therapy. 18 (4): 323—7. PMID 16297004. doi:10.1111/j.1529-8019.2005.00036.x.
- ^ Colombo B, Annovazzi PO, Comi G (2004). „Therapy of primary headaches: the role of antidepressants”. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 25 Suppl 3: S171—5. PMID 15549531. doi:10.1007/s10072-004-0280-x.
- ^ Tajti J, Almási J (2006). „[Effects of mirtazapine in patients with chronic tension-type headache. Literature review]”. Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület Lapja = Official Journal of the Hungarian Association of Psychopharmacology (на језику: Hungarian). 8 (2): 67—72. PMID 17073214.
Literatura
уреди- Stimmel GL, Dopheide JA, Stahl SM (1997). „Mirtazapine: an antidepressant with noradrenergic and specific serotonergic effects”. Pharmacotherapy. 17 (1): 10—21. PMID 9017762.
- Anttila SA, Leinonen EV (2001). „A review of the pharmacological and clinical profile of mirtazapine”. CNS Drug Rev. 7 (3): 249—64. PMID 11607047. doi:10.1111/j.1527-3458.2001.tb00198.x.