Mirtazapine oral single dose kinetics in patients with different degrees of renal failure

Bengtsson, Finn; Höglund, Peter; Timmer, C. J.; Hegbrant, Jörgen

doi:10.1002/(sici)1099-1077(199807)13:5<357::aid-hup8>3.0.co;2-k

Cited by 16 publications

(11 citation statements)

References 20 publications

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“…87,89 High clearance values indicate renal tubular secretion. 83,87,89 The elimination rate is strongly affected by CYP2D6 polymorphism. 79,80 Steady state is reached in less than a week.…”

Section: Mirtazapinesupporting

confidence: 85%

“…73,84 Mirtazapine has low affinity for central and peripheral dopaminergic and muscarinic receptors, and high affinity for H 1 receptors. 83,84 Following oral administration, mirtazapine is rapidly absorbed, but the absolute bioavailability is moderate (see Table 2). 73 The drug is nonspecifically and reversibly bound to proteins and possess a high distribution volume.…”

Section: Mirtazapinementioning

confidence: 99%

“…74 Low inhibitory effects of mirtazapine on major CYP isoenzymes were reported in vitro. 83,88 No significant interactions with the CYP2D6 substrates amitriptyline, clozapine, olanzapine, and risperidone were observed. [90][91][92] In contrast, plasma concentrations of mirtazapine were reduced after concomitant administration of the CYP3A4 inducers carbamazepine 87,90 and phenytoin.…”

Section: Mirtazapinementioning

confidence: 99%

“…Moreover, patients should be advised to avoid alcohol while taking mirtazapine. 83,87 The drug is predominantly excreted in the urine and feces. 87,89 The activity is prolonged by the circulation of the parent compound.…”

Section: Mirtazapinementioning

confidence: 99%

“…Mirtazapine exposure in patients with severe or moderate renal insufficiency is increased compared with healthy controls. 83 Although there are no differences in reported adverse effects, 102 the drug should be used with caution in these patients. 84 Gender affects mirtazapine plasma levels, but the changes are not clinically important (see Table 3).…”

mentioning

confidence: 99%

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Getting the balance right: Established and emerging therapies for major depressive disorders

Perović

Jovanović²,

Miljković³

et al. 2010

NDT

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Major depressive disorder (MDD) is a common and serious illness of our times, associated with monoamine deficiency in the brain. Moreover, increased levels of cortisol, possibly caused by stress, may be related to depression. In the treatment of MDD, the use of older antidepressants such as monoamine oxidase inhibitors and tricyclic antidepressants is decreasing rapidly, mainly due to their adverse effect profiles. In contrast, the use of serotonin reuptake inhibitors and newer antidepressants, which have dual modes of action such as inhibition of the serotonin and noradrenaline or dopamine reuptake, is increasing. Novel antidepressants have additive modes of action such as agomelatine, a potent agonist of melatonin receptors. Drugs in development for treatment of MDD include triple reuptake inhibitors, dual-acting serotonin reuptake inhibitors and histamine antagonists, and many more. Newer antidepressants have similar efficacy and in general good tolerability profiles. Nevertheless, compliance with treatment for MDD is poor and may contribute to treatment failure. Despite the broad spectrum of available antidepressants, there are still at least 30% of depressive patients who do not benefit from treatment. Therefore, new approaches in drug development are necessary and, according to current research developments, the future of antidepressant treatment may be promising.

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“…87,89 High clearance values indicate renal tubular secretion. 83,87,89 The elimination rate is strongly affected by CYP2D6 polymorphism. 79,80 Steady state is reached in less than a week.…”

Section: Mirtazapinesupporting

confidence: 85%