Mirtazonal - instructions for use, analogs, reviews and release forms (tablets 15 mg, 30 mg, 45 mg) drug for the treatment of depression, insomnia, increased anxiety in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Mirtazonal. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Mirtazonal in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Mirtazonal in the presence of existing structural analogs. Use for the treatment of depression, insomnia, increased anxiety in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Mirtazonal - is an antidepressant of a four-ring structure with predominantly sedative effect. The drug is most effective in depressive states with symptoms in the clinical picture such as inability to experience pleasure and joy, loss of interest (anhedonia), psychomotor retardation, sleep disorders (especially in the form of early awakenings) and weight loss, as well as other symptoms: suicidal thoughts and daily mood swings. The antidepressant effect of the drug usually comes in 1-2 weeks of treatment. In therapeutic doses, it has no significant effect on the cardiovascular system.

Composition

Mirtazapine + excipients.

Pharmacokinetics

Mirtazapine after oral administration is rapidly absorbed from the digestive tract. Bioavailability is 50%. The maximum concentration in the blood plasma is reached after 2 hours. The steady-state concentration of the substance in the blood plasma is established after 3-4 days of constant reception. Binding to plasma proteins is 85%.

Actively metabolized in the liver by demethylation and oxidation followed by conjugation.Dimethyl-mirtazapine is also pharmacologically active, as is the starting material. Mirtazapine is excreted by the kidneys and through the intestines. The half-life is 20-40 hours. With renal and hepatic insufficiency, a decrease in the clearance of mirtazapine is possible.

Indications

• anhedonia (loss of interest);
• psychomotor retardation;
• insomnia;
• early awakening;
• decreased body weight;
• loss of interest in life;
• suicidal thoughts;
• mood lability;
• other depressive states.

Forms of release

Tablets coated with 15 mg, 30 mg and 45 mg.

Instructions for use and dosing regimen

When administered orally, the effective dose for adults is 15-45 mg per day, preferably 1 time per day before bedtime. The dose is gradually increased to 30-45 mg per day. The antidepressant effect develops gradually, usually 2-3 weeks after the start of treatment, but the reception should be continued for another 4-6 months. If the therapeutic effect is not observed within 6-8 weeks, treatment should be discontinued.

Side effect

• drowsiness;
• retardation;
• emotional lability (instability of mood);
• changes in mentality;
• agitation (excited state);
• anxiety;
• apathy;
• hallucinations;
• depersonalization (self-perception disorder);
• hostility;
• mania;
• epileptic seizures;
• dizziness;
• hyperesthesia (hypersensitivity to irritants acting on the sensory organs);
• convulsions;
• tremor;
• myoclonus (sudden muscle contractions);
• hyperkinesis (involuntary movements of muscles);
• hypokinesia (insufficient motor activity);
• orthostatic hypotension;
• various disorders of hematopoiesis;
• increased appetite and weight gain;
• edema;
• nausea, vomiting;
• constipation;
• dry mouth;
• thirst;
• stomach ache;
• decreased potency;
• dysmenorrhea (painful menstruation);
• skin rashes;
• hives;
• influenza-like syndrome;
• suffocation;
• Myalgia (pain in the muscles);
• back pain;
• dysuria (urination disorders).

Contraindications

• renal and hepatic impairment;
• pregnancy, lactation;
• hypersensitivity to mirtazapine.

Application in pregnancy and lactation

Mirtazonal is contraindicated in pregnancy and lactation.

Use in children

Mirtazapine is not used in children due to the lack of data on the efficacy and safety of its use in pediatric practice.

special instructions

They are used with caution in patients with epilepsy and organic brain lesions, with impaired liver or kidney function, with acute cardiovascular diseases, with arterial hypotension, with urinary disorders due to benign prostatic hyperplasia, with closed-angle glaucoma, and diabetes mellitus.

In patients with schizophrenia, mirtazapine may cause increased delirium, hallucinations. In the treatment of the depressive phase of manic-depressive psychosis, this condition can go into a manic phase.

Sudden withdrawal of Mirtazonal after long-term treatment can cause nausea, headache, deterioration of well-being.

It should be borne in mind that when symptoms such as fever, sore throat, and stomatitis appear during treatment, it should be stopped and a clinical blood test done. When jaundice occurs, mirtazapine should be discontinued.

Do not use simultaneously with MAO inhibitors and within 2 weeks after they are discontinued.Perhaps the development of drug dependence, withdrawal syndrome. During treatment, patients should refrain from drinking alcohol.

Impact on the ability to drive vehicles and manage mechanisms

Use with caution in patients whose activities are associated with the need for high concentration of attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous use of Mirtazonal increases the sedative effect of benzodiazepine derivatives. A case of development of a hypertensive crisis with simultaneous application with clonidine is described.

With simultaneous use with levodopa, a case of severe psychosis is described; with sertraline - a case of development of hypomania. With simultaneous use with ethanol (alcohol), it is possible to increase the inhibitory effect on the CNS of ethanol (alcohol) and ethanol-containing drugs.

Analogues of the drug Mirtazonal

Structural analogs for the active substance:

• Kaliksta;
• Mirzaten;
• Mirtazapine;
• Mirtalan;
• Noxibel;
• Remeron.

Analogues for the pharmacological group (antidepressants):

• Agomelatine;
• Adress;
• Azafen;
• Azona:
• Aktaparoxetine;
• Alventa;
• Aleval;
• Amizole;
• Amirol;
• Amitriptyline;
• Anaphranil;
• Asentra;
• Aurorix;
• Brintellix;
• Valdoxane;
• Velaxin;
• Velafax;
• Venlaksor;
• Venlafaxine;
• Vokssel;
• Gelarium;
• Heparett;
• Heptor;
• Heptral;
• Daplex;
• Depres;
• Depenone;
• Deprefalt;
• Deprim;
• Duloxent;
• Zoloft;
• Ixelles;
• Clominal;
• Clomipramine;
• Clofranil;
• Coaxyl;
• Lenuksin;
• Lerivon;
• Maprotiline;
• Melipramine;
• Miansan;
• Miracitol;
• Neuroplant;
• Newvelong;
• Oprah;
• Paxil;
• Paroxetine;
• Pirazidol;
• Portal;
• Prozac;
• Profluzak;
• Rexetin;
• Saroten;
• Selektra;
• Sirleft;
• The Siozam;
• Sierestill;
• Stimuloton;
• Triptysole;
• Févarine;
• Floxet;
• Fluval;
• Fluxonil;
• Flunisan;
• Fluoxetine;
• Framex;
• Cipralex;
• Cipramyl;
• The citalift;
• Citalopram;
• Elivel;
• Escitalopram;
• Ephevelone.

Doctor therapist's comment

Mirtazonal is an effective antidepressant. Assign it to patients with various depressive and depressive-anxiety disorders. Especially good is the drug for insomnia and other sleep disorders, for example, with early awakenings. Mirtazonal is effective for treating patients with suicidal thoughts, mood lability, loss of interest in life. The course of treatment to achieve the desired therapeutic effect will take a long time.The medicine is characterized by a large number of dangerous side reactions, so the therapy is carried out under medical supervision.

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