Mirtazapine in combination

Abstract

Depression is undoubtedly a particularly important disease in terms of personal suffering and death as well as social, family, and economic costs. Pharmacological treatment is a reasonably effective therapeutic approach; however, a delayed therapeutic response and the persistence of depressive symptoms represent serious drawbacks to clinical recovery.

Although the pharmacological action of antidepressants begins a few hours after the start of treatment, an antidepressant response usually takes between 2 and 6 weeks.

The persistence of depressive symptoms after the fi rst 6 weeks of treatment is indicative of a poor prognosis in terms of chronicity and a return to normal social function.

The combination of mirtazapine with other antidepressants may signifi cantly lessen these drawbacks. Its antagonist effect on the presynaptic receptors reduces the latency of the antidepressant response. Moreover, its robust noradrenergic effect enhances the serotoninergic effects of the most common antidepressants. In addition, the side effects of mirtazapine can be partially neutralized by the pharmacodynamic activity of other antidepressants, while mirtazapine can ameliorate the serious adverse effects, such as sexual dysfunction, of other medications.