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Zispin (mirtazapine)

Posted by Martin Wright on July 26, 2003, at 20:27:41

I took zispin (called remeron in other countries) on and off for about 2 years. I found it very effective in managing my depression and insomnia/anxiety but the side effects for me were so unpleasant that I would take it for about 2 weeks and then have to stop. I also found that it worked very quickly. I don't know whether that was because it helped me to sleep or what but it certainly improved my mood.

The downside was this - I would suffer the worst nasal congestion, have a dry mouth, daytime sleepiness, weight gain and after about 2 weeks, flu like symptoms and sore throat.

I do know that mirtazapine is actually very similar chemically to an old tetracyclic antidepressant called mianserin - which had the unfortunate side effect in some users of lowering white blood cell count. Some say that Organon deliberately re-engineered the old off patent mianserin into mirtazapine so that they could re-market it as something new. I have tried mianserin too and can say that the effects for me are almost identical to those of mirtazapine.

Because of the side effects I would find that it was more effective if taken occasionally and that it would help reset my system by a) giving me a good nights sleep and b) relieving some of the anxiety that I had been experiencing. I always found that it improved my mood no end.

More recently I have (upon the suggestion of a psychiatrist) tried a combination of reboxetine and citalopram - this cocktail certainly worked and theoretically should have had the same mood boosting properties as the so called 'dual action' mirtazapine that I had found successful but unworkable due to the side effects. Anything that raises serotonin and noradrenaline levels seems to be doubly effective for me. Unfortunately even reboxetine has side effects - I would suffer painful urine retention and unpleasant anticholinergic side effects like dry mouth and sleepiness.

Would be interested to hear of anyone else who has experienced nasal congestion from mirtazapine (my theory is that since it is a presynaptic alpha-2 antagonist it desensitises response of the airways and nasal passages to adrenaline making them less responsive to adrenaline and therefore effectively constricting the nasal passages) A doctor might phrase this as stimulation of the parasympathetic nervous system. Reboxetine incidentally does completely the opposite and I actually find it a very effective nasal decongestant as well as antidepressant.




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