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Re: Mirtazapine worked so well for me,but liver issues

Posted by undopaminergic on July 3, 2021, at 3:37:35

In reply to Mirtazapine worked so well for me,but liver issues, posted by TriedEveryMedication on July 2, 2021, at 10:01:49

> My pdoc thinks it was maybe the 5-HT2C action what was helpful. I looked for other drugs that are antagonists for this and couldn't find much. Mianserin is very similar to mirtazapine and probably has the same liver issues.
> So anyway, my questions:
> Do you think my psych is right that the 5-HT2C action in MIRT is what is helpful?

In my view, it is not unlikely, because serotonin 5-HT2C antagonism enhances dopamine release.

> And if so, are there any alternatives that might be more liver friendly?

Asenapine may be the strongest 5-HT2C antagonist available. It is structurally related to mianserin though, and so may provoke the same reaction as mirtazapine.

Another 5-HT2C antagonist is agomelatine (Valdoxan), and sertindole (Serdolect) is an inverse agonist.





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