Psycho-Babble Medication Thread 693478

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4Toby: mirtazapine and histamine(H1)antagonist?

Posted by natalja on October 10, 2006, at 4:28:15

Hi all/ Toby,

I have read several mails about mirtazapine and it's antihistaminic action. I use it for 9 months now for depression/anxiety and also for my skin/ blood vessel condition rosacea. It improves my facial flushing to a degree, perhaps due to this histamine blockage. I wonder: how strong exactely is this action? Reports vary from "very strong" to "very mild". Below are a few quotes from different websites.

MY questions are:
** how strong exactely is this histamine blockage? I might need to add a conventional antihistamine, like Zyrtec or hydroxyzine and an H 2 antagonist like ranitidine (don't believe mirtazapine doesn anything for H2, right?)

**at lower doses, 15 mg for instance, the antihistaminic side-effects like drowsiness are predominant, while at higher doses (from 30 mg) the noradrenergic action counterbalance this for some. Does this mean that from 30 mg. on the antihistaminic actions get less? Or just that their side-effects become less noticable?
According to the Dutch company that produce the drug here the antihistaminic actions become less at higher doses..But it sounded to me the woman I spoke just guessed a bit.

I REALLY hope someone (Toby???) can help me out here,
best wishes, Natalja (Holland)

QUOTES:

In vitro studies of the potency of H1 receptor blockade list the antidepressants mirtazapine (Remeron mfl.), doxepin (Sinquan) and trimipramine (Surmotil) as the most potent.


Doxepin and mirtazapine are the most potent antihistamines on the world market, indeed, because of this doxepin has been marketed as a topical skin preparation."
Mirtazapine is getting close to 2x stonger than Doxepin. People I have spoken with who have taken both say 15mg of Mirtazapine is about as potent as 25mg of Doxepin for sleep.

Mirtazapine (Remeron) relies on alpha-2 antagonist
effects and 5-HT2 and 5-HT3 blockade; it is also a
strong antihistamine associated with increased appetite
and weight gain, but no sexual dysfunction


BUT:
-http://www.biopsychiatry.com/mirtazapine.html

"In addition, mirtazapine has only a weak affinity for 5-HT1 receptors and has very weak muscarinic anticholinergic and histamine (H1) antagonist properties."
Mirtazapine (Remeron) relies on alpha-2 antagonist
effects and 5-HT2 and 5-HT3 blockade; it is also a
strong antihistamine associated with increased appetite
and weight gain, but no sexual dysfunction
Mirtazapine has strong antihistamine
properties, which explains its side
effects of weight gain and sedation

 

Re: 4Toby: mirtazapine and histamine(H1)antagonist

Posted by notfred on October 15, 2006, at 4:50:52

In reply to 4Toby: mirtazapine and histamine(H1)antagonist?, posted by natalja on October 10, 2006, at 4:28:15


> MY questions are:
> ** how strong exactely is this histamine blockage? I might need to add a conventional antihistamine, like Zyrtec or hydroxyzine and an H 2 antagonist like ranitidine (don't believe mirtazapine doesn anything for H2, right?)
>


I have taken allergy tests while on Remeron, the two are not contraindicated. An injection of histamine produced a normal allergic response. Zyrtec or Doxipin, for me, are several orders of magnitude stronger than Remeron, antihistamine wise.


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