Mirtazapine - Seretonin Antagonist - Adrenergic Affinity Mechanisms

[Jwicks1995]

Mirtazapine is an antagonist of the Adrenergic Alpha 2 receptor - this elicits an increase in noradrenergic activity. Wouldn't this cause an increase in anxiety? Or is it the eventual down-regulation of the receptor that may be efficacious regarding this mechanism. I understand that it also antagonizes many serotonin receptors as well as histamine. However, there is a definite stimulating component that comes with acute administration of higher doses - I'm just wondering if this would be cumulative and potentially harmful for those sensitive to added stimulation - OR - if this actually leads to a reduction in overall stimulus activity, thus increasing the threshold for various social/endogenous forms of stimulation that result in norepinephrine release.



I also have the understanding that it is proven to decrease cortisol and put the handle on glutamate - I'm just not sure how to make sense of this drug. My knowledge of pharmacology is mediocre. But if someone can explain to me how it's activity on the A2 receptor can aid anxiety it would be extremely helpful to me. My nervous system is fried, and I'm trying to figure out how to get back on track.


- currently taking - Lexapro 12.5mg, Ativan 1mg per day, Lithium Carbonate 500mg, Mirtazapine 22.5mg (after 3 days of 30mg I was EXTREMELY anxious and in borderline panic, yet my anhedonia and drive, cognition and zest for life felt as if they were coming back)

I come off Lexapro a few years back and shortly after I crashed extremely hard incuring immense anhedonia and anxiety - and without having the knowledge i do now I mistakely went back on. I plan on reducing doseage but need to stabilize first. I also have a supply of Cyproheptadine and awaiting the arrival of Metergoline via idealabs.


Very interested to hear people thoughts on the various receptor sites mentioned. A deeper understanding of this topic would aid me in bettering myself, so I can be a better person, a better boyfriend & lover, a better son, and better brother and so forth. This has been a long standing condition, it is quite tragic and those close to me have suffered because of it, so aiding my knowledge would not only help me but those also close to me and the ones a love but continue to hurt, through being stuck under the rock of brain shattering anxiety, cognitive and depression.


Thanks

Jordan

 

[Zigzag]

antagonist of the Adrenergic Alpha 2 receptor - this elicits an increase in noradrenergic activity. Wouldn't this cause an increase in anxiety?

Yohimbine works the same way and it definitely casues anxiety. I've experienced it many times.

 

[Jwicks1995]

I'm going to reduce Mirtazapine and add in/increase Cyproheptadine -

 

[GelatinGoblin]

Not really related to your insight requests but I love Mirtazapine as a drug (and the only SSRI which I would ever take again probably, stopped all others after learning of Peat's work about 6 months or maybe less ago, stopped the one I was taking except Mirtazapine), not much Serotogenic action and powerfully lowers Cortisol. I'm taking a bit for sleep. Works wonders, really lowers my Cortisol.
This with some OJ and Ice Cream made with butter and a bit but of dark chocolate with no Soy or added UFA and a washed carrot with the skin in the end really makes me sleepy and calm. Inhibition also drops to 0. After that I take a walk and go to bed. If you don't drink before bed (1-2 hours ideally) then I also don't wake up at night to go to the toilet. Been taking it for about 2 years (I think) now.

Mirtazapine really cured my insomnia. Combined with this I eventually recovered from depression and learned helplessness (Serotonin driven state)... Still close no matter how far though, sometimes it come back a bit... But so far I have a good streak. I am in a state of HOPE (both logical and emotional). Still not perfect and immoral.

 

[Jwicks1995]

What dose do you take?? I'm going to reduce to 15mg or even 10mg because I seem to be sensitive to the increase norepinephrine which is annoying because the first 2 days on 30mg I felt amazing and could handle coffee etc really well..then this all turned into extreme anxiety

 

[GelatinGoblin]

About a 4th of a film coated 30mg tablet, so 7.5mg. Lately upped to visually a bit less then half a tablet usually so 8-15mg.