Mirtazapine for ADHD
Brand name: Remergil
Dopaminergic, adrenergic, and noradrenergic but not serotonergic antidepressant.
Increases dopamine release in the PFC and noradrenergic transmission in cortical-limbic areas.1
The serotonin level is only marginally affected.1
After 21 days of mirtazapine treatment, rats showed desensitization of presynaptic a2 heteroreceptors at the 5-HT nerve terminal in the hippocampus. This caused increased tonic activation of postsynaptic 5-HT1A receptors.2 This increased tonic activation of inhibitory 5-HT1A receptors could explain the increased CRH release in the HPA axis, which was acutely reduced before treatment initiation.3
Millan, Gobert, Rivet, Adhumeau-Auclair, Cussac, Newman-Tancredi, Dekeyne, Nicolas, Lejeune (2000): Mirtazapine enhances frontocortical dopaminergic and corticolimbic adrenergic, but not serotonergic, transmission by blockade of α2-adrenergic and serotonin2C receptors: a comparison with citalopram; DOI: 10.1046/j.1460-9568.2000.00982.x ↥ ↥
Haddjeri, Blier, de Montigny (1998): Long-Term Antidepressant Treatments Result in a Tonic Activation of Forebrain 5-HT1A Receptors; Journal of Neuroscience 1 December 1998, 18 (23) 10150-10156; DOI: https://doi.org/10.1523/JNEUROSCI.18-23-10150.1998 ↥