Best non sedating antidepressants
Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity.It is at least as effective as the older antidepressants for treating mild to severe depression. Although agranulocytosis is the most serious side effect, it is rare (approximately one in 1,000) and usually reversible when the medication is stopped. Many clinicians consider mirtazapine a second-line or even third-line antidepressant, to be used when older antidepressants are not tolerated or are ineffective.
Although mirtazapine has been used successfully in Europe for a number of years, its place in the care of patients with depression in the United States has not yet been established.*—Estimated cost to the pharmacist based on average wholesale prices, for one month's therapy at the lowest usual dosage level, in Red book. Mirtazapine is a tetracyclic piperazinoazepine, which has a different structure from any other currently used antidepressant.
This medication is associated with minimal side effects, a relatively easy withdrawal, no major sedation, and is clinically effective for anxiety.
The best anti anxiety medication (anxiolytic) should be one that treats anxiety, but has minimal side effects.
Physicians who are concerned about the risks of elevated lipid levels and agranulocytosis may choose to reserve mirtazapine as a third-line choice.
It is particularly useful in patients who experience sexual side effects from other antidepressants. Cost to the patient will be higher, depending on prescription filling fee As with any new drug, mirtazapine's place in the treatment of depression is not yet clear.