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Re: Why do people not like Amitriptyline + Mirtazapine

Posted by Hordak on July 27, 2019, at 16:01:56

In reply to Re: Why do people not like Amitriptyline + Mirtazapine, posted by SLS on July 2, 2019, at 12:03:10

> > There is no logic in combining Amitriptyline and Mirtazapine: Both are strong antihistamines and strong 5HT2 antagonists... so why take them both?
>
> Perhaps there is some logic. Amitriptyline is a reuptake inhibitor, primarily of norepinephrine. It also inhibits the reuputake of serotonin to some extent. Mirtazapine does neither of these things. I guess it is possible that that the NE reuptake inhibition of amitriptyline will work synergistically with the NE alpha2 antagonism of mirtazapine. I don't think I have seen these two drugs combined, though. I would think that using nortriptyline would be a better choice to combine with mirtazapine because it is not antihistaminic. I haven't seen this combination used, either.
>
>
> - Scott
> >
>
>

Yes, Nortriptyline would be preferable... less side effects.


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