Anti-addictive properties of mirtazepine (and another question)

[swilow]

It would seem that this medication does/should have anti-addiction properties, partially through its actions on serotonin but apparently it also acts as a kappa opioid agonist. IIRC, this should give it anti-addiction properties with a reduction in OCD behaviours. But, I cannot find much mention of this usage.

Any thoughts? I think its a weak agonist, so maybe I am misunderstanding why it has been suggested I take this medication.

Also, it should lower the seizure threshold. I have epilepsy, would it be unwise to take this medication?

 

[Cotcha Yankinov]

Mirtazapine can indeed lower the seizure threshold but this may only be appreciable at doses above 15mg - its real antidepressant effects typically don't kick in until 30mg or so depending on body weight, 7.5-15mg tends to be a primarily antihistamine dose

I'm not aware that the kappa opioid agonism is appreciable, but often with antidepressants there can be modulation of endogenous opioid function. Indeed some of the serotonin blockade properties (5-HT2C and 5-HT3 antagonism) may help with addiction - in addition, treating depression should help with self-medication related addiction..

In some senses OCD has to due with reduced function of inhibitory cortical circuitry, mirtazapine may tend to increase the release of neurotransmitters in the PFC and boost function there which may help inhibit unwanted behaviors. However everybody is different, and there can be differences in the acute vs. chronic response to meds