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| | Column - Imipramine, Mirtazapine, and Nefazodone: Multiple Targets |
 | | Thus, mirtazapine most likely causes sedation at low doses (i.e., concentrations) by preferentially blocking the histamine-1 receptor, while at higher doses (i.e., concentrations), mirtazapine blocks the alpha-2 adrenergic receptor, which theoretically could reduce its sedating effects to some degree. |
 | | Imipramine, mirtazapine, and nefazodone are at the opposite end of the spectrum from the SSRIs (e.g., sertraline) or the NSRIs (e.g., desipramine or reboxetine) in terms of number of mechanisms of action that are affected at concentrations achieved in the usual patient taking these drugs at their respective antidepressant doses. |
 | | In contrast, the pharmacology of imipramine, mirtazapine, and nefazodone is richer or more varied or more complicated (i.e., pick the spin you prefer) than that of the SSRIs as a result of their effects on multiple mechanisms of action. |
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