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Letters to the Editor
July 2002

Mirtazapine in the Treatment of Panic Disorder

Arch Gen Psychiatry. 2002;59(7):661-662. doi:10.1001/archpsyc.59.7.661

Mirtazapine has been reported to target symptoms of anxiety (agitation, somatization, psychic anxiety, panic attacks) that often occur in depressed patients.1-3 Enhancement of both noradrenergic and serotonergic transmission through α autoreceptor and α-heteroreceptor antagonism, respectively, coupled with the blockade of 5-HT2 and 5-HT3 receptors, has been considered the main mechanism of this apparent pharmacological efficacy for anxiety symptoms.3,4 Additionally, H1 receptor antagonism facilitates an initial soporific effect.

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