Mirtazapine nervous system

A number of antidepressants do not fit neatly into the other classes. Among these are bupropion,mirtazapine, amoxapine, and maprotiline (Figure 30-5). Bupropion has a unicyclic aminoketone structure. Its unique structure results in a different side-effect profile than most antidepressants (described below). Bupropion somewhat resembles amphetamine in chemical structure and like the stimulant, has central nervous system (CNS) activating properties. 

Nervous system There have been two reports of movement disorders induced by mirtazapine. Most of a case series of 14 patients with restless legs syndrome presented within a few days of starting treatment, and the symptom occurred more often in those who also took tramadol or dopamine receptor antagonists, such as antiemetics [72 ]. In one case, severe akathisia developed within 4 hours of a first... 

Nervous system A 58-year-old woman who was taking mirtazapine and metoclopra-mide started to take levofloxacin 1 day later she had an episode of loss of consciousness associated with urinary incontinence and on the following day two tonic-clonic seizures [60 ]. Levofloxacin and mirtazapine were withdrawn and the seizure activity stopped. No other cause for her seizures was found. The authors concluded that levofloxacin is epileptogenic and had also, by inhibiting CYP1A2, increased the serum concentrations of mirtazapine and metoclopramide, drugs that also have epileptogenic effects. 

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