NaSSA - NorAdrenergic and Specific Serotonergic Antidepressant
Please note: Dosage equivalents are provided for certain drugs below and are denoted as unit equivalents, i.e. one unit of drug x is roughly the equivalent as one unit of drug y, where the dosage equal to one unit varies.
A relatively new class of antidepressants, NaSSAs are thought to work by antagonising the monoamine neurotransmitters serotonin and noradrenaline. The drugs are perceived as having fewer side effects than TCA or SSRI antidepressants as well as being equally as effective; in particular, NaSSAs tend not to cause in comparison to many other antidepressant classes (such as SSRIs) sexual dysfunction.
Mirtazapine
Introduced in 1996, mirtazapine is chemically a tetracyclic antidepressant but is primarily labelled as an NaSSA due to its mode of action.
Mirtazapine is a viable first line treatment amongst drugs; it is effective and boasts a very small side effect profile, one which mostly lacks anticholinergic, adrenolytic or serotonin related side effects (as commonly exhibited by the popular SSRI antidepressant family). It is sedative and as such is a viable treatment for anxiety and stress related disorders or where insomnia is a symptom of the illness.
Major side effects include sedation (54%), a dry mouth (25%), an increased appetite (17%), weight gain (12%) and dizziness (7%). The most serious side effect is agranulocytosis but this is very rare indeed; the chance of experiencing this is approximately one in one thousand. Mirtazapine is relatively safe in overdose.