Kontent qismiga oʻtish

Mianserin

Vikipediya, ochiq ensiklopediya

Mianserin, insonlar orasida Tolvon nomli brend nomi ostida sotiladigan, asosan yevropa va dunyoning boshqa joylarida depressiyaga qarshi kurashishda ishlatiladigan atipik antidepresantdir[1]. Bu tetrasiklik antidepresant (TeCA) hisoblanadi. Mianserin mirtazapin nomli dori bilan kimyoviy va tarkibi hamda taʼsiri jihatidan yaqin, garchi ikkita dori oʻrtasida sezilarli farq boʻlsa ham[2].

Tibbiy maqsadlarda foydalanish[tahrir | manbasini tahrirlash]

Mianserin yuqori dozalarda (kuniga 30-90mg) katta depressiv kasalliklarni davolash uchun ishlatiladi[1].

Bundan tashqari, uyqusizlikni davolash uchun kamroq dozalarda (kuniga 10 mg) ishlatilishi mumkin[3][4].

Qoʻllash mumkin boʻlmagan holatlar[tahrir | manbasini tahrirlash]

Bu tibbiy yordam 18 yoshdan kichik insonlarga klinik ehtiyojlarga asoslangan va qatʼiy tibbiy nazorat ostida boʻlmagan holda berilmasligi kerak, chunki bu oʻz joniga qasd qilishga urinishlar va oʻz joniga qasd qilish fikrlash xavfini oshirishi va tajovuzkorlikni oshirishi mumkin[1].

Hayvon modellaridan homilaga zarar yetkazishi mumkinligi haqida hech qanday dalillar yoʻq boʻlsa-da, homilador ayollar uchun uni qabul qilish xavfsizligini koʻrsatadigan maʼlumotlar yoʻq[1].

Ogʻir jigar kasalliklariga chalingan bemorlar mianserinni qabul qilmasligi kerak va epilepsiya yoki tutilish(tutqanoq) xavfi boʻlgan odamlar bundan ehtiyotkorlik bilan foydalanishlari kerak, chunki bu tutilish xavfini pasaytirishi mumkin. Agar klinik qarorga asoslangan boʻlsa, oddiy ehtiyot choralarini koʻrish va mianserinning dozalari va har qanday parallel terapiyani koʻrib chiqish va kerak boʻlganda tuzatish kerak[1].

Nojoʻya taʼsirlari[tahrir | manbasini tahrirlash]

Juda keng tarqalgan (tasodif > 10%) salbiy taʼsirlar: qoʻriq, ogʻiz qurishi va davolash boshida uxlash[5][1].

Oddiy (1% < hodisa ≤ 10%) salbiy taʻsirlar:parvarishlash terapiyasi paytida uyquchanlik, tremor, bosh ogʻrigʻi, bosh aylanishi, vertigo va zaiflik kiradi[5].

Kamdan-kam (0,1% < hodisa ≤ 1%) salbiy taʻsirlar: inson vazninig ortishi[5].

Tez toʻxtatib qoʻyish[tahrir | manbasini tahrirlash]

Mianserinni toʻsatdan yoki tezda toʻxtatish ogʻir kasalliklarni keltirib chiqarishi mumkin, uning oqibatlari-depressiya, tashvishlanish, vahima hujumlari[6], ishtahaning pasayishi yoki anoreksiya, uyqusizlik, diareya, koʻngil aynishi va qusish va grippga oʻxshash alomatlar, masalan, barcha allergiya yoki qichishish va boshqalar.

Dozani oshirib yuborish[tahrir | manbasini tahrirlash]

Mianserinning haddan tashqari koʻp istemol qilish sedasyon, koma, gipotenziya yoki gipertenziya, taxikardiya va QT oraligʻini uzaytirishi mumkin[7].

Oʻzaro taʼsirlari[tahrir | manbasini tahrirlash]

Mianserin birgalikda qoʻllanganda spirtli ichimliklar, anksiyolitiklar, gipnozlar yoki antipsikotiklar kabi dorilarning sedativ taʼsirini kuchaytirishi mumkin. Antiepileptik dorilarning samaradorligini pasaytirishi mumkin.

Karbamazepin va Fenobarbital mianserinni tezroq metabolizatsiya qilishini va uning taʼsirini kamaytirishi mumkin. Agar odamlar diazoxid, hidralazina yoki nitroprusid bilan birga mianserinni qabul qilishsa, qon bosimining xavfi xavfli darajada pasayishi kuzatiladi. Mianserin antihistamin va anti-muskariniklarni kuchaytirishi mumkin. Mianserinni apraklonidin, brimonidin, sibutramin yoki artemeter va lumefantrin kombinatsiya dorilari bilan birga qabul qilish kerak emas[1].

Farmakologiyada[tahrir | manbasini tahrirlash]

Farmakodinamikasi[tahrir | manbasini tahrirlash]

Mianserin[8]
Site Ki (nM) Species Ref Human [9]
71 Human [9]
9,400 Human [9]
5-HT<sub id="mwog">1A</sub> 400-2,600 Human [10][11]
5-HT<sub id="mwrQ">1B</sub> ≥2,800 Rat [12]
5-HT<sub id="mwtg">1D</sub> 220-400 Human [13][14]
5-HT<sub id="mwwQ">1E</sub> ND ND ND
5-HT<sub id="mwyw">1F</sub> 13 Human [10]
5-HT<sub id="mw1A">2A</sub> 1.6-55 Human [15][16]
5-HT<sub id="mw3w">2B</sub> 1.6-20 Human [17][18]
5-HT<sub id="mw6g">2C</sub> 0.63-6.5 Human [15][19]
5-HT<sub id="mw9Q">3</sub> 5.8-300 Rodent [20][11]
5-HT<sub id="mwAQA">4</sub> ND ND ND
5-HT<sub id="mwAQo">5A</sub> ND ND ND
5-HT<sub id="mwARQ">6</sub> 55-81 Human [21][22]
5-HT<sub id="mwAR8">7</sub> 48-56 Human [23][24][25]
α<sub id="mwASw">1</sub> 34 Human [26]
α<sub id="mwATU">2</sub> 73 Human [26]
  α<sub id="mwAUA">2A</sub> 4.8 Human [23]
  α<sub id="mwAUs">2B</sub> 27 Human [27]
  α<sub id="mwAVY">2C</sub> 3.8 Human [23]
D<sub id="mwAV8">1</sub> 426-1,420 Human [11][23]
D<sub id="mwAWo">2</sub> 2,100-2,700 Human [26][28]
D<sub id="mwAXU">3</sub> 2,840 Human [26]
D<sub id="mwAX4">4</sub> ND ND ND
D<sub id="mwAYg">5</sub> ND ND ND
H<sub id="mwAZI">1</sub> 0.30-1.7 Human [29][26][23]
H<sub id="mwAZ8">2</sub> 437 Human [30]
H<sub id="mwAag">3</sub> 95,500 Human [30]
H<sub id="mwAbE">4</sub> >100,000 Human [30][31]
820 Human [26]
21,000 Human [32]
30,200 Human [32] Human [32]
Values are Ki (nM), unless otherwise noted. The smaller the value, the more strongly the drug binds to the site.

Mianserin oʻz taʼsirini histamin va serotonin retseptorlarining antagonizmi va norepinefrin vositalarini qayta qabul qilinishini toʻxtatish orqali amalga oshirishi koʻrildi. Xususan, u histamin H1 retseptorining koʻp yoki barcha joylarida anthistamin:WikiLink" title="Inverse agonist">akronist /invers agonist, serotonin 5-HT<sub id="mwAe0">1D</sub>, 5-HT<sub id="mwAe8">1F</sub>, 5-HT2C" id="mwAfI" rel="mw: WikiLink" title="5-HT2B">5-HT2B" id="mwAfA" rel="mw: WikiLink" title="5-HT2A">5-HT2A, 5-HT 2B, 5-HT<sub id="mwAfc">3</sub> , 5-HT<sub id="mwAfk">6</sub> va 5-HT7 retseptorlari, adrenergik α1-va α2-adrenergik retseptorlari va shuningdek, norepinefrin qayta qabul qilish inhibitori hisoblanadi[33][34]. H1 retseptorlari yuqori darajaga ega boʻlgan agonist sifatida mianserin kuchli antihistamin taʼsirlariga ega (masalan, sedatsiya). Aksincha, u muskarinik asetilkolin retseptorlariga kam yaqinlik qiladi va shuning uchun anticholinergik xususiyatlarga ega emas[26]. MI kichik afinatli, ammo k-oploid retseptorining (Ki = 1.7 μM; EC<sub id="mwAhM">50</sub> = 0.53 μM) qismli agonisti boʻlishi aniqlandi[32][35].

H 1 va, ehtimol, a 1 -adrenergik retseptorlarini qayta ishlash sedativ taʼsirga ega [5], shuningdek, 5-HT 2A va a 1 -adrenergik retseptorlari antagonizmi hujayra ichidagi fosfolipaza C (PLC) faollashishini nazorat qiladi, bu jarayon keng tarqalgan hisoblanadi. Antidepressantlar bir necha turli sinflar uchun maqsad boʻlishi mumkin[36]. Asosan, nazoratlovchi avtoretseptorlar va heteroreseptorlar vazifasini bajaradigan somatodendritik va presinaptik a 2 -adrenergik retseptorlarini antagonizatsiya qilish orqali mianserin miya va tananing turli sohalarida norepinefrin, dopamin, serotonin va asetilkolin chiqarilishini nazorat qiladi.

Mirtazapin vositasi bilan bir qatorda, nisbatan kamroq darajada boʻlsa ham, mianserin baʼzan noradrenerjik va oʻziga xos serotonerjik antidepressant (NaSSA) sifatida tavsiflangan[37]. Biroq, ushbu belgilarni qoʻllab-quvvatlovchi haqiqiy dalillar hali oʻz tasdiqini topmagan[38].

Farmakokinetik[tahrir | manbasini tahrirlash]

Mianserinning tabiatda biologik mavjudligi 20% dan 30% gacha boʻladi[39]. Uning plazmadagi protein bogʻlanish miqdori 95% ni tashkil qiladi. MiaN N" data-linkid="568" href="./Liver" id="mwAkM" rel="mw:WikiLink" title="Liver">jigar CYP2D6 ferment tomonidan N-oksidatsiya va N-demetilatsiya orqali metabolizatsiya qilinadi. Uning eliminatsiyasi 21 soatdan 61 soatgacha boʻladi. Bu dori tanadan siydik orqali 4% dan 7% gacha va najas orqali 14% dan 28% gacha chiqarib tashlanadi[39].

Kimyo[tahrir | manbasini tahrirlash]

- MianS.

Mianserin — tetratsiklik piperazinoazepin hisoblanadi. Mirtazapin bir xil organik kimyogarlar jamoasi tomonidan ishlab chiqilgan va halqalardan birida azot atomining qoʻshilishi bilan hosil boʻlgan[40][41]. (S)-(+) -Mianserin oʻzining enantiomeridan (R)-(-)-mianserindan taxminan 200-300 marta faolroq; demak, mianserinning faolligi (S)-(+) izomerida yotadi. </link>[ iqtibos kerak ]

Tarixi[tahrir | manbasini tahrirlash]

Bu dori Organon International tomonidan ishlab chiqilgan, ammo kashf etilmagan; birinchi patentlar 1967-yilda Gollandiyada berilgan va 1979-yilda Fransiyada Athymil nomli brend ostida ishga tushirilgan va shundan soʻng Buyuk Britaniyada Norval nomidan ishga tushirilgan. AQShda klinik sinovlar oʻtkazganda tadqiqotchilar firibgarlik maʼlumotlarini taqdim etishdi va bu vosita AQShda hech qachon tasdiqlanmagan[42]:21[43]:318.

Mianserin Buyuk Britaniyada birinchi antidepressivlardan biri boʻlib, bu tritsiklik antidepressivlarga qaraganda xavfi nisbatan kamroq; lekin kamroq boʻlsa ham 2012-yildan boshlab Buyuk Britaniyada bu vosita qoʻllamishi bekor qilingan[44].

Jamiyat va madaniyatdagi oʻrni[tahrir | manbasini tahrirlash]

Mianserin.

Umumiy nomlari[tahrir | manbasini tahrirlash]

Mianserin-bu preparatning ingliz va nemischa umumiy nomi, mianserin gidroxloridi esa uning USAN Tooltip nomi. Uning frantsuz tilidagi umumiy nomi va DCF-miansérine, Ispan va Italyan tillarida DCIT-mianserina, lotincha esa-mianserinum [45][46][47][48].

Mashhur nomlari[tahrir | manbasini tahrirlash]

Mianserin mahsuloti koʻplab mamlakatlarda asosan Tolvon nomli brend ostida sotiladi. Bu vosita shuningdek, butun dunyoda Athymil, Bonserin, Bolividon, Deprivon, Lantanon, Lerivon, Lumin, Miansan, Serelan, Tetramid va Tolvin kabi turli xil brend nomlari ostida mavjud[46][48][45].

Foydalanishi[tahrir | manbasini tahrirlash]

Mianserin AQShda foydalanishga ruxsat berilmagan, lekin Buyuk Britaniyada va boshqa Yevropa mamlakatlarida foydalanishga ruxsat berilgan[49][50]. 1996-yil may oyida mianserin generik dori TGA Terapeutik tovarlar maʼmuriyati tomonidan maʼqullandi va Avstraliyada sotuvga ruxsat berildi[51].

Tadqiqoti[tahrir | manbasini tahrirlash]

Psixologik sinovlarda shizofreniyaga chalingan odamlarga yordam berish uchun mianserindan foydalanish oʻrganilgan; ammo natija yaxshi boʻlmagan[52][53].

Manbalar[tahrir | manbasini tahrirlash]

Yana qarang[tahrir | manbasini tahrirlash]

  1. ↑ 1,0 1,1 1,2 1,3 1,4 1,5 1,6 „Mianserin 30 mg film-coated tablets“. UK Electronic Medicines Compendium (2014-yil yanvar). Qaraldi: 2017-yil 20-avgust.
  2. ↑ „A Comparison of the Physicochemical and Biological Properties of Mirtazapine and Mianserin“. Journal of pharmacy and pharmacology. Oxford University Press (2011-yil aprel). Qaraldi: 2022-yil 29-yanvar.
  3. ↑ „Que faire devant une insomnie“ (fr). Sommeil. University of Lyon.
  4. ↑ „Traitement des troubles du sommeil“ (fr). Research gate. 2019-yil 30-martda asl nusxadan arxivlangan.
  5. ↑ 5,0 5,1 5,2 5,3 „Tolvon Product Information“. Medicines. Merck Sharp & Dohme. 2016-yil 2-aprelda asl nusxadan arxivlangan. Qaraldi: 2013-yil 5-oktyabr. Manba xatosi: Invalid <ref> tag; name "TOLVON" defined multiple times with different content
  6. ↑ "Panic anxiety after abrupt discontinuation of mianserin". The Japanese Journal of Psychiatry and Neurology 43 (2): 155–59. June 1989. doi:10.1111/j.1440-1819.1989.tb02564.x. PMID 2796025. 
  7. ↑ The Maudsley Prescribing Guidelines in Psychiatry, 11th, Chichester, West Sussex: John Wiley & Sons, 2012. 
  8. ↑ „PDSP Ki Database“. Psychoactive Drug Screening Program (PDSP). University of North Carolina at Chapel Hill and the United States National Institute of Mental Health. Qaraldi: 2017-yil 14-avgust.
  9. ↑ 9,0 9,1 9,2 "Pharmacological profile of antidepressants and related compounds at human monoamine transporters". European Journal of Pharmacology 340 (2–3): 249–258. December 1997. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821. 
  10. ↑ 10,0 10,1 "Molecular biology of 5-HT receptors". Neuropharmacology 33 (3–4): 275–317. 1994. doi:10.1016/0028-3908(94)90059-0. PMID 7984267. 
  11. ↑ 11,0 11,1 11,2 "Standard binding and functional assays related to medications development division testing for potential cocaine and opiate narcotic treatment medications". NIDA Research Monograph 178: 440–466. March 1998. PMID 9686407. 
  12. ↑ "Characterization of 5-hydroxytryptamine1B receptors in rat spinal cord via [125I]iodocyanopindolol binding and inhibition of [3H]-5-hydroxytryptamine release". The Journal of Pharmacology and Experimental Therapeutics 260 (2): 614–626. February 1992. PMID 1738111. 
  13. ↑ "Identification of 5-hydroxytryptamine1D binding sites in human brain membranes". Synapse 3 (1): 61–66. 1989. doi:10.1002/syn.890030109. PMID 2521959. 
  14. ↑ "Molecular pharmacology of 5-HT1D recognition sites: radioligand binding studies in human, pig and calf brain membranes". Naunyn-Schmiedeberg's Archives of Pharmacology 337 (6): 595–601. June 1988. doi:10.1007/bf00175783. PMID 2975354. https://archive.org/details/sim_naunyn-schmiedebergs-archives-of-pharmacology_1988-06_337_6/page/595. 
  15. ↑ 15,0 15,1 "Agonist and antagonist actions of yohimbine as compared to fluparoxan at alpha(2)-adrenergic receptors (AR)s, serotonin (5-HT)(1A), 5-HT(1B), 5-HT(1D) and dopamine D(2) and D(3) receptors. Significance for the modulation of frontocortical monoaminergic transmission and depressive states". Synapse 35 (2): 79–95. February 2000. doi:10.1002/(SICI)1098-2396(200002)35:2<79::AID-SYN1>3.0.CO;2-X. PMID 10611634. 
  16. ↑ "Comparison of [125I]iodolysergic acid diethylamide binding in human frontal cortex and platelet tissue". Journal of Neurochemistry 53 (1): 191–196. July 1989. doi:10.1111/j.1471-4159.1989.tb07313.x. PMID 2723656. 
  17. ↑ "RS-127445: a selective, high affinity, orally bioavailable 5-HT2B receptor antagonist". British Journal of Pharmacology 127 (5): 1075–1082. July 1999. doi:10.1038/sj.bjp.0702632. PMID 10455251. PMC 1566110. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1566110. 
  18. ↑ "The pharmacology and distribution of human 5-hydroxytryptamine2B (5-HT2B) receptor gene products: comparison with 5-HT2A and 5-HT2C receptors". British Journal of Pharmacology 115 (4): 622–628. June 1995. doi:10.1111/j.1476-5381.1995.tb14977.x. PMID 7582481. PMC 1908489. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1908489. 
  19. ↑ "Pharmacologic characterization of the human 5-hydroxytryptamine2B receptor: evidence for species differences". The Journal of Pharmacology and Experimental Therapeutics 276 (2): 720–727. February 1996. PMID 8632342. 
  20. ↑ "[3H]-BRL 43694 (Granisetron), a specific ligand for 5-HT3 binding sites in rat brain cortical membranes". Biochemical Pharmacology 38 (10): 1693–1695. May 1989. doi:10.1016/0006-2952(89)90319-5. PMID 2543418. 
  21. ↑ "Cloning, characterization, and chromosomal localization of a human 5-HT6 serotonin receptor". Journal of Neurochemistry 66 (1): 47–56. January 1996. doi:10.1046/j.1471-4159.1996.66010047.x. PMID 8522988. 
  22. ↑ "Differences in the central nervous system distribution and pharmacology of the mouse 5-hydroxytryptamine-6 receptor compared with rat and human receptors investigated by radioligand binding, site-directed mutagenesis, and molecular modeling". Molecular Pharmacology 64 (6): 1295–1308. December 2003. doi:10.1124/mol.64.6.1295. PMID 14645659. 
  23. ↑ 23,0 23,1 23,2 23,3 23,4 "Discovery of new tetracyclic tetrahydrofuran derivatives as potential broad-spectrum psychotropic agents". Journal of Medicinal Chemistry 48 (6): 1709–1712. March 2005. doi:10.1021/jm049632c. PMID 15771415. 
  24. ↑ "Cloning, expression and pharmacology of a truncated splice variant of the human 5-HT7 receptor (h5-HT7b)". British Journal of Pharmacology 122 (1): 126–132. September 1997. doi:10.1038/sj.bjp.0701336. PMID 9298538. PMC 1564895. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1564895. 
  25. ↑ "The 5-HT7 receptor: orphan found". Trends in Pharmacological Sciences 18 (4): 104–107. April 1997. doi:10.1016/s0165-6147(97)01043-2. PMID 9149537. https://archive.org/details/sim_trends-in-pharmacological-sciences_1997-04_18_4/page/104. 
  26. ↑ 26,0 26,1 26,2 26,3 26,4 26,5 26,6 "Antagonism by antidepressants of neurotransmitter receptors of normal human brain in vitro". The Journal of Pharmacology and Experimental Therapeutics 230 (1): 94–102. July 1984. PMID 6086881. 
  27. ↑ "Cloning, expression, and pharmacological characterization of a human alpha 2B-adrenergic receptor". Molecular Pharmacology 38 (5): 681–688. November 1990. PMID 2172775. 
  28. ↑ "Cloning of the cDNA and gene for a human D2 dopamine receptor". Proceedings of the National Academy of Sciences of the United States of America 86 (24): 9762–9766. December 1989. doi:10.1073/pnas.86.24.9762. PMID 2532362. PMC 298581. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=298581. 
  29. ↑ "Novel ligands for the human histamine H1 receptor: synthesis, pharmacology, and comparative molecular field analysis studies of 2-dimethylamino-5-(6)-phenyl-1,2,3,4-tetrahydronaphthalenes". Bioorganic & Medicinal Chemistry 14 (19): 6640–6658. October 2006. doi:10.1016/j.bmc.2006.05.077. PMID 16782354. 
  30. ↑ 30,0 30,1 30,2 "Interactions of recombinant human histamine H₁R, H₂R, H₃R, and H₄R receptors with 34 antidepressants and antipsychotics". Naunyn-Schmiedeberg's Archives of Pharmacology 385 (2): 145–170. February 2012. doi:10.1007/s00210-011-0704-0. PMID 22033803. 
  31. ↑ "Discovery of a novel member of the histamine receptor family". Molecular Pharmacology 59 (3): 427–433. March 2001. doi:10.1124/mol.59.3.427. PMID 11179435. https://cdr.lib.unc.edu/downloads/8336h388z. 
  32. ↑ 32,0 32,1 32,2 32,3 "The atypical antidepressant mianserin exhibits agonist activity at κ-opioid receptors". British Journal of Pharmacology 167 (6): 1329–1341. November 2012. doi:10.1111/j.1476-5381.2012.02078.x. PMID 22708686. PMC 3504997. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3504997. 
  33. ↑ „Synaptic Effects of Antidepressants: Relationship to Their Therapeutic and Adverse Effects“,Schizophrenia and Mood Disorders: The New Drug Therapies in Clinical Practice. Oxford: Butterworth-Heinemann, 2000 — 67–84 bet. ISBN 978-0-7506-4096-1. 
  34. ↑ „Target Family-directed Masterkeys in Chemogenomics“,Chemogenomics in Drug Discovery: A Medicinal Chemistry Perspective. John Wiley & Sons, 8 May 2006 — 25 bet. ISBN 978-3-527-60402-9. 
  35. ↑ "Direct agonist activity of tricyclic antidepressants at distinct opioid receptor subtypes". The Journal of Pharmacology and Experimental Therapeutics 332 (1): 255–265. January 2010. doi:10.1124/jpet.109.159939. PMID 19828880. https://archive.org/details/sim_journal-of-pharmacology-and-experimental-therapeutics_2010-01_332_1/page/255. 
  36. ↑ "Antidepressants reduce phosphoinositide-specific phospholipase C (PI-PLC) activity and the mRNA and protein expression of selective PLC beta 1 isozyme in rat brain". Neuropharmacology 43 (8): 1269–1279. December 2002. doi:10.1016/S0028-3908(02)00253-8. PMID 12527476. https://archive.org/details/sim_neuropharmacology_2002-12_43_8/page/1269. 
  37. ↑ "Meta-analysis of noradrenergic and specific serotonergic antidepressant use in schizophrenia". The International Journal of Neuropsychopharmacology 17 (2): 343–354. February 2014. doi:10.1017/S1461145713000667. PMID 23823741. 
  38. ↑ "A systematic review of the serotonergic effects of mirtazapine in humans: implications for its dual action status". Human Psychopharmacology 21 (2): 117–125. March 2006. doi:10.1002/hup.750. PMID 16342227. https://archive.org/details/sim_human-psychopharmacology_2006-03_21_2/page/117. 
  39. ↑ 39,0 39,1 Truven Health Analytics, Inc. Drugdex System (Internet) [cited 2013 Sep 29]. Greenwood Village, CO: Thomsen Healthcare; 2013.
  40. ↑ „Mirtazapine label – Australia“. GuildLink, Pharmacy Guild of Australia (2016-yil 27-may). 2018-yil 21-noyabrda asl nusxadan arxivlangan. Qaraldi: 2017-yil 21-iyun.
  41. ↑ "A comparison of the physicochemical and biological properties of mirtazapine and mianserin". The Journal of Pharmacy and Pharmacology 49 (4): 403–11. April 1997. doi:10.1111/j.2042-7158.1997.tb06814.x. PMID 9232538. 
  42. ↑ A historical dictionary of psychiatry. Oxford: Oxford Univ. Press, 2005. ISBN 978-0-19-517668-1. 
  43. ↑ Stahl's essential psychopharmacology : neuroscientific basis and practical application, 4th, Cambridge: Cambridge University Press, 2013. ISBN 978-1-10702598-1. 
  44. ↑ „29. Affective Disorders“,Clinical pharmacy and therapeutics, 5th, Edinburgh: Churchill Livingston/Elsevier, 2012 — 472 bet. ISBN 978-0-70204293-5. 
  45. ↑ 45,0 45,1 The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer, 14 November 2014 — 822– bet. ISBN 978-1-4757-2085-3. 
  46. ↑ 46,0 46,1 Index Nominum 2000: International Drug Directory. Taylor & Francis, 2000 — 689– bet. ISBN 978-3-88763-075-1.  Manba xatosi: Invalid <ref> tag; name "IndexNominum2000" defined multiple times with different content
  47. ↑ Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media, 31 October 1999 — 181– bet. ISBN 978-0-7514-0499-9. 
  48. ↑ 48,0 48,1 „International brands for mianserin“. Drugs.com. Qaraldi: 2017-yil 20-avgust. Manba xatosi: Invalid <ref> tag; name "Drugs.com" defined multiple times with different content
  49. ↑ „Major Psychiatric Disorders: Depression“,The Practitioner's Guide to Psychoactive Drugs. Springer Science & Business Media, 29 June 2013 — 39– bet. ISBN 978-1-4757-1137-0. 
  50. ↑ „Antidepressants“,Current Psychotherapeutic Drugs. Routledge, 24 May 2013 — 57– bet. ISBN 978-1-135-06284-2. 
  51. ↑ „Lumin Mianserin hydrochloride product information“. Medicines. AlphaPharm.
  52. ↑ "Randomized Controlled Trials of Add-On Antidepressants in Schizophrenia". The International Journal of Neuropsychopharmacology 18 (9): pyv049. May 2015. doi:10.1093/ijnp/pyv049. PMID 25991654. PMC 4576515. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4576515. 
  53. ↑ "Antidepressants for cognitive impairment in schizophrenia--a systematic review and meta-analysis". Schizophrenia Research 159 (2–3): 385–394. November 2014. doi:10.1016/j.schres.2014.08.015. PMID 25240772. PMC 4252251. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4252251.  
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