Which medications in the drug class Atypical Antidepressants are used in the treatment of Anxiety Disorders?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Answer

Atypical Antidepressants

Antidepressants that are not FDA-approved for the treatment of a given anxiety disorder, such as nefazodone and mirtazapine still may be beneficial for the treatment of anxiety disorders. Mirtazapine has a much more sedating effect, generally reducing its potential to aggravate initial anxiety. Mirtazapine acts distinctly as an alpha-2 antagonist, consequently increasing synaptic norepinephrine and serotonin, while also blocking some postsynaptic serotonergic receptors that conceptually mediate excessive anxiety when stimulated with serotonin.

Nefazodone (Serzone)

Antagonist at the 5-HT2 receptor and inhibits the reuptake of 5-HT. Also has negligible affinity for cholinergic and histaminergic receptors. Withdrawn from the US due to liver impairment.

Trazodone (Desyrel)

Useful in the treatment of panic disorders. Antagonist at the 5-HT2 receptor and inhibits the reuptake of 5-HT. Also has negligible affinity for cholinergic and histaminergic receptors.

In animals, selectively inhibits serotonin uptake by brain synaptosomes and potentiates the behavioral changes induced by the serotonin precursor 5-HTP.

Mirtazapine (Remeron)

Increases availability of serotonin and norepinephrine.


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