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A tetracyclic antidepressant is an antidepressant drug from the tetracyclic drug group.
The name tetracyclic is derived from the drug's molecular structure which consists of four ring-like structures in a T-shape (compare tricyclic antidepressant).
Maprotiline (trade named Ludiomil), and Mirtazapine (trade named Remeron in the USA, Remergil, Remeron and Zispin in Europe, and Avanza in Australia) are the only two drugs from this group widely used for the treatment of clinical depression. The tetracyclic antidepressant Mianserin was previously available internationally, however in most markets it has been phased out in favor of Mirtazapine.
Research on other tetracyclic antidepressant compounds (for example setiptiline) have been reported in the scientific literature. These other tetracyclic antidepressants are not publicly available.
List of tetracyclic antidepressants
According to MeSH the tetracyclic antidepressants have the following effects:
| Adrenergic Uptake Inhibitor | Adrenergic Alpha-Receptor Antagonist | Dopamine Receptor Antagonist | Serotonin Uptake Inhibitor | Serotonin 5-HT2 Receptor Antagonist | Histamine H1 Receptor Antagonist | |
| Amoxapine | yes | - | yes | weak | yes | yes |
| Maprotiline | yes | yes | weak | - | yes | yes |
| Mianserin | - | yes | - | - | yes | yes |
| Mirtazapine | - | yes | - | - | yes | yes |
| Trazodone | - | - | weak | yes | yes | weak |