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Tetracyclic antidepressant

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There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline.

The structure of the tetracyclic antidepressant mirtazapine

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. Mianserin was previously available internationally, however in it has been phased out in favor of mirtazapine in most markets.

Research on other tetracyclic antidepressant compounds (for example setiptiline) have been reported in the scientific literature. These other tetracyclic antidepressants are not available for clinical use.

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
Antidepressants (N06A)
Specific reuptake inhibitors and/or receptor modulators
SSRIsTooltip Selective serotonin reuptake inhibitors
SNRIsTooltip Serotonin–norepinephrine reuptake inhibitors
NRIsTooltip Norepinephrine reuptake inhibitors
NDRIsTooltip Norepinephrine–dopamine reuptake inhibitors
NaSSAsTooltip Noradrenergic and specific serotonergic antidepressants
SARIsTooltip Serotonin antagonist and reuptake inhibitors
SMSTooltip Serotonin modulator and stimulators
Others
Tricyclic and tetracyclic antidepressants
TCAsTooltip Tricyclic antidepressants
TeCAsTooltip Tetracyclic antidepressants
Others
Monoamine oxidase inhibitors
Non-selective
MAOATooltip Monoamine oxidase A-selective
MAOBTooltip Monoamine oxidase B-selective
Adjunctive therapies
Miscellaneous
Category: