Posted by mtdewcmu on April 30, 2011, at 15:09:55
I was reading about the alpha-2 adrenergic receptor in wikipedia, and I discovered that one of the effects of the receptor is to inhibit release of insulin and induce the release of glucagon from the pancreas. So, an alpha-2 agonist would tend to raise blood sugar, which you would expect as part of the fight-or-flight response. But mirtazapine is an alpha-2 antagonist, so it would be expected to lower blood sugar by causing the opposite response.
This is consistent with mirtazapine's side effect of inducing hunger and weight-gain. But I previously thought it had more to do with the 5-ht2c receptor. The idea that mirtazapine causes you to binge eat due to messing with your insulin and causing hypoglycemia is a darker, more sinister explanation, in my view, than the serotonin story.
I don't know if I like the idea of taking a drug that has the side effect of causing hyperinsulinemia and hypoglycemia, considering that other psychiatric drugs have already been shown to increase the risk of adult-onset diabetes.
poster:mtdewcmu
thread:984165
URL: http://www.dr-bob.org/babble/20110418/msgs/984165.html