{"id":59206,"date":"2024-02-28T05:46:21","date_gmt":"2024-02-28T05:46:21","guid":{"rendered":"https:\/\/medsname.com\/nasdep\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"nasdep","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nasdep\/","title":{"rendered":"Nasdep"},"content":{"rendered":"

<\/p>\n

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Nasdep?<\/h3>\n
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Nasdep<\/strong> obsahuje mirtazapine 30 mg<\/strong> od v\u00fdrobce certifikovan\u00e9ho WHO-GMP (Lupin Pharmaceuticals) \u2014 tetracyklick\u00fd NaSSA antidepresivum<\/strong> s jedine\u010dn\u00fdm mechanismem: antagonismus alfa-2 adrenergn\u00edch auto- a heteroreceptor\u016f zvy\u0161uje uvol\u0148ov\u00e1n\u00ed noradrenalinu i serotoninu, zat\u00edmco antagonismus 5-HT2 \/ 5-HT3 p\u0159esm\u011bruje aktivovan\u00fd serotonin od receptor\u016f, kter\u00e9 zp\u016fsobuj\u00ed vedlej\u0161\u00ed \u00fa\u010dinky SSRI. Standardn\u00ed d\u00e1vka: 15\u201345 mg p\u0159ed span\u00edm<\/strong> (za\u010dn\u011bte s 15 mg, c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed 30\u201345 mg). Siln\u011b preferov\u00e1no, kdy\u017e se MDD projevuje s nespavost\u00ed, sn\u00ed\u017eenou chut\u00ed k j\u00eddlu, \u00fabytkem hmotnosti nebo l\u00e9\u010debn\u011b rezistentn\u00ed agitovanou depres\u00ed<\/strong>. Paradoxn\u00ed sedativn\u00ed vzorec<\/strong>: v\u00edce sedativn\u00ed p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch (15 mg) ne\u017e p\u0159i pln\u00e9 d\u00e1vce (45 mg), proto\u017ee vy\u0161\u0161\u00ed d\u00e1vky aktivuj\u00ed v\u00edce noradrenergn\u00ed aktivity. V\u00fdznamn\u00fd p\u0159\u00edr\u016fstek hmotnosti \u2014 nejv\u00edce mezi antidepresivy spolu s paroxetinem.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<\/div>\n

D\u016fle\u017eit\u00e9 \u2014 nejedn\u00e1 se o l\u00e9k na situa\u010dn\u00ed \u00fazkost.<\/strong> Nasdep je tetracyklick\u00e9 noradrenergn\u00ed a specifick\u00e9 serotonergn\u00ed antidepresivum (NaSSA)<\/strong>, p\u0159edepisov\u00e1n a titrov\u00e1n po t\u00fddny pro z\u00e1va\u017en\u00e1 depresivn\u00ed porucha (MDD), zejm\u00e9na s v\u00fdraznou nespavost\u00ed, sn\u00ed\u017eenou chut\u00ed k j\u00eddlu, \u00fabytkem hmotnosti nebo agitac\u00ed<\/strong>. Nen\u00ed ne<\/strong> spr\u00e1vn\u00fdm l\u00e9kem pro akutn\u00ed, v\u00fdkonov\u011b souvisej\u00edc\u00ed \u00fazkost (l\u00e9t\u00e1n\u00ed, ve\u0159ejn\u00e9 vystupov\u00e1n\u00ed, zkou\u0161ky) \u2014 pro tyto p\u0159\u00edpady jsou klinicky vhodn\u011bj\u0161\u00ed betablok\u00e1tory (propranolol), benzodiazepiny nebo hydroxyzin. Pokud nem\u00e1te diagnostikovanou poruchu n\u00e1lady, \u00fazkostnou nebo psychiatrickou poruchu, neza\u010d\u00ednejte s u\u017e\u00edv\u00e1n\u00edm tohoto l\u00e9ku.<\/div>\n
FDA \u010dern\u00e9 varov\u00e1n\u00ed \u2014 sebevra\u017eednost.<\/strong> V\u0161echna antidepresiva nesou \u010dern\u00e9 varov\u00e1n\u00ed FDA pro zv\u00fd\u0161en\u00e9 riziko sebevra\u017eedn\u00e9ho my\u0161len\u00ed a chov\u00e1n\u00ed u d\u011bt\u00ed, dosp\u00edvaj\u00edc\u00edch a mlad\u00fdch dosp\u011bl\u00fdch do 25 let, zejm\u00e9na b\u011bhem prvn\u00edch t\u00fddn\u016f l\u00e9\u010dby nebo po zm\u011bn\u00e1ch d\u00e1vkov\u00e1n\u00ed. \u010clenov\u00e9 rodiny a p\u0159edepisuj\u00edc\u00ed l\u00e9ka\u0159i by m\u011bli pe\u010dliv\u011b sledovat zhor\u0161en\u00ed n\u00e1lady, agitovanost nebo sebevra\u017eedn\u00e9 my\u0161lenky v t\u00e9to v\u011bkov\u00e9 skupin\u011b.<\/div>\n

Co je Nasdep?<\/h2>\n

Nasdep je peror\u00e1ln\u00ed tableta mirtazapine 30 mg<\/strong> vyroben\u00e1 spole\u010dnost\u00ed Lupin Pharmaceuticals. Mirtazapin (americk\u00e1 zna\u010dka Remeron<\/strong>) je tetracyklick\u00e9 noradrenergn\u00ed a specifick\u00e9 serotonergn\u00ed antidepresivum (NaSSA)<\/strong> uveden\u00fd spole\u010dnost\u00ed Organon v roce 1994. Jeho mechanismus se li\u0161\u00ed od v\u0161ech ostatn\u00edch b\u011b\u017en\u011b pou\u017e\u00edvan\u00fdch antidepresiv: nam\u00edsto blokov\u00e1n\u00ed zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed antagonizuje presynaptick\u00e9 alfa-2 adrenergn\u00ed receptory na noradrenergn\u00edch neuronech (zvy\u0161uje uvol\u0148ov\u00e1n\u00ed noradrenalinu) a na serotonergn\u00edch nervov\u00fdch zakon\u010den\u00edch (heteroreceptorov\u00fd efekt, zvy\u0161uje uvol\u0148ov\u00e1n\u00ed serotoninu), sou\u010dasn\u011b antagonizuje 5-HT2A<\/sub>, 5-HT2C<\/sub>, a 5-HT3<\/sub> receptory. Blok\u00e1da 5-HT2<\/sub> a 5-HT3<\/sub> p\u0159esm\u011bruje zv\u00fd\u0161en\u00fd serotonin od receptor\u016f zodpov\u011bdn\u00fdch za vedlej\u0161\u00ed \u00fa\u010dinky SSRI (sexu\u00e1ln\u00ed dysfunkce, \u00fazkost, gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee).<\/p>\n

Je to siln\u00fd H1<\/sub> antihistaminikum, co\u017e zp\u016fsobuje sedaci a stimulaci chuti k j\u00eddlu.<\/p>\n

Schv\u00e1len\u00e9 indikace<\/h2>\n
    \n
  • Hlavn\u00ed depresivn\u00ed porucha (MDD)<\/strong> \u2014 zejm\u00e9na kdy\u017e jsou v\u00fdrazn\u00e9 nespavost, sn\u00ed\u017een\u00e1 chu\u0165 k j\u00eddlu, \u00fabytek hmotnosti nebo agitovanost<\/li>\n
  • Mimo indikaci: \u00fazkostn\u00e9 poruchy (GAD, soci\u00e1ln\u00ed \u00fazkost, PTSD), chronick\u00e1 nespavost (n\u00edzk\u00e1 d\u00e1vka 7,5\u201315 mg), refraktern\u00ed sv\u011bd\u011bn\u00ed, chronick\u00e1 nevolnost, anorexie\/kachexie, n\u00e1valy horka<\/li>\n
  • Terapeuticky rezistentn\u00ed deprese: kombinace s venlafaxinem (\u201cCalifornia rocket fuel\u201d) pod odborn\u00fdm dohledem<\/li>\n<\/ul>\n

    D\u00e1vkov\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n\n
    Indikace<\/th>\nStart<\/th>\nC\u00edlov\u00e1 d\u00e1vka<\/th>\nMaxim\u00e1ln\u011b<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    MDD<\/td>\n15 mg p\u0159ed span\u00edm \u00d7 1 t\u00fdden<\/td>\n30\u201345 mg p\u0159ed span\u00edm<\/td>\n45 mg\/den<\/td>\nVy\u0161\u0161\u00ed d\u00e1vky aktivuj\u00ed v\u00edce noradrenergn\u00ed aktivity \u2014 paradoxn\u011b m\u00e9n\u011b sedativn\u00ed<\/td>\n<\/tr>\n
    Neschv\u00e1len\u00e9 pou\u017eit\u00ed p\u0159i nespavosti<\/td>\n7,5\u201315 mg p\u0159ed span\u00edm<\/td>\n7,5\u201315 mg p\u0159ed span\u00edm<\/td>\n\u2014<\/td>\nOmezit na kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed; p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze je re\u00e1ln\u00e9 i p\u0159i n\u00edzk\u00e9 d\u00e1vce<\/td>\n<\/tr>\n
    Star\u0161\u00ed pacienti<\/td>\n7,5\u201315 mg p\u0159ed span\u00edm<\/td>\n15\u201330 mg p\u0159ed span\u00edm<\/td>\n30 mg\/den<\/td>\nSn\u00ed\u017eit po\u010d\u00e1te\u010dn\u00ed d\u00e1vku; v\u011bt\u0161\u00ed ortostatick\u00e1 hypotenze a sedace<\/td>\n<\/tr>\n
    Jatern\u00ed\/ren\u00e1ln\u00ed selh\u00e1n\u00ed<\/td>\n15 mg p\u0159ed span\u00edm<\/td>\nA\u017e 30 mg\/den<\/td>\n\u2014<\/td>\nSn\u00ed\u017een\u00e1 clearance \u2014 pomalej\u0161\u00ed navy\u0161ov\u00e1n\u00ed d\u00e1vky<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n

    Profil vedlej\u0161\u00edch \u00fa\u010dink\u016f podle mechanismu<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
    Mechanismus \u00fa\u010dinku<\/th>\n\u00da\u010dinky<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    H1<\/sub> blok\u00e1da<\/td>\nSedace, p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze (stimulace chuti k j\u00eddlu)<\/td>\nP\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze je v\u00fdznamn\u00e9 \u2014 b\u011b\u017en\u011b 4\u20137 kg za 6 m\u011bs\u00edc\u016f. Sedace paradoxn\u011b kles\u00e1 p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch<\/td>\n<\/tr>\n
    Blok\u00e1da alfa-1<\/td>\nOrtostatick\u00e1 hypotenze, z\u00e1vrat\u011b<\/td>\nZvl\u00e1\u0161t\u011b u star\u0161\u00edch pacient\u016f \u2014 kontrolovat TK vle\u017ee\/vstoje<\/td>\n<\/tr>\n
    Anticholinergn\u00ed \u00fa\u010dinek (m\u00edrn\u00fd)<\/td>\nSucho v \u00fastech<\/td>\nM\u00e9n\u011b ne\u017e u TCA<\/td>\n<\/tr>\n
    5-HT3<\/sub> Antagonismus<\/td>\nAntiemetikum; sn\u00ed\u017een\u00e9 GI pot\u00ed\u017ee<\/td>\nPro\u010d mirtazapin zp\u016fsobuje mnohem m\u00e9n\u011b nauzey ne\u017e SSRI\/SNRI<\/td>\n<\/tr>\n
    Jin\u00e9<\/td>\nZv\u00fd\u0161en\u00fd cholesterol, triglyceridy, gluk\u00f3za<\/td>\nMetabolick\u00fd monitoring vhodn\u00fd za 6\u201312 m\u011bs\u00edc\u016f<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nAgranulocyt\u00f3za (1\/1000)<\/td>\nP\u0159eru\u0161it l\u00e9\u010dbu a zkontrolovat krevn\u00ed obraz p\u0159i p\u0159etrv\u00e1vaj\u00edc\u00ed hore\u010dce, bolesti v krku nebo slizni\u010dn\u00edch v\u0159edech v prvn\u00edch 6 t\u00fddnech<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nHyponatr\u00e9mie (SIADH)<\/td>\nNejvy\u0161\u0161\u00ed riziko maj\u00ed star\u0161\u00ed dosp\u011bl\u00ed<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nSyndrom neklidn\u00fdch nohou, \u017eiv\u00e9 sny<\/td>\nPoradenstv\u00ed pro pacienty<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Paradox sedace u mirtazapinu<\/h2>\n

    Mnoho pacient\u016f je zmateno, \u017ee mirtazapin 15 mg je v\u00edce sedativn\u00ed<\/strong> ne\u017e mirtazapine 30\u201345 mg. To je skute\u010dn\u00e9 a farmakologicky dob\u0159e popsan\u00e9: p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch, H1<\/sub> blok\u00e1da dominuje (sedativn\u00ed). P\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch je noradrenergn\u00ed stimulace z antagonismu alfa-2 receptor\u016f v\u00edce aktivuj\u00edc\u00ed, \u010d\u00edm\u017e \u010d\u00e1ste\u010dn\u011b vyrovn\u00e1v\u00e1 antihistaminovou sedaci. Pacient\u016fm, kte\u0159\u00ed za\u010d\u00ednaj\u00ed na 15 mg a c\u00edt\u00ed se p\u0159\u00edli\u0161 otup\u011bl\u00ed, tak n\u011bkdy m\u016f\u017ee pomoci , nikoli sn\u00ed\u017een\u00edm. Toto je kontraintuitivn\u00ed a stoj\u00ed za to to vysv\u011btlit p\u0159i p\u0159edepisov\u00e1n\u00ed.<\/strong>, ne dol\u016f. To je neintuitivn\u00ed a stoj\u00ed za to vysv\u011btlit p\u0159i p\u0159edepisov\u00e1n\u00ed.<\/p>\n

    Interakce s l\u00e9\u010divy<\/h2>\n

    Absolutn\u00ed kontraindikace<\/strong>: MAOI (14denn\u00ed vym\u00fdv\u00e1n\u00ed). Riziko serotoninov\u00e9ho syndromu je ni\u017e\u0161\u00ed ne\u017e u SSRI, proto\u017ee mirtazapin nezvy\u0161uje synaptick\u00fd serotonin inhibic\u00ed zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed, ale varov\u00e1n\u00ed p\u0159esto plat\u00ed.<\/p>\n

    Aditivn\u00ed deprese CNS<\/strong>: alkohol, benzodiazepiny, opioidy, sedativn\u00ed antihistaminika, l\u00e9ky na span\u00ed.<\/p>\n

    : hladiny stoupaj\u00ed p\u0159i u\u017e\u00edv\u00e1n\u00ed siln\u00fdch inhibitor\u016f; kombinace s paroxetinem, fluoxetinem, ketokonazolem nebo ritonavirem vy\u017eaduje opatrnost.<\/strong>: hladiny se zvy\u0161uj\u00ed p\u0159i siln\u00fdch inhibitorech; kombinace s paroxetinem, fluoxetinem, ketokonazolem, ritonavirem vy\u017eaduje opatrnost.<\/p>\n

    \u010casto kladen\u00e9 dotazy<\/h2>\n

    Jak dlouho trv\u00e1, ne\u017e Nasdep za\u010dne \u00fa\u010dinkovat?<\/h3>\n

    Sp\u00e1nek a chu\u0165 k j\u00eddlu se \u010dasto zlep\u0161\u00ed b\u011bhem 1\u20132 t\u00fddn\u016f. \u00dapln\u00e1 odezva n\u00e1lady u MDD se obvykle objev\u00ed za 4\u20136 t\u00fddn\u016f. Mnoho p\u0159edepisuj\u00edc\u00edch l\u00e9ka\u0159\u016f zva\u017euje mirtazapin u pacient\u016f s nespavost\u00ed a \u00fabytkem hmotnosti, proto\u017ee p\u0159\u00edzniv\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky pro n\u011b funguj\u00ed sp\u00ed\u0161e ne\u017e proti nim.<\/p>\n

    Pro\u010d Nasdep zp\u016fsobuje p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze?<\/h3>\n

    Mirtazapin je siln\u00fd H1<\/sub> antihistaminikum a 5-HT2C<\/sub> antagonista \u2014 oba stimuluj\u00ed chu\u0165 k j\u00eddlu. P\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze je nez\u00e1visl\u00e9 na d\u00e1vce a \u010dasto v\u00fdrazn\u00e9 (4\u20137 kg za 6 m\u011bs\u00edc\u016f). U pacient\u016f s depres\u00ed spojenou s \u00fabytkem hmotnosti je to terapeutick\u00e9; pro ostatn\u00ed je to hlavn\u00ed d\u016fvod k p\u0159echodu na jin\u00fd l\u00e9k.<\/p>\n

    M\u016f\u017eu u\u017e\u00edvat Nasdep na span\u00ed bez deprese?<\/h3>\n

    N\u011bkdy se pou\u017e\u00edv\u00e1 v n\u00edzk\u00e9 d\u00e1vce (7,5\u201315 mg) p\u0159i chronick\u00e9 nespavosti u pacient\u016f, u kter\u00fdch selhaly jin\u00e9 l\u00e9ky na span\u00ed. Nen\u00ed l\u00e9kem prvn\u00ed volby, proto\u017ee p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze a sedace p\u0159etrv\u00e1vaj\u00ed dlouhodob\u011b.<\/p>\n

    Pro\u010d doch\u00e1z\u00ed k paradoxu d\u00e1vkov\u00e1n\u00ed?<\/h3>\n

    P\u0159i 15 mg dominuje H1<\/sub> blok\u00e1da (sedativn\u00ed \u00fa\u010dinek). P\u0159i 30\u201345 mg je noradrenergn\u00ed stimulace z alfa-2 antagonismu v\u00edce aktivuj\u00edc\u00ed \u2014 \u010d\u00e1ste\u010dn\u011b kompenzuje antihistaminovou sedaci. Pacienti mohou n\u011bkdy vy\u0159e\u0161it ospalost p\u0159i 15 mg zv\u00fd\u0161en\u00edm d\u00e1vky na 30 mg.<\/p>\n

    Zp\u016fsobuje Nasdep sexu\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky?<\/h3>\n

    Mnohem m\u00e9n\u011b ne\u017e SSRI \u2014 5-HT2<\/sub> antagonismus p\u0159esm\u011brov\u00e1v\u00e1 serotonin od receptor\u016f zodpov\u011bdn\u00fdch za sexu\u00e1ln\u00ed dysfunkci zp\u016fsobenou SSRI. Mirtazapin se n\u011bkdy p\u0159id\u00e1v\u00e1 k SSRI nebo jimi nahrazuje pr\u00e1v\u011b proto, aby zm\u00edrnil sexu\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky.<\/p>\n

    M\u016f\u017ee se Nasdep kombinovat s venlafaxinem?<\/h3>\n

    Ano \u2014 kombinace venlafaxinu a mirtazapinu se neform\u00e1ln\u011b naz\u00fdv\u00e1 \u201ckalifornsk\u00e9 raketov\u00e9 palivo\u201d a pat\u0159\u00ed mezi nejl\u00e9pe prok\u00e1zan\u00e9 strategie pro l\u00e9\u010dbu deprese rezistentn\u00ed na l\u00e9\u010dbu. Prov\u00e1d\u00ed se pod odborn\u00fdm dohledem.<\/p>\n

    Je Nasdep bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n

    Omezen\u00e9 \u00fadaje o bezpe\u010dnosti \u2014 nen\u00ed l\u00e9kem prvn\u00ed volby. SSRI (preferuje se sertralin) maj\u00ed rozs\u00e1hlej\u0161\u00ed registry dat. Proberte individu\u00e1ln\u011b s p\u0159edepisuj\u00edc\u00edm l\u00e9ka\u0159em.<\/p>\n

    Co se stane, kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n

    Vezm\u011bte si ho, jakmile si vzpomenete, pokud nen\u00ed bl\u00edzko dal\u0161\u00ed d\u00e1vka \u2014 nikdy ned\u00e1vejte dvojitou d\u00e1vku. Mirtazapin m\u00e1 dlouh\u00fd polo\u010das (20\u201340 h), tak\u017ee jedna vynechan\u00e1 d\u00e1vka obvykle nevad\u00ed.<\/p>\n

    Jak by m\u011bl b\u00fdt Nasdep vysazen?<\/h3>\n

    Mirtazapin m\u00e1 m\u00edrn\u011bj\u0161\u00ed abstinen\u010dn\u00ed syndrom ne\u017e SSRI\/SNRI. Sni\u017eujte d\u00e1vku o 15 mg ka\u017ed\u00e9 2\u20134 t\u00fddny. Zm\u011bny sp\u00e1nku a chuti k j\u00eddlu se mohou vr\u00e1tit \u2014 po\u010d\u00edtejte s t\u00edm.<\/p>\n

    Jak by m\u011bl b\u00fdt Nasdep skladov\u00e1n?<\/h3>\n

    Skladujte p\u0159i 15\u201330 \u00b0C v p\u016fvodn\u00edm blistru, chr\u00e1n\u011bno p\u0159ed vlhkost\u00ed a slune\u010dn\u00edm sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n

    Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Informace na t\u00e9to str\u00e1nce jsou ur\u010deny dosp\u011bl\u00fdm u\u017e\u00edvaj\u00edc\u00edm p\u0159edepsan\u00e9 psychiatrick\u00e9 l\u00e9ky a nenahrazuj\u00ed individu\u00e1ln\u00ed l\u00e9ka\u0159skou p\u00e9\u010di. Antidepresiva, antipsychotika a p\u0159\u00edbuzn\u00e9 l\u00e9ky mohou interagovat s jin\u00fdmi l\u00e9ky, alkoholem a st\u00e1vaj\u00edc\u00edmi zdravotn\u00edmi stavy. Jak\u00e9koli nov\u00e9 l\u00e9ky, zm\u011bnu d\u00e1vkov\u00e1n\u00ed nebo pl\u00e1novan\u00e9 vysazen\u00ed konzultujte s kvalifikovan\u00fdm l\u00e9ka\u0159em. Pokud se u v\u00e1s objev\u00ed sebevra\u017eedn\u00e9 my\u0161lenky, m\u00e1nie, t\u011b\u017ek\u00e1 akathisie, p\u0159\u00edznaky serotoninov\u00e9ho syndromu (vysok\u00e1 hore\u010dka, zmatenost, svalov\u00e1 ztuhlost, zrychlen\u00fd srde\u010dn\u00ed tep) nebo neuroleptick\u00fd malign\u00ed syndrom, vyhledejte okam\u017eit\u011b l\u00e9ka\u0159skou pomoc.<\/div>\n

    <\/p>\n

    Souvisej\u00edc\u00ed alternativy<\/h3>\n

    Dal\u0161\u00ed produkty v Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n