Abstract

Simple SummaryMirtazapine, a tetracyclic antidepressant, acts through noradrenergic and specific serotonergic systems. Consequently, it was recently applied in major depressive disorder treatment. Moreover, because mirtazapine may have effective glucose control function, its mechanism of action warrants further investigation. In our study, we examined how mirtazapine affects metabolic parameters, insulin profiles, glucose metabolism, and obesity changes in high-fat diet-fed C57BL6/J mice. Our results indicated that compared with untreated mice, mirtazapine-treated obese mice had lower insulin levels, daily food efficiency, body weight, serum triglyceride levels, aspartate aminotransferase levels, liver and epididymal fat pad weight, and fatty acid regulation marker expression. Moreover, the blood glucose levels and area under the curve for glucose levels observed over a 120 min assessment period were lower in the treated mice, but the insulin sensitivity and glucose transporter 4 expression levels were higher in these mice. They also demonstrated a considerable decrease in fatty liver scores and mean fat cell size in the epididymal white adipose tissue, paralleling adenosine monophosphate (AMP)-activated protein kinase expression activation. In conclusion, mirtazapine administration may alleviate type 2 diabetes mellitus with hyperglycemia.Metabolic syndrome is known to engender type 2 diabetes as well as some cardiac, cerebrovascular, and kidney diseases. Mirtazapine—an atypical second-generation antipsychotic drug with less severe side effects than atypical first-generation antipsychotics—may have positive effects on blood glucose levels and obesity. In our executed study, we treated male high-fat diet (HFD)-fed C57BL/6J mice with mirtazapine (10 mg/kg/day mirtazapine) for 4 weeks to understand its antiobesity effects. We noted these mice to exhibit lower insulin levels, daily food efficiency, body weight, serum triglyceride levels, aspartate aminotransferase levels, liver and epididymal fat pad weight, and fatty acid regulation marker expression when compared with their counterparts (i.e., HFD-fed control mice). Furthermore, we determined a considerable drop in fatty liver scores and mean fat cell size in the epididymal white adipose tissue in the treated mice, corresponding to AMP-activated protein kinase expression activation. Notably, the treated mice showed lower glucose tolerance and blood glucose levels, but higher glucose transporter 4 expression. Overall, the aforementioned findings signify that mirtazapine could reduce lipid accumulation and thus prevent HFD-induced increase in body weight. In conclusion, mirtazapine may be useful in body weight control and antihyperglycemia therapy.

Highlights

  • Mirtazapine, a tetracyclic antidepressant that acts through specific serotonergic and noradrenergic systems, has predominantly been evaluated for its alleviating effects on major depressive disorder (MDD) [1]

  • We present all data in this figure as mean ± SEMs (n = 10) for both groups. * p < 0.05, Fatty synthase (FASN) is a key enzyme in triglyceride synthesis and lipid homeostasis [10]

  • In our HFD-fed mice, mirtazapine treatment was found to inhibit fatty acid synthase (FASN)—a protein that plays a role in adipocyte differentiation and fat accumulation—expression [33]. These results indicate mirtazapine can prevent obesity engendered by excess caloric intake; mirtazapine may become beneficial for the identification of pivotal energy balance regulators considering its influence on lipolysis and lipogenesis

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Summary

Introduction

Mirtazapine, a tetracyclic antidepressant that acts through specific serotonergic and noradrenergic systems, has predominantly been evaluated for its alleviating effects on major depressive disorder (MDD) [1]. The exact mechanism underlying the therapeutic effects of mirtazapine remains unclear, mirtazapine is potentially as effective as other antidepressants and exhibits noradrenergic together with serotonergic effects; its onset of action is considered to be faster than that of selective serotonin reuptake inhibitors (SSRIs). Mirtazapine inhibits presynaptic central α2-adrenergic receptors; this inhibitory effect intensifies noradrenaline and serotonin release [1,3], thereby enhancing norepinephrine and serotonin transmission. This mechanism is possibly responsible for the rapid onset of action of mirtazapine

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