Many patients will take acetaminophen for their pain management. It is cheap, somewhat effective, and typically pretty safe at normal dosages. There are potential downsides when it comes to acetaminophen. Let me outline a couple of common mistakes with acetaminophen.
Mirtazapine is commonly used in elderly patients with depression who are also suffering from insomnia. Mirtazapine is often chosen because it is much safer than benzodiazepines, “z-drugs”, and antipsychotics. The mechanisms of mirtazapine (podcast episode on the pharmacology) include the release of norepinephrine via presynaptic adrenergic auto-receptor blockade, increased serotonin production through stimulation of adrenoreceptors on serotonergic cell bodies, and the direct blockade of 5-HT2 and 5-HT3 receptors. Mirtazapine has a high H1 receptor affinity, leading to antihistamine effects. So what does this mean as far as dosing of mirtazapine for insomnia?