Mirtazapine was significantly more effective than a serotonin-noradrenaline reuptake inhibitor ( venlafaxine only , two trials , n = 415 ) at two weeks ( OR 2.29 , 95 % CI 1.45 to 3.59 ) and at the end of acute-phase treatment ( OR 1.53 , 95 % CI 1.03 to 2.25).In terms of dropouts , there was no robust evidence to detect a difference between mirtazapine and other antidepressants .
Mirtazapine was more likely to cause weight gain or increased appetite and somnolence than SSRIs but less likely to cause nausea or vomiting and sexual dysfunction .
AUTHORS ' CONCLUSIONS Some statistically significant and possibly clinical ly meaningful differences between mirtazapine and other antidepressive agents were found for the acute-phase treatment of major depression .
Mirtazapine is likely to have a faster onset of action than SSRIs during the acute-phase treatment .
Dropouts occur similarly in participants treated with mirtazapine and those treated with other antidepressants , although the adverse event profile of mirtazapine is unique
BACKGROUND Mirtazapine has a unique mechanism of antidepressive action and is one of the commonly used antidepressants in clinical practice .
OBJECTIVES The aim of the present review was to assess the evidence on the efficacy and acceptability of mirtazapine compared with other antidepressive agents in the acute-phase treatment of major depression in adults .
A 12-week study comparing moclobemide and sertraline in the treatment of outpatients with atypical depression
One hundred and ninety-seven out patients with atypical depression [ Atypical Depression Diagnostic Scale ( ADDS ) score=4 ] were r and omized to 12 weeks of double-blind treatment with sertraline or moclobemide  in a multicentre , parallel-group clinical trial . Patients were started on either 50 mg/day sertraline or 300 mg/day moclobemide . If the therapeutic response was not satisfactoryafter 4 weeks , the dose could be increased to either 100 mg/day sertraline or 450 mg/day moclobemide . Primary effcacy evaluations were the 29-item Hamilton Psychiatric Rating Scale for Depression ( HAM-D ) and the Clinical Global Impression of Improvement ( CGI I ) response rate ( much or very much improved ) at study endpoint . Secondary effcacy evaluations included the ADDS , the Hamilton Anxiety Scale ( HAMA ) , the Leeds Sleep Scale , and the Battelle Quality of Life Battery ( BQOLB ) . In the analysis of the 172 patient effcacy-evaluable population , there was significant baseline to endpoint improvement in all primary and secondary effcacy assessment s after treatment with either sertraline or moclobemide . At the endpoint , the proportion of responders on CGI-I , was 77.5 % in the sertraline group and 67.5 % in the moclobemide group ( p=0.052 ) . The baseline to endpoint mean 29-item HAM-D score decreased from 35.9 to 14.5 in the sertraline group and from 36.3 to 16.1 in the moclobemide group . Sertraline also result ed in a significantly ( p50.05 ) greater degree of improvement at the endpoint , compared with moclobemide , in the proportion of remitters on the HAMA ( total score47 ) , ADDS Category IID ( Rejection Sensitivity ) , Leeds Sleep Factor 4 ( Integrity of Behaviour Following Awakening ) , and on three dimensions of the BQOLB ( Energy/Vitality , Social Interaction and Life Satisfaction ) . There were no other significant differences between treatment groups . Overall , both medications were well tolerated . In this study , both sertraline and moclobemide improved the symptoms of atypical depression
Mirtazapine was significantly more effective than a serotonin-noradrenaline reuptake inhibitor ( venlafaxine only , two trials , n = 415 ) at two weeks ( OR 2.29 , 95 % CI 1.45 to 3.59 ) and at the end of acute-phase treatment ( OR 1.53 , 95 % CI 1.03 to 2.25).In terms of dropouts , there was no robust evidence to detect a difference between mirtazapine and other antidepressants .
Mirtazapine was more likely to cause weight gain or increased appetite and somnolence than SSRIs but less likely to cause nausea or vomiting and sexual dysfunction .
AUTHORS ' CONCLUSIONS Some statistically significant and possibly clinical ly meaningful differences between mirtazapine and other antidepressive agents were found for the acute-phase treatment of major depression .
Mirtazapine is likely to have a faster onset of action than SSRIs during the acute-phase treatment .
Dropouts occur similarly in participants treated with mirtazapine and those treated with other antidepressants , although the adverse event profile of mirtazapine is unique
BACKGROUND Mirtazapine has a unique mechanism of antidepressive action and is one of the commonly used antidepressants in clinical practice .
OBJECTIVES The aim of the present review was to assess the evidence on the efficacy and acceptability of mirtazapine compared with other antidepressive agents in the acute-phase treatment of major depression in adults .