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 .
Comparison of 2 treatment strategies for depressed inpatients: imipramine and lithium addition or mirtazapine and lithium addition.
BACKGROUND The purpose of this study was to compare the overall effectiveness of 2 treatment strategies for in patients with severe major depressive episode ( DSM-III-R ) : ( 1 ) mirtazapine ( phase 1 ) and subsequent lithium addition ( phase 2 ) or ( 2 ) imipramine ( phase 1 ) and subsequent lithium addition ( phase 2 ) . We previously reported the results of phase 1 . METHOD In phase 1 , patients were r and omly assigned to treatment with either mirtazapine or imipramine , and doses were adjusted to obtain predefined blood drug levels . Nonresponders had lithium added to the double-blind mirtazapine or imipramine medication . The dose was adjusted to obtain a blood lithium level of 0.5 - 1.0 mmol/L. Treatment effects were evaluated weekly by the Montgomery-Asberg Depression Rating Scale for up to 2 weeks on this blood lithium level . RESULTS Data for 100 patients were available for comparison of the 2 treatment strategies . 80 patients received no comedication . By the end of phase 2 , 24 ( 48 % ) of 50 had responded to mirtazapine and 32 ( 64 % ) of 50 had responded to imipramine ( intent-to-treat analysis ) . A survival analysis of the total patient group intent-to-treat showed a significant difference in favor of the treatment strategy with imipramine and subsequent lithium addition . CONCLUSION Efficacy of imipramine and subsequent lithium addition for nonresponders is superior to the same treatment strategy with mirtazapine . This applies to the patient sample studied , which consisted of 100 severely depressed in patients , 29 of whom were psychotically depressed . More serious side effects of imipramine , however , led to discontinuation of imipramine in 5 patients . No serious side effects were observed during the phase of lithium addition to either imipramine or mirtazapine . We , therefore , prefer to start treatment with imipramine and test for fixed blood drug levels , and , if necessary , add lithium . In the case of prohibitive side effects , patients are switched to a modern antidepressant such as mirtazapine , and , if necessary , lithium is added to this antidepressant
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 .