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 .
Comparisons of the Efficacy and Tolerability of Extended-Release Venlafaxine, Mirtazapine, and Paroxetine in Treatment-Resistant Depression: A Double-Blind, Randomized Pilot Study in a Chinese Population
To compare the efficacy and tolerability of antidepressants switch with extended-release venlafaxine ( venlafaxine-XR ) , mirtazapine , and paroxetine in Chinese patients with major depressive disorder who had 2 consecutive unsuccessful antidepressant trials . One hundred fifty adult patients with treatment-resistant depression according to their medical records and /or response to current treatments were r and omly assigned to receive fixed-dosage treatment of venlafaxine-XR 225 mg/d ( n = 50 ) , mirtazapine 45 mg/d ( n = 55 ) , or paroxetine 20 mg/d ( n = 45 ) for 8 weeks . The primary outcome was the remission rates that were defined as a score 7 or lower on the 17-item Hamilton Rating Scale for Depression ( HRSD-17 ) . Secondary outcomes included the remission rate defined by the Self-Rating Depression Scale of 50 or lower and the response rate defined by a 50 % reduction or greater on the HRSD-17 total score , and the improvement of patients ' general health functions . The completion rates were 82 % for venlafaxine-XR , 81.8 % for mirtazapine , and 82.2 % for paroxetine . Only one patient in paroxetine arm discontinued the study owing to an adverse event . The remission rates based on the HRSD-17 were 42.0 % for venlafaxine-XR , 36.4 % for mirtazapine , and 46.7 % for paroxetine . There were no statistical significance s between treatment arms in remission rates . Similarly , there were also no significant differences between groups in secondary outcome measure .  Venlafaxine-XR , mirtazapine , and paroxetine were equally effective in the treatment of Chinese patients with major depressive disorder who failed at least 2 previous antidepressant treatments . Selecting any of these 3 antidepressants as a third-step antidepressant is a reasonable choice for this group of patients
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 .