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 .
Efficacy and tolerability of hypericum extract STW3 in long-term treatment with a once-daily dosage in comparison with sertraline.
OBJECTIVE The objective of this double-blind , multi-center clinical study was to demonstrate the non-inferiority of hypericum extract versus sertraline in the treatment of moderate depression . METHODS A total of 241 patients with a diagnosis of moderate depressive disorder ( according to ICD-10 criteria ) were r and omized with either 50 mg sertraline or 612 mg hypericum extract ( hypericum group n = 123 ; sertraline group n = 118 ) . According to the study protocol , 200 patients were treated for at least 12 weeks ( n = 102 hypericum extract ; n = 98 sertraline )  ; 81 patients in the hypericum group and 80 in the sertraline group were treated after week 12 for an additional 12 weeks . Thus , most patients were treated for a period of 6 months . The primary efficacy variable was the 17-item HAMD total score at the end of the first 12-week double-blind treatment period . RESULTS After the first 12-week treatment period , the HAMD score decreased from almost identical initial values ( 22.0 + /- 1.1 for hypericum and 22.1 + /- 1.1 points for sertraline ) to 8.3 + /- 5.5 points ( hypericum ) and 8.1 + /- 5.6 points ( sertraline ) ( mean + /- SD ) in the patients treated per- protocol ( PP ) population . The statistical test for non-inferiority ( boundary delta = 3 ) revealed that hypericum extract is not inferior to sertraline ( P < 0.0001 ) . The mean difference between the treatments was 0.1995 points , with a corresponding one-sided 97.5 % confidence interval ( -infinity , 1.3772 ) . In patients who continued treatment in the follow-up phase , the HAMD score at the end of the study was 5.7 + /- 4.8 points ( hypericum group ) and 7.1 + /- 6.3 points ( sertraline group ) . Comparable improvement was also found for the von Zerssen 's Adjective Mood Scale ( BfS ) and CGI during the first and second 12-week treatment period in both treatment groups . With 68.6 % of patients in the hypericum group and 70.4 % in the sertraline group , the percentage of patients rated as responders did not differ significantly between treatment groups ( 12 weeks ) . The adverse events of 12 patients in the hypericum group ( 9.8 % ) and of 16 patients in the sertraline group ( 13.6 % ) were possibly related to study medication . No basic differences in the treatment groups were observed and no interaction with concomitant medication was documented . In most cases , the investigators assessed the tolerability of hypericum extract and sertraline as " good " or " very good . " CONCLUSIONS The results indicate that hypericum extract STW 3 is not inferior to sertraline and that it is a well-tolerated drug for the treatment of moderate depression . These favorable effects were achieved with a once-daily dose of 612 mg of hypericum extract given for up to 24 weeks
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 .