Efficacy and tolerability of mirtazapine in treating major depressive disorder with anxiety symptoms: an 8-week open-label randomised paroxetine-controlled trial

2011 ◽  
Vol 65 (3) ◽  
pp. 323-329 ◽  
Author(s):  
J. E. Kim ◽  
S. J. Yoon ◽  
J. Kim ◽  
J. Y. Jung ◽  
H. S. Jeong ◽  
...  
2021 ◽  
Vol 11 ◽  
pp. 204512532110131
Author(s):  
Pratap Chokka ◽  
Holly Ge ◽  
Joanna Bougie ◽  
Anders Ettrup ◽  
Guerline Clerzius

Background: Anxiety symptoms are common in patients with major depressive disorder (MDD) and usually confer worse treatment outcomes. The long-term, open-label AtWoRC study in working patients with MDD treated with vortioxetine demonstrated a significant correlation between severity of anxiety symptoms and impaired work productivity. This analysis was undertaken to further explore clinical characteristics and treatment outcomes in patients with different levels of severity of anxiety symptoms at baseline. Methods: Post hoc analysis in 199 working patients with MDD treated with vortioxetine (10–20 mg/day), stratified by Generalized Anxiety Disorder 7-item (GAD-7) score at baseline [mild/moderate anxiety (GAD-7 ⩽14), n = 83; severe anxiety (GAD-7 ⩾15), n = 116]. Associations were examined between GAD-7 and other outcome assessment scores at baseline. Observed mean changes from baseline to week 52 were compared between groups. Results: Patients with severe anxiety had significantly worse depressive and cognitive symptoms, functioning, and work productivity at baseline than those with mild/moderate anxiety, but similar cognitive performance. Statistically significant improvements from baseline were seen for all outcomes after 52 weeks of vortioxetine treatment, with no significant differences observed between the two groups after adjustment for baseline anxiety scores. Conclusion: Treatment with vortioxetine was associated with long-term improvement in clinical symptoms and measures of work productivity in patients with MDD in a real-world setting, irrespective of severity of anxiety symptoms at the start of treatment.


2012 ◽  
Vol 4 ◽  
pp. CMT.S7632
Author(s):  
Alexandre González Rodriguez ◽  
Cristóbal Gastó Ferrer ◽  
Victor Navarro Odriozola

Objective To compare the efficacy and tolerability of paroxetine and mirtazapine in the treatment of major depression. Data sources Searches were conducted to identify studies through Medline (1980-2011), PsycInfo (1980-2011) and PubMed databases up to June 2011. The searches were not restricted to publication type or clinical trial design. Study Selection A clinical trial was included if it described a trial of paroxetine versus mirtazapine in patients with major depression, based on the research evidence of reviews. Data Abstraction Three assessors analyzed the quality of the trials and extracted study design data, trial features, efficacy and toler-ability assessment tools, discontinuation reasons for both antidepressants and remitter and responder rates. Results We included six randomized controlled trials, one open-label, randomized controlled trial and four systematic reviews and metaanalysis. Rates of remission and response between mirtazapine and paroxetine were compared: at the beginning (1-2 weeks) there were statistically significant differences in mirtazapine treated patients, but these were not found at the end of assessment period (6-8 weeks). Discontinuation rates between the two drugs showed no differences, with an adverse event profile characteristic of each drug. Conclusions Mirtazapine and paroxetine were equally effective and well-tolerated in major depressive disorder. Differences in effectiveness were only observed in the first or second week of treatment when mirtazapine showed earlier onset of action.


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