Table 1.

Use of Mirtazapine in Subtypes of Depression

Indication	Reference	Study Population	Design	Outcome
Melancholic depression	Guelfi et al, 200127	153 hospitalized patients	8-wk, randomized, double-blind trial comparing mirtazapine and venlafaxine	62% response rates with mirtazapine vs 52% with venlafaxine
Relapse prevention	Thase et al, 200128	156 fully remitted patients	40-wk, randomized, double-blind, therapy-continuation, placebo-controlled trial	Significantly lower relapse rates vs placebo
	Montgomery et al, 199829	217 patients who responded in a 6-wk double-blind trial	2-y, randomized, double-blind, placebo-controlled trial comparing mirtazapine, amitriptyline, and placebo	Significantly lower relapse rates vs placebo and amitriptyline
Persistent and treatment-resistant depression	Carpenter et al, 200230	26 patients with persistent depression after monotherapy	4-wk, randomized, double-blind, placebo-controlled trial of augmentation with mirtazapine	Response rate: 64% vs 20% with placebo; higher remission rates: 45.4% vs 13.3% with placebo
	Fava et al, 200631 (Sequenced Treatment Alternatives to Relieve Depression trial)	235 patients who failed to respond to 2 consecutive antidepressants	14-wk, randomized, unblinded trial comparing mirtazapine and nortriptyline	Insignificantly lower response and lower remission rates with nortriptyline
	Hirschfeld, 200232	250 patients with selective serotonin reuptake inhibitor–resistant depression	8-wk, multicenter, double-blind study comparing mirtazapine to sertraline	Equally efficacious at endpoint; remission rates at wk 1 and wk 2 significantly higher for mirtazapine
Depression with anxiety	Kim et al, 201122	60 patients with major depressive disorder and a high level of anxiety symptoms	8-wk, randomized, open-label trial comparing orally disintegrating mirtazapine and paroxetine	Similar rates of improvement at endpoint; mirtazapine more effective in wk 1–2
	Versiani et al, 200533	294 severely depressed patients	8-wk, randomized, double-blind study comparing mirtazapine and fluoxetine	Similar rates of improvement; mirtazapine more effective in wk 1–2