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. Author manuscript; available in PMC: 2014 Sep 9.
Published in final edited form as: Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006528. doi: 10.1002/14651858.CD006528.pub2

Comparison 1. Mirtazapine versus TCAs.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Primary outcome (response) at 2 weeks 8 1294 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.64, 1.13]
 1.1 vs Amitriptyline 5 722 Odds Ratio (M-H, Random, 95% CI) 0.77 [0.54, 1.12]
 1.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.46, 1.73]
 1.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 1.11 [0.58, 2.12]
 1.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.84 [0.22, 3.22]
2 Primary outcome (response) at end of the acute-phase treatment 9 1501 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.72, 1.10]
 2.1 vs Amitriptyline 6 929 Odds Ratio (M-H, Random, 95% CI) 0.90 [0.69, 1.17]
 2.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.90 [0.47, 1.71]
 2.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.44, 1.63]
 2.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.91 [0.53, 1.55]
3 Secondary outcome (remission) at 2 weeks 8 1294 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.55, 1.32]
 3.1 vs Amitriptyline 5 722 Odds Ratio (M-H, Random, 95% CI) 0.67 [0.35, 1.29]
 3.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.34, 2.31]
 3.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 1.27 [0.54, 3.00]
 3.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.70 [0.12, 4.28]
4 Secondary outcome (remission) at end of the acute-phase treatment 9 1501 Odds Ratio (M-H, Random, 95% CI) 0.86 [0.69, 1.08]
 4.1 vs Amitriptyline 6 929 Odds Ratio (M-H, Random, 95% CI) 0.87 [0.65, 1.16]
 4.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.77 [0.41, 1.45]
 4.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.94 [0.50, 1.74]
 4.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.46, 1.56]
5 Secondary outcome (depression severity) at 2 weeks 2 361 Std. Mean Difference (IV, Random, 95% CI) 0.10 [−0.11, 0.31]
 5.1 vs Amitritpyline 2 361 Std. Mean Difference (IV, Random, 95% CI) 0.10 [−0.11, 0.31]
6 Secondary outcome (depression severity) at end of the acute-phase treatment 1 144 Std. Mean Difference (IV, Random, 95% CI) 0.12 [−0.21, 0.45]
 6.1 vs Amitritpyline 1 144 Std. Mean Difference (IV, Random, 95% CI) 0.12 [−0.21, 0.45]
7 Secondary outcome (Social adjustment) at 2 weeks 1 138 Mean Difference (IV, Random, 95% CI) 1.60 [−1.98, 5.18]
 7.1 vs Amitriptyline 1 138 Mean Difference (IV, Random, 95% CI) 1.60 [−1.98, 5.18]
8 Secondary outcome (Social adjustment) at end of the acute-phase treatment 3 440 Std. Mean Difference (IV, Random, 95% CI) 0.02 [−0.17, 0.21]
 8.1 vs Amitriptyline 1 114 Std. Mean Difference (IV, Random, 95% CI) 0.03 [−0.34, 0.40]
 8.2 vs Clomipramine 1 163 Std. Mean Difference (IV, Random, 95% CI) 0.12 [−0.19, 0.43]
 8.3 vs Doxepin 1 163 Std. Mean Difference (IV, Random, 95% CI) −0.09 [−0.39, 0.22]
9 Secondary outcome (withdrawal due to any reason) 7 1166 Odds Ratio (M-H, Random, 95% CI) 0.83 [0.63, 1.10]
 9.1 vs Amitriptyline 5 829 Odds Ratio (M-H, Random, 95% CI) 0.90 [0.65, 1.25]
 9.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.80 [0.42, 1.54]
 9.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.51 [0.22, 1.19]
10 Secondary outcome (withdrawal due to adverse events) 8 1266 Odds Ratio (M-H, Random, 95% CI) 0.65 [0.41, 1.03]
 10.1 vs Amitriptyline 6 929 Odds Ratio (M-H, Random, 95% CI) 0.60 [0.35, 1.03]
 10.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 1.14 [0.42, 3.10]
 10.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.30 [0.06, 1.56]
11 Secondary outcome (having some adverse events) 2 442 Odds Ratio (M-H, Random, 95% CI) 1.06 [0.54, 2.10]
 11.1 vs Amitriptyline 1 207 Odds Ratio (M-H, Random, 95% CI) 0.74 [0.16, 3.37]
 11.2 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 1.17 [0.55, 2.49]
12 Hypertension/Tachycardia 4 522 Odds Ratio (M-H, Random, 95% CI) 0.44 [0.24, 0.81]
 12.1 vs Amitriptyline 4 522 Odds Ratio (M-H, Random, 95% CI) 0.44 [0.24, 0.81]
13 Hypotension/Bradycardia 2 215 Odds Ratio (M-H, Random, 95% CI) 0.46 [0.12, 1.81]
 13.1 vs Amitriptyline 2 215 Odds Ratio (M-H, Random, 95% CI) 0.46 [0.12, 1.81]
14 Sweating 2 458 Odds Ratio (M-H, Random, 95% CI) 0.42 [0.05, 3.24]
 14.1 vs Amitriptyline 2 458 Odds Ratio (M-H, Random, 95% CI) 0.42 [0.05, 3.24]
15 Constipation 6 1003 Odds Ratio (M-H, Random, 95% CI) 0.72 [0.46, 1.12]
 15.1 vs Amitriptyline 5 829 Odds Ratio (M-H, Random, 95% CI) 0.72 [0.40, 1.29]
 15.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.62 [0.26, 1.48]
16 Dry mouth/Decreased salivation 8 1266 Odds Ratio (M-H, Random, 95% CI) 0.52 [0.24, 1.14]
 16.1 vs Amitriptyline 6 929 Odds Ratio (M-H, Random, 95% CI) 0.36 [0.14, 0.92]
 16.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.81 [0.39, 1.69]
 16.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 2.86 [1.18, 6.94]
17 Nausea/Vomiting/Gastric distress 4 581 Odds Ratio (M-H, Random, 95% CI) 0.29 [0.05, 1.59]
 17.1 vs Amitriptyline 3 407 Odds Ratio (M-H, Random, 95% CI) 0.33 [0.04, 2.59]
 17.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.16 [0.02, 1.33]
18 Weight gain/Increased appetite 3 463 Odds Ratio (M-H, Random, 95% CI) 1.04 [0.58, 1.86]
 18.1 vs Amitriptyline 3 463 Odds Ratio (M-H, Random, 95% CI) 1.04 [0.58, 1.86]
19 Sexual dysfunction 2 351 Odds Ratio (M-H, Random, 95% CI) 0.41 [0.06, 2.61]
 19.1 vs Amitriptyline 2 351 Odds Ratio (M-H, Random, 95% CI) 0.41 [0.06, 2.61]
20 Anxiety/Agitation 2 307 Odds Ratio (M-H, Random, 95% CI) 0.87 [0.34, 2.19]
 20.1 vs Amitriptyline 2 307 Odds Ratio (M-H, Random, 95% CI) 0.87 [0.34, 2.19]
21 Dizziness/Vertigo/Faintness 7 1166 Odds Ratio (M-H, Random, 95% CI) 0.75 [0.43, 1.28]
 21.1 vs Amitriptyline 5 829 Odds Ratio (M-H, Random, 95% CI) 0.64 [0.35, 1.17]
 21.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.70 [0.21, 2.29]
 21.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 3.04 [0.59, 15.53]
22 Fatigue/Tiredness/Asthenia 4 673 Odds Ratio (M-H, Random, 95% CI) 1.25 [0.71, 2.21]
 22.1 vs Amitriptyline 4 673 Odds Ratio (M-H, Random, 95% CI) 1.25 [0.71, 2.21]
23 Headache 4 522 Odds Ratio (M-H, Random, 95% CI) 0.74 [0.31, 1.74]
 23.1 vs Amitriptyline 4 522 Odds Ratio (M-H, Random, 95% CI) 0.74 [0.31, 1.74]
24 Tremor 7 1103 Odds Ratio (M-H, Random, 95% CI) 0.36 [0.22, 0.57]
 24.1 vs Amitriptyline 6 929 Odds Ratio (M-H, Random, 95% CI) 0.36 [0.20, 0.62]
 24.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.36 [0.15, 0.88]
25 Sleep disturbance 1 207 Odds Ratio (M-H, Random, 95% CI) 1.43 [0.69, 2.98]
 25.1 vs Amitriptyline 1 207 Odds Ratio (M-H, Random, 95% CI) 1.43 [0.69, 2.98]
26 Sleepiness/Drowsiness/Somnolence 6 841 Odds Ratio (M-H, Random, 95% CI) 0.92 [0.66, 1.27]
 26.1 vs Amitriptyline 5 678 Odds Ratio (M-H, Random, 95% CI) 0.81 [0.58, 1.14]
 26.2 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 1.86 [0.82, 4.21]
27 Suicide attempt 5 935 Odds Ratio (M-H, Random, 95% CI) 1.77 [0.47, 6.58]
 27.1 vs Amitriptyline 2 363 Odds Ratio (M-H, Random, 95% CI) 2.08 [0.27, 16.29]
 27.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 1.0 [0.06, 16.25]
 27.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.32 [0.01, 7.91]
 27.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 9.90 [0.53, 185.90]
28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients 2 425 Odds Ratio (M-H, Random, 95% CI) 0.81 [0.50, 1.32]
 28.1 vs Amitriptyline 1 251 Odds Ratio (M-H, Random, 95% CI) 0.73 [0.36, 1.48]
 28.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.46, 1.73]
29 Subgroup analysis: Response at end of the acute-phase treatment: Treatment settings: Psychiatric inpatients 3 632 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.64, 1.23]
 29.1 vs Amitriptyline 2 458 Odds Ratio (M-H, Random, 95% CI) 0.88 [0.60, 1.29]
 29.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.90 [0.47, 1.71]
30 Sensitivity analysis: Response at 2 weeks: Studies without imputation 7 1179 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.64, 1.15]
 30.1 vs Amitriptyline 4 607 Odds Ratio (M-H, Random, 95% CI) 0.76 [0.51, 1.13]
 30.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.89 [0.46, 1.73]
 30.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 1.11 [0.58, 2.12]
 30.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.84 [0.22, 3.22]
31 Sensitivity analysis: Response at end of the acute-phase treatment: Studies without imputation 8 1386 Odds Ratio (M-H, Random, 95% CI) 0.93 [0.74, 1.15]
 31.1 vs Amitriptyline 5 814 Odds Ratio (M-H, Random, 95% CI) 0.95 [0.72, 1.26]
 31.2 vs Clomipramine 1 174 Odds Ratio (M-H, Random, 95% CI) 0.90 [0.47, 1.71]
 31.3 vs Doxepin 1 163 Odds Ratio (M-H, Random, 95% CI) 0.85 [0.44, 1.63]
 31.4 vs Nortriptyline 1 235 Odds Ratio (M-H, Random, 95% CI) 0.91 [0.53, 1.55]
32 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks Other data No numeric data
33 Secondary outcome (SKEWED DATA: depression severity) at end of the acute-phase treatment Other data No numeric data