New study led by U. Pitt researcher shows mirtazapine cuts risk of depression relapse by more than 50 percent

December 14, 1999

Mirtazapine Also Shown to Relieve Depression More Rapidly Than Some Commonly Prescribed SSRIs

PITTSBURGH, Dec. 15 -- A study led by a University of Pittsburgh researcher being presented at the annual meeting of the American College of Neuropsychopharmacology (ACNP) today in Acapulco found that twice as many placebo-treated patients experienced a relapse of their depression versus those who continued treatment with the antidepressant Remeron® (mirtazapine). Additional data presented at the meeting demonstrated that mirtazapine, a dual-action antidepressant, relieves depression more quickly than some commonly prescribed selective serotonin reuptake inhibitor (SSRI) antidepressants.

Depression and related mood disorders cost U.S. society an estimated $16 billion annually1. Depressive disorders account for 7.4 million hospital days and 13 million physician visits a year, and affect 4.8 million people 18 or older in any six-month period, according to the Agency for Health Care Policy and Research. Each year, 16,000 suicides or 7 deaths per 100,000 occur due to depression.2

In a multi-center study led by Michael Thase, M.D., Professor, Department of Psychiatry, University of Pittsburgh School of Medicine, the relapse rate for patients on mirtazapine was less than half that of patients on placebo in the 40-week double-blind study. The initial phase of the study included patients who had chronic or recurrent major depressive episodes. Those patients who received treatment with mirtazapine and recovered from their depression advanced to the double-blind phase of the trial, in which 79 patients continued therapy with mirtazapine and 81 were switched to placebo. Twice as many mirtazapine-treated patients remained in remission during the double-blind phase.

Dr. Thase said, "It is not uncommon for patients who have recovered from a depressive episode to suffer a relapse. The results of this study tell us we can prevent relapse, and that's very significant for patients."

In addition, data on mirtazapine's speed of efficacy was presented at the ACNP meeting by Andrew Nierenberg, M.D., Associate Professor of Psychiatry, Harvard Medical School and Associate Director of the Depression and Clinical Research Program. The research found that mirtazapine relieved depression faster than some commonly prescribed SSRIs. Dr. Nierenberg and his colleagues analyzed three double-blind, controlled studies of mirtazapine compared with Prozac® (fluoxetine), Paxil® (paroxetine), and Celexa™ (citalopram) in 642 depressed patients. Within the first week, the patients taking mirtazapine showed a greater improvement in their depressive symptoms more quickly than patients on fluoxetine and paroxetine. In this particular study, the difference between mirtazapine and citalopram was not statistically significant.

"While SSRIs are highly safe and effective, they exhibit a delay in onset of therapeutic action," said Dr. Nierenberg. "Mirtazapine's dual action on both norepinephrine and serotonin in the brain may contribute to its ability to relieve depression more quickly."
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Remeron(R) (mirtazapine) is marketed in the United States by Organon Inc. of West Orange, NJ, a division of Akzo Nobel.

The University of Pittsburgh School of Medicine is consistently ranked among the nation's leading medical schools. Among the many areas for which its faculty and programs are internationally recognized are psychiatry, oncology, genetics, transplantation and public health.

1. The AHCPR guidelines for the treatment of depression 5b. Depression in Primary Care - Treatment (Clinical Guide)
Executive Summary.
2. Stoudemire A, Frank R, Hedemark N, Kamlet M, Blazer D. The economic burden of depression. Gen Hosp Psychiatry 1986; 8:387-94.

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