A pilot study of mirtazapine in post-traumatic stress disorder

Recently, studies of pharmacotherapy for post-traumatic stress disorder (PT SD) have been focused on serotonin-selective reuptake inhibitors (SSRI), de spite a number of treatment-limiting side-effects. Mirtazapine, a novel dru g with both noradrenergic and serotonergic properties, may be effective in individuals who demonstrate intolerance to side-effects of and a limited re sponse to SSRIs. Six outpatients with severe, chronic PTSD were treated wit h mirtazapine, up to 45 mg/day for 8 weeks. Efficacy assessments and side-e ffect monitoring were performed at baseline and weeks 2, 4, 6 and 8. Fifty percent of the sample demonstrated improvement of 50% or more from baseline using a global rating. In addition, improvements were noted on both interv iewer-administered and self-rated scales of PTSD and of depression. The dru g was well tolerated with few significant side-effects. Mirtazapine was ass ociated with clinical improvement in 50% of subjects with severe, chronic P TSD, suggesting a need for further investigation in double-blind, placebo-c ontrolled trials. Int Clin Psychopharmacol 14:29-31 (C) 1999 Lippincott Wil liams & Wilkins.