PHARMACOLOGICAL TREATMENT OF SEVERELY DEPRESSED-PATIENTS - A METAANALYSIS COMPARING EFFICACY OF MIRTAZAPINE AND AMITRIPTYLINE

Efficacy data were available from 405 severely depressed patients (bas eline 17-item Hamilton Rating Scale for Depression-HAMD scores greater than or equal to 25) participating in randomized, double-blind, amitr iptyline-controlled studies of mirtazapine. Main efficacy variables we re changes from baseline in the group mean 17-item HAMD scores and res ponder rates. Secondary efficacy variables were changes in depressed m ood item on the HAMD and in factors derived from the 17-item HAMD scal e. Treatment with either mirtazapine or amitriptyline resulted in robu st reductions of baseline HAMD scores and in similar and high percenta ges of responders, Both drugs produced favourable effects on depressed mood and on symptoms commonly associated with depression. such as anx iety, sleep and vegetative disturbances. There were neither statistica lly significant nor clinically relevant differences between mirtazapin e and amitriptyline at any assessment point nor at endpoint. The resul ts demonstrate that the new antidepressant mirtazapine and the tricycl ic antidepressant amitriptyline are equally effective in the treatment of severely depressed patients. (C) 1997 Elsevier Science B.V.