PHARMACOLOGICAL TREATMENT OF SEVERELY DEP RESSED-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 depressed mood item on the HAMD and in factors derived from the 17-item HAMD scale. Treatment with either mirtazapine or amitriptyline resulted in robust reductions of baseline HAMD scores and in similar and high percentages of responders. Both drugs produced favorable effects on depressed moo d and on symptoms commonly associated with depression, such as anxiety , sleep and vegetative disturbances. There were neither statistically significant nor clinically relevant differences between mirtazapine an d amitriptyline at any assessment point nor at endpoint. The results d emonstrate that the new antidepressant mirtazapine and the tricyclic a ntidepressant amitriptyline are equally effective in the treatment of severely depressed patients.