Whether to increase or maintain dosage of mirtazapine in early nonimprovers with depression

Fumihiko Ueno, Shinichiro Nakajima, Takefumi Suzuki, Takayuki Abe, Yuji Sato, Masaru Mimura, Hiroyuki Uchida

研究成果: Article

4 引用 (Scopus)

抄録

Objective: To compare outcomes between increasing versus maintaining the dose of mirtazapine in patients with depression without initial improvement. Method: Data from a 6-week double-blind randomized placebo-controlled trial of mirtazapine in major depressive disorder (DSM-IV) conducted from November 2004 to December 2005 were used. Percentages of remitters (ie, a score of ≤ 7 in the 17-item Hamilton Depression Rating Scale [HDRS-17]) and HDRS-17 score changes from baseline to week 6 were compared in the following 2 pairs, using Fisher exact test or mixed-effects model for repeated measures: (1) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores at week 1 but were assigned to continue 15 mg/d (stay<inf>15</inf> group) versus those who were assigned to increase the dose to 30 mg/d (increase<inf>30</inf> group) and (2) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores with 30 mg/d at week 2 but were assigned to continue 30 mg/d (stay<inf>30</inf> group) versus those who were assigned to increase the dose to 45 mg/d (increase45 group). Results: The increase<inf>30</inf> group showed a numerically but not significantly higher remission rate and a significantly greater decrease in the HDRS-17 total score at week 6 than the stay<inf>15</inf> group (34.7% [8 of 23 patients] vs 14.3% [3 of 21 patients], P = .2; least squares mean, -15.8 vs -10.9, P = .003). No significant differences were found between the increase<inf>45</inf> and stay<inf>30</inf> groups. Conclusions: Dose increase of mirtazapine from 15 mg/d to 30 mg/d may be effective for patients with depression without initial improvement. However, effectiveness may not be the case beyond 30 mg/d.

元の言語English
ページ(範囲)434-439
ページ数6
ジャーナルJournal of Clinical Psychiatry
76
発行部数4
DOI
出版物ステータスPublished - 2015 4 1

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Depression
Major Depressive Disorder
Least-Squares Analysis
Diagnostic and Statistical Manual of Mental Disorders
Randomized Controlled Trials
Placebos
mirtazapine
Dose

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)
  • Medicine(all)

これを引用

Whether to increase or maintain dosage of mirtazapine in early nonimprovers with depression. / Ueno, Fumihiko; Nakajima, Shinichiro; Suzuki, Takefumi; Abe, Takayuki; Sato, Yuji; Mimura, Masaru; Uchida, Hiroyuki.

:: Journal of Clinical Psychiatry, 巻 76, 番号 4, 01.04.2015, p. 434-439.

研究成果: Article

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title = "Whether to increase or maintain dosage of mirtazapine in early nonimprovers with depression",
abstract = "Objective: To compare outcomes between increasing versus maintaining the dose of mirtazapine in patients with depression without initial improvement. Method: Data from a 6-week double-blind randomized placebo-controlled trial of mirtazapine in major depressive disorder (DSM-IV) conducted from November 2004 to December 2005 were used. Percentages of remitters (ie, a score of ≤ 7 in the 17-item Hamilton Depression Rating Scale [HDRS-17]) and HDRS-17 score changes from baseline to week 6 were compared in the following 2 pairs, using Fisher exact test or mixed-effects model for repeated measures: (1) subjects who failed to show a ≥ 20{\%} decrease in the HDRS-17 total scores at week 1 but were assigned to continue 15 mg/d (stay15 group) versus those who were assigned to increase the dose to 30 mg/d (increase30 group) and (2) subjects who failed to show a ≥ 20{\%} decrease in the HDRS-17 total scores with 30 mg/d at week 2 but were assigned to continue 30 mg/d (stay30 group) versus those who were assigned to increase the dose to 45 mg/d (increase45 group). Results: The increase30 group showed a numerically but not significantly higher remission rate and a significantly greater decrease in the HDRS-17 total score at week 6 than the stay15 group (34.7{\%} [8 of 23 patients] vs 14.3{\%} [3 of 21 patients], P = .2; least squares mean, -15.8 vs -10.9, P = .003). No significant differences were found between the increase45 and stay30 groups. Conclusions: Dose increase of mirtazapine from 15 mg/d to 30 mg/d may be effective for patients with depression without initial improvement. However, effectiveness may not be the case beyond 30 mg/d.",
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AU - Ueno, Fumihiko

AU - Nakajima, Shinichiro

AU - Suzuki, Takefumi

AU - Abe, Takayuki

AU - Sato, Yuji

AU - Mimura, Masaru

AU - Uchida, Hiroyuki

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N2 - Objective: To compare outcomes between increasing versus maintaining the dose of mirtazapine in patients with depression without initial improvement. Method: Data from a 6-week double-blind randomized placebo-controlled trial of mirtazapine in major depressive disorder (DSM-IV) conducted from November 2004 to December 2005 were used. Percentages of remitters (ie, a score of ≤ 7 in the 17-item Hamilton Depression Rating Scale [HDRS-17]) and HDRS-17 score changes from baseline to week 6 were compared in the following 2 pairs, using Fisher exact test or mixed-effects model for repeated measures: (1) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores at week 1 but were assigned to continue 15 mg/d (stay15 group) versus those who were assigned to increase the dose to 30 mg/d (increase30 group) and (2) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores with 30 mg/d at week 2 but were assigned to continue 30 mg/d (stay30 group) versus those who were assigned to increase the dose to 45 mg/d (increase45 group). Results: The increase30 group showed a numerically but not significantly higher remission rate and a significantly greater decrease in the HDRS-17 total score at week 6 than the stay15 group (34.7% [8 of 23 patients] vs 14.3% [3 of 21 patients], P = .2; least squares mean, -15.8 vs -10.9, P = .003). No significant differences were found between the increase45 and stay30 groups. Conclusions: Dose increase of mirtazapine from 15 mg/d to 30 mg/d may be effective for patients with depression without initial improvement. However, effectiveness may not be the case beyond 30 mg/d.

AB - Objective: To compare outcomes between increasing versus maintaining the dose of mirtazapine in patients with depression without initial improvement. Method: Data from a 6-week double-blind randomized placebo-controlled trial of mirtazapine in major depressive disorder (DSM-IV) conducted from November 2004 to December 2005 were used. Percentages of remitters (ie, a score of ≤ 7 in the 17-item Hamilton Depression Rating Scale [HDRS-17]) and HDRS-17 score changes from baseline to week 6 were compared in the following 2 pairs, using Fisher exact test or mixed-effects model for repeated measures: (1) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores at week 1 but were assigned to continue 15 mg/d (stay15 group) versus those who were assigned to increase the dose to 30 mg/d (increase30 group) and (2) subjects who failed to show a ≥ 20% decrease in the HDRS-17 total scores with 30 mg/d at week 2 but were assigned to continue 30 mg/d (stay30 group) versus those who were assigned to increase the dose to 45 mg/d (increase45 group). Results: The increase30 group showed a numerically but not significantly higher remission rate and a significantly greater decrease in the HDRS-17 total score at week 6 than the stay15 group (34.7% [8 of 23 patients] vs 14.3% [3 of 21 patients], P = .2; least squares mean, -15.8 vs -10.9, P = .003). No significant differences were found between the increase45 and stay30 groups. Conclusions: Dose increase of mirtazapine from 15 mg/d to 30 mg/d may be effective for patients with depression without initial improvement. However, effectiveness may not be the case beyond 30 mg/d.

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