Comparative studies on the therapeutic and adverse effects of mirtazapine and fluoxetine in the treatment of adult depression

Abstract

Purpose: To evaluate comparatively the therapeutic and adverse effects of mirtazapine and fluoxetine for the management of adult depression.Methods: Adults (58) with depression admitted to the Neurology Department of Zaozhuang Municipal Hospital from August 2014 to July 2016 were randomly assigned to either mirtazapine group or fluoxetine group. Those in mirtazapine group were given mirtazapine while the fluoxetine group took fluoxetine. The patients were graded for Hamilton Depression Scale (HAMD) and Treatment Emergent Symptoms Scale (TESS) scores before treatment and at weeks 2, 4, 6, and 8 post-treatment, with the aim of comparing therapeutic effects and adverse reactions to mirtazapine and fluoxetine.Results: The therapeutic effects seen in the two groups did not differ significantly (p > 0.05), but mirtazapine had a slight advantage over fluoxetine. Effectiveness appeared after 2 weeks in the mirtazapine group, and 4 weeks in the other group. Moreover, there were significant differences in HAMD scores between the two groups after 2 and 4 weeks of treatment (p < 0.05), but the differences in scores after 6 and 8 weeks of treatment were not significant (p > 0.05). However, there were significant differences in score between pretreatment and 8-week post-treatment scores (p < 0.05). Mirtazapine group also had lower incidents of adverse reactions (sleepiness, dyspepsia, nausea, vomiting, excitation, and headache) than the fluoxetine group (p < 0.05).Conclusion: Mirtazapine has similar effect as fluoxetine in the treatment of adult depression, but works faster, with low incidence of adverse reactions. Thus, it is a safer and quicker antidepressant for clinical application.Keywords: Mirtazapine, Fluoxetine, Adult depression, Clinical effect, Adverse reactions