Abstract | BACKGROUND: OBJECTIVE: To assess the effectiveness of mirtazapine for combat-related PTSD among veterans treated in an Australian hospital. METHODS: This open-label prospective study assessed the effectiveness of mirtazapine as empirical treatment for combat-related PTSD. The initial dose was 15 mg at night, titrated against response to 15-45 mg. PTSD symptoms were assessed using the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and the Clinician-Administered PTSD Scale (CAPS). Subjects also completed the Hospital Anxiety and Depression Scale ( HADS). Body weight and biochemical assessments, including fasting blood glucose (FBG), total serum cholesterol, and serum triglycerides, were also measured. Baseline measurements were repeated after 12 weeks. RESULTS: During the 18-month recruitment phase, 17 subjects were enrolled and 13 completed the protocol. The CAPS measurement decreased from a mean pretreatment score of 87.5 to 64.4 (p = 0.01). In 4 cases, the CAPS score decreased to below the diagnostic cut-point, consistent with a remission of PTSD. The Mississippi scale measurement decreased from a mean pretreatment score of 126.6 to 115.5 (p < 0.01). The mean HADS anxiety score decreased from 15.6 +/- 4.2 to 13.5 +/- 5.6 (p = 0.016), although the proportion of subjects with scores above the diagnostic cut-point remained high. The mean HADS depression score at baseline was not significantly different from the postintervention score. One subject had a postintervention FBG of 155 mg/dL (consistent with diabetes mellitus), which was increased from the baseline level of 83 mg/dL. All subjects experienced an increase in body weight. One subject had an increase in body weight of 8.75 kg (8.4%) from baseline. CONCLUSIONS: Although small and with methodological limitations, this study suggests that mirtazapine is an effective treatment for combat-related PTSD. Additional research incorporating an appropriately powered, double-blind, placebo-controlled study design is required.
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Authors | Christopher P Alderman, John T Condon, Andrew L Gilbert |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 43
Issue 7
Pg. 1220-6
(Jul 2009)
ISSN: 1542-6270 [Electronic] United States |
PMID | 19584388
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antidepressive Agents, Tricyclic
- Mianserin
- Mirtazapine
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Topics |
- Antidepressive Agents, Tricyclic
(administration & dosage, therapeutic use)
- Australia
- Combat Disorders
(drug therapy)
- Dose-Response Relationship, Drug
- Humans
- Male
- Mianserin
(administration & dosage, analogs & derivatives, therapeutic use)
- Middle Aged
- Mirtazapine
- Prospective Studies
- Psychiatric Status Rating Scales
- Severity of Illness Index
- Stress Disorders, Post-Traumatic
(drug therapy)
- Treatment Outcome
- Veterans
(psychology)
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