More evidence on additive antipsychotic effect of adjunctive mirtazapine in schizophrenia: an extension phase of a randomized controlled trial.

Abstract

OBJECTIVE:

Adjunctive mirtazapine improved negative symptoms of schizophrenia in several studies. Recently, we found an improvement also in positive symptoms when mirtazapine was added to first generation antipsychotics (FGAs) in a 6 week randomized controlled trial (RCT). The short duration of that trial was its limitation. This study aimed to explore whether longer treatment is worthwhile.

METHOD:

Completers of the RCT (n = 39) received open-label add-on mirtazapine for additional 6 weeks. The Positive and Negative Syndrome Scale (PANSS) total score (primary outcome) and several other clinical parameters were measured prospectively.

RESULTS:

During the open-label phase, significant improvement was achieved in all parameters, with an effect size of 0.94 (CI 95% = 0.45-1.43) on the primary outcome and an impressive additive antipsychotic effect. Patients who received mirtazapine during both phases demonstrated greater improvement in positive symptoms (29.6% versus 21.2%, p = 0.027) than those who received mirtazapine during open-label extension phase only.

CONCLUSIONS:

These findings support our previous data on the additive antipsychotic effect of mirtazapine in FGAs-treated schizophrenia. Mirtazapine may be effective in other symptom domains, too. Longer duration of mirtazapine treatment may yield additional benefits. If these results will be confirmed in larger studies, add-on mirtazapine may become a feasible option in difficult-to-treat schizophrenia.

• Authors: Viacheslav Terevnikov, Jan-Henry Stenberg, Marina Joffe, Jari Tiihonen, Mark Burkin, Evgueni Tchoukhine, Grigori Joffe
• Journal: Human psychopharmacology (Hum Psychopharmacol) Vol. 25 Issue 6 Pg. 431-8 (Aug 2010) ISSN: 1099-1077 [Electronic] England
• PMID: 20737516 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 John Wiley & Sons, Ltd.

Chemical References

• Adrenergic alpha-Antagonists
• Antidepressive Agents, Tricyclic
• Antipsychotic Agents
• Mianserin
• Mirtazapine

Topics

• Adolescent
• Adrenergic alpha-Antagonists (therapeutic use)
• Adult
• Aged
• Antidepressive Agents, Tricyclic (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Double-Blind Method
• Drug Administration Schedule
• Drug Synergism
• Drug Therapy, Combination
• Female
• Humans
• Male
• Mianserin (analogs & derivatives, therapeutic use)
• Middle Aged
• Mirtazapine
• Psychiatric Status Rating Scales
• Schizophrenia (drug therapy)
• Treatment Outcome