Effects of add-on mirtazapine on neurocognition in schizophrenia: a double-blind, randomized, placebo-controlled study.

Abstract

Mirtazapine added to antipsychotics appears to improve the clinical picture of schizophrenia, including both negative and positive symptoms. This study explored the effect of adjunctive mirtazapine on neurocognition in patients with schizophrenia who had shown an insufficient response to first-generation antipsychotics (FGAs). Thirty-seven schizophrenia patients, who were at least moderately ill despite their FGA treatment, received add-on mirtazapine (n=19) or placebo (n=18) in a 6-wk double-blind, randomized trial. Widely used neuropsychological tests were performed to explore visual-spatial functions, verbal and visual memory, executive functions, verbal fluency and general mental and psychomotor speed. The data were analysed on the modified intent-to-treat basis with last observation carried forward. False discovery rate was applied to correct for multiple testing. Mirtazapine outperformed placebo in the domains of visual-spatial ability and general mental speed/attentional control as assessed by, correspondingly, Block Design and Stroop dots. The difference in the degree of change (i.e. change while on mirtazapine minus that on placebo) was 18.6% (p=0.044) and 11.1% (p=0.044), respectively. Adjunctive mirtazapine might offer a safe, effective and cost-saving option as a neurocognitive enhancer for FGA-treated schizophrenia patients. Mirtazapine+FGA combinations may become especially useful in light of the currently increasing attention towards FGAs. Larger and longer studies that incorporate functional outcomes, as well as comparisons with second-generation antipsychotics are, however, still needed for more definite conclusions.

• Authors: Jan-Henry Stenberg, Viatcheslav Terevnikov, Marina Joffe, Jari Tiihonen, Evgueni Tchoukhine, Mark Burkin, Grigori Joffe
• Journal: The international journal of neuropsychopharmacology (Int J Neuropsychopharmacol) Vol. 13 Issue 4 Pg. 433-41 (May 2010) ISSN: 1469-5111 [Electronic] England
• PMID: 19941694 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Nootropic Agents
• Placebos
• Mianserin
• Mirtazapine

Topics

• Adult
• Antipsychotic Agents (administration & dosage)
• Cognition (drug effects)
• Double-Blind Method
• Drug Therapy, Combination
• Executive Function (drug effects)
• Female
• Humans
• Male
• Memory (drug effects)
• Mianserin (administration & dosage, analogs & derivatives, pharmacology)
• Middle Aged
• Mirtazapine
• Nootropic Agents (administration & dosage, pharmacology)
• Placebos
• Psychomotor Performance (drug effects)
• Schizophrenia (drug therapy)
• Schizophrenic Psychology