The aim of this open label trial was to evaluate mirtazapine tolerability and effectiveness in controlling symptomatology of patients with panic disorder. Forty-five patients with panic disorder, with or without agoraphobia, 11 of them with a comorbid diagnosis of major depression, were included. Patients were assessed with a structured psychiatric interview and their symptomatology evaluated with specific psychometric scales. Three study participants dropped out due to adverse events. Mirtazapine was administered at an established dose of 30 mg daily for 3 months. Patients were assessed at weeks 2 and 4, and then at monthly intervals. All psychometric measures showed statistically significant reductions in total scores at the rated time points, with a pronounced decline in number and intensity of panic attacks and anticipatory anxiety throughout the study. Mirtazapine was well tolerated as signified by the low discontinuation rate (6.3%), and all patients showed a significant symptomatic improvement. The improvement did not appear to be linked to the concurrent presence of a depressive illness.
"Concerning PD, Ribeiro et al. (2001) compared the effect of mirtazapine and fluoxetine in a double-blind, randomized, flexible-dose trial conducted on 27 outpatients and found that both groups improved significantly in almost all efficacy measures. More recently, Sarchiapone et al. (2003), in a open label trial, administered mirtazapine to 45 PD patients and found a global significant symptomatic improvement. There are also some preliminary evidences regarding mirtazapine efficacy in the treatment of social anxiety disorder (Van Veen et al., 2002). "
[Show abstract][Hide abstract] ABSTRACT: We investigated the efficacy of mirtazapine in the treatment of generalized anxiety disorder (GAD). Forty-four adult outpatients with GAD were treated openly with a fixed dose of mirtazapine (30 mg) for 12 weeks. The primary outcome measure was the change from baseline in total score on the Hamilton Rating Scale for Anxiety (HAM-A). The Clinical Global Impression of Improvement (CGI-I) was rated at the endpoint. Patients with a reduction of 50% or more on the HAM-A total score and a CGI-I score of 1 or 2 at endpoint were considered responders to treatment; remission was defined as a HAM-A score <or=7. At 12 weeks, response was achieved by 79.5% of the patients (n=35) and remission by 36.4% of patients (n=16). This study supports the notion that mirtazapine is an efficacious and well tolerated treatment for GAD. Limitations of the present study must be considered and further placebo-controlled trials are needed.
Journal of Psychopharmacology 10/2005; 19(5):483-7. DOI:10.1177/0269881105056527 · 3.59 Impact Factor
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