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More evidence on additive antipsychotic effect of adjunctive mirtazapine in schizophrenia: an extension phase of a randomized controlled trial
Author(s) -
Terevnikov Viacheslav,
Stenberg JanHenry,
Joffe Marina,
Tiihonen Jari,
Burkin Mark,
Tchoukhine Evgueni,
Joffe Grigori
Publication year - 2010
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.1137
Subject(s) - mirtazapine , randomized controlled trial , schizophrenia (object oriented programming) , antipsychotic , psychology , medicine , psychiatry , antidepressant , anxiety
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. Copyright © 2010 John Wiley & Sons, Ltd.