Effectiveness of mirtazapine in the treatment of depression with associated somatic symptoms

Abstract

Introduction. A assess the efficacy of mirtazapine in the treatment of depression with somatic symptoms in a 3-months follow-up study.

Material and methods. Design: multicenter, prospective, observational, open-label, and non controlled study. Sample: seven hundred and eleven patients recruited in outpatient psychiatric consultations by 98 psychiatrists nationwide. Instruments: 17-Item Hamilton Depression Rating Scale (HAMD17) and Standardized Polyvalent Psychiatric Interview (SPPI), somatic symptoms section. Patients were assessed pretreatment and at 15, 30 and 90 days post-treatment.

Results. Severity of depression assessed by HAMD-17 significantly decreased (p<0.0001) from 23.27 in the pretreatment assessment to 6.75 at 3 months post-treatment. Severity of somatic symptoms assessed by EPEP significantly decreased (p<0.0001) from 7.68 in the pre-treatment assessment to 2.28 at 3 months post-treatment. Mirtazapine modifies attribution of somatic symptoms in somatizers: in pretreatment assessment, 41.3% of the sample attributed somatic symptoms to a psychological origin, while at 3 months post-treatment this percentage significantly increased (p<0.05) to 63.94%. Nearly half of the sample (48.52%) took benzodiazepines at the start of the study; but at 3 months post-treatment only 6.71% of the patients needed them. The incidence of adverse effects was 13.36% of the patients. From the total dropouts 4% were due to adverse events.

Conclusions. Mirtazapine is an effective and safe antidepressant for the treatment of depression with somatic symptoms and is able to modify attribution of somatic symptoms in somatizing patients.