The Tolerability of Mirtazapine Augmentation in Schizophrenic Patients Treated with Risperidone: A Preliminary Randomized Placebo-controlled Trial

OBJECTIVE: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI). METHODS: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo. RESULTS: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05). CONCLUSION: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.

1-Year Follow-Up of Mindfulness-Based Cognitive Therapy in Patients with Generalized Anxiety Disorder or Panic Disorder / 신경정신의학

OBJECTIVES: Mindfulness-base cognitive therapy (MBCT) has been used to treat patients with depression to prevent relapse. The purpose of this study was to examine the effectiveness of Mindfulness- Base Cognitive Therapy for patients who suffer with generalized anxiety disorder or panic disorder for 1 year. METHODS: 19 patients with generalized anxiety disorder or panic disorder were assigned to receive MBCT for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used at 0 weeks, 8 weeks and 1 year to assess the results. RESULTS: MBCT demonstrated significantly decreases on all the anxiety scale scores (HAM-A, p=0.00 ; BAI, p=0.00) and depressive scale scores (HAM-D, p=0.00 ; BDI, p=0.00). The patients who received 8-week of MBCT showed a higher remission rate (15/19, 78%) during the 1-year followup period. CONCLUSION: MBCT may be effective at relieving the anxiety and depressive symptoms of patients who suffer with generalized anxiety disorder or panic disorder for 1 year. However, further well-designed controlled trials are needed to assess the value of MBCT.