Background: The
SSRIs being used as 1st line
therapy in
treatment of
depression have delayed
therapeutic effect which makes the
patient vulnerable to an increased
risk of
suicide and decreased adherence to the
treatment and
will prematurely discontinue the
therapy . The present study was conducted to evaluate if low
dose mirtazapine -
escitalopram combination
therapy has any add on benefit over monotherapy with
escitalopram .
Methods: In a single-centered,
comparative study involving
patients with
depression attending the
out-patient after
screening and exclusion, 60 eligible
patients were randomly assigned to receive
tablet mirtazapine 7.5 mg plus
tablet escitalopram 10 mg intervention or
tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week
treatment phase. The primary
outcome measure was the change in the 17-item Hamilton
Depression Rating Scale (HDRS) and Montgomery-Asberg
Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using
Chi-Square test for
adverse effects and independent t-test
analysis for
efficacy parameter.
Results: In the
analysis of results at 6th week the numbers of
patients achieved remission in
mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in
mirtazapine group are also more which is statistically significant on
chi-square test . There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.
Conclusions: Adding low
dose mirtazapine has an added benefit in terms of
efficacy and getting remission early with more number of responders in the
treatment of major
depression .