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Comparative clinical profile of mirtazapine and duloxetine in practical clinical settings in Japan: a 4-week open-label, parallel-group study of major depressive disorder

Authors Nagao K, Kishi T , Moriwaki M, Fujita K, Hirano S, Yamanouchi Y, Funahashi T, Iwata N 

Received 2 February 2013

Accepted for publication 28 March 2013

Published 5 June 2013 Volume 2013:9 Pages 781—786


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 6

Kei Nagao,1,2 Taro Kishi,1 Masatsugu Moriwaki,1 Kiyoshi Fujita,3,4 Shigeki Hirano,5 Yoshio Yamanouchi,1 Toshihiko Funahashi,2 Nakao Iwata1

1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, The Jindai Hospital, Toyota, Aichi, Japan; 3Department of Psychiatry, The Okehazama Hospital, Toyoake, Aichi, Japan; 4The Neuroscience Research Center, Toyoake, Aichi, Japan; 5Department of Psychiatry, The Toyota Memorial Hospital, Toyota, Aichi, Japan

Abstract: No studies have compared mirtazapine with duloxetine in patients with major depressive disorder (MDD). Fifty-six patients were nonrandomly assigned to a 4-week treatment with either 15 to 45 mg/day of mirtazapine (n = 22) or 20 to 60 mg/day of duloxetine (n = 34). The primary efficacy measurements were the Hamilton Rating Scale for Depression (HRSD) and the Montgomery–Åsberg Depression 6-point Rating Scale (MADRS) scores. The second efficacy measurements were the response and remission rates of treatment. Tolerability assessments were also performed. Fifty-six patients (43 male; age, 43.6 years) were recruited. There was no significant difference in the discontinuation rate between the mirtazapine and duloxetine treatment groups (P = 0.867). Both mirtazapine and duloxetine significantly improved the HRSD and MADRS scores from baseline (P < 0.0001–0.0004). While mirtazapine was superior to duloxetine in the reduction of HRSD scores (P = 0.0421), there was no significant change in MADRS scores in terms of between-group differences (P = 0.171). While more somnolence was observed with mirtazapine (P = 0.0399), more nausea was associated with duloxetine (P = 0.0089). No serious adverse events were observed for either antidepressant. Mirtazapine and duloxetine were safe and well-tolerated treatments for Japanese patients with MDD. Double-blind controlled studies are needed to further explore the efficacy and safety of mirtazapine and duloxetine in Japanese patients with MDD.

Keywords: mirtazapine, duloxetine, major depressive disorder

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