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Oral Mirtazapine Effective, Well-tolerated by Depressed Nursing-Home Patients: Presented at AAGP

By Bonnie Darves

HONOLULU, HA -- March 7, 2003 -- The new orally disintegrating antidepressant mirtazapine appears effective and well tolerated in elderly nursing home patients with depression, according to a study presented here March 4^th at the Annual Meeting of the American Association for Geriatric Psychiatry.

In another study, researchers led by Steven P. Roose of Columbia University College of Physicians and Surgeons in New York found that oral mirtazapine is efficacious and well tolerated in elderly depressed patients who do not live in nursing homes.

To determine if the drug would be effective for treatment of depression in institutionalized elderly patients, the same researchers conducted a 6-week, 30-site study in 127 nursing home residents with a mean age of 82.9 years.

At baseline, patients had a mean score on the Hamilton Rating Scale for Depression (Ham-D) of 15.7, Clinical Global Impression (CGI) severity of 4.0, and a mean score on the Mini-Mental State Examination (MMSE) of 21.87. Patients who had unstable mental illness or who had attempted suicide were excluded from the study.

Patients received a mean dose of mirtazapine of 19.1 mg/day. The researchers conducted caregiver interviews at baseline and at days 14, 28, 56 and 84.

The researchers reported that patients appeared to respond well to the drug and that only 11% discontinued because of adverse events. The most common adverse event was urinary tract infection, which affected 24 patients.

Ham-D anxiety/somatisation factor scores decreased from 6.9 at baseline to 3.5 at day 84, with slightly better improvement in the patients who were 85 years of age or older. Sleep problems also declined; mean Ham-D sleep disturbance factor decreased from 2.1 at baseline to 0.9 at the end of the study.

Dr. Roose noted that the study might be more generalizable to everyday practice because subjects included patients who would normally be excluded from controlled clinical-efficacy trials on the basis of dementia, comorbidity or other factors.

He added that the caregiver interviews used in this study are a potentially valuable tool in diagnosing depression in this population, as patients who may be depressed at some time show no evidence of depression during physician interviews.

The research was supported by funding from Organon Pharmaceuticals, Inc.


[Study title: Multicenter, Open-Label, Naturalistic Study Of Mirtazapine Orally Disintegrating Tablets In Depressed Nursing Home Patients. Abstract PO-129]

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