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Mirtazapine Effective For Anxiety and Depression in Alcohol Detoxification: Presented at ECNP

By Paula Moyer

PRAGUE, CZECH REPUBLIC -- October 6, 2003 -- Mirtazapine (Remeron) and venlafaxine (Effexor) are both effective at alleviating the anxiety and depression often present in alcoholics prior to undergoing detoxification. Mirtazapine, however, may reduce such symptoms more markedly, according to findings presented here September 22^nd at the 16^th Annual Meeting of the European College of Neuropsychopharmacology.

"Although both were effective, mirtazapine had a faster onset of action," said Konstantinos Kontoangelos, MD, psychiatry resident, Athens University Medical School, Greece.

Because alcohol abuse is associated with anxiety and depression, Dr. Kontoangelos and his colleagues wanted to determine whether the antidepressants mirtazapine and venlafaxine were effective in ameliorating such symptoms in individuals undergoing detoxification. The study base consisted of 30 patients who were diagnosed as alcoholic according to the Diagnostic and Statistical Manual IV (DSM-IV).

The 8 men and 7 women in the venlafaxine group were an average of 46.7±8.0 years old, and received pharmacologic treatment as an adjunct to psychotherapy. The dosage ranged from 150 to 225 mg daily. Similarly, the 8 men and 7 women in the mirtazapine group averaged 47.5±11.7 years old and received 30 to 60 mg daily in addition to psychotherapy.

The investigators used the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS) to assess patients' symptoms. Dr. Kontoangelos and his co-investigators used the scales at the beginning and at the end of the detoxification period, which ranged from 4 to 6 weeks.

Prior to the commencement of detoxification, patients' scores showed similar levels of moderate to severe symptoms of depression and anxiety, he said. In the venlafaxine-augmentation group the HARS scores averaged 39.5±5.7, while the HDRS scores averaged 40.3±5.6. In the mirtazapine group, the HARS scores averaged 36.4±12.7, and the HDRS scores averaged 40.2±7.2.

By the end of the detoxification period, patients' symptoms had significantly subsided. Dr. Kontoangelos noted, however, that the symptom reduction was more marked in the mirtazapine treatment group. The post-detoxification HARS scores averaged 7.3±3.1 for the venlafaxine group and 3.8±4.0 for the mirtazapine group (p=0.012). The HDRS scores averaged 6.7±2.3 for the venlafaxine group and 4.1±3.1 for the mirtazapine group (p=0.016).

"When admitted for detoxification, people who abuse alcohol exhibit considerable anxiety and depressive symptoms," Dr. Kontoangelos said. He and his colleagues reported that, after 4 to 6 weeks of alcohol detoxification with either venlafaxine or mirtazapine as an adjunct to a standard psychotherapy, such symptoms drop to normal levels, but mirtazapine may address such symptoms more efficiently.


[Study title: Mirtazapine and venlafaxine administration in alcohol detoxification: Impact on anxiety and depression symptoms. Abstract P.5.046]

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