Posted by Elroy on June 3, 2005, at 16:55:03
Noted new report issued (last week?) on Remeron effectiveness:
http://www.docguide.com/news/content.nsf/news/8525697700573E188525700E00608A93
QUOTE:
Mirtazapine Betters Major SSRIs for Treatment of Depression
By Bruce SylvesterATLANTA, GA -- May 27, 2005 -- A meta-analysis of clinical trials involving more than 2,500 subjects suggests that treatment of depression with mirtazapine (Remeron) results in a more rapid onset of clinical improvement compared to treatment with fluoxetine, paroxetine, and sertraline (all SSRIs), researchers reported here May 24th at the 158th Annual Meeting of the American Psychiatric Association (APA).
"Mirtazapine is mechanistically a different kind of antidepressant than the more widely prescribed SSRIs or selective serotonin reuptake inhibitors," said presenter and lead investigator Michael Thase, MD, professor of psychiatry at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania, United States. "One of the consequences of a mechanistic difference is that it may follow a different temporal characteristic. … There is about a one week earlier onset of benefit with mirtazapine."
The investigators conducted a meta-analysis of data from 12 double-blind, randomized, controlled trials of mirtazapine versus SSRIs, involving more than 2,500 depressed patients. They compared remission rates (Hamilton Rating Scale for Depression -17 Item [HAMD-17] less than or equal to 7 or Montgomery-Asberg Depression Rating Scale [MADRS] less than or equal to 12) at weeks 1-6 and time-to-sustained remission using Kaplan-Meier graphing. They also calculated values of early response at week 6 as predictive of later remission.
After 6 weeks, remission rates were 38.8% for mirtazapine and 34.7% for SSRI-treated groups. "The difference between the two groups was statistically significant in favor of mirtazapine at all assessments and across time (P less than or equal to .03; Logrank test). This advantage was largely explained by the onset of remission during the first three weeks of treatment (P less than or equal to .001)," according to the authors.
They added that the results demonstrate that mirtazapine patients show a "significantly higher probability of response compared to SSRI-treated patients in the first three weeks of therapy" and that the sustained response indicated the same tendency.
The study was supported by Organon International, Inc., which manufactures Remeron.
END QUOTE
I did specifically note the last sentence....
What I find interesting is the language from another study:
http://content.karger.com/ProdukteDB/produkte.asp?Doi=68873
QUOTE:
Unlike other antidepressants, mirtazapine does not inhibit the reuptake of norepinephrine or serotonin but acts as an antagonist at presynaptic 2-receptors, at postsynaptic 5-HT2 and 5-HT3 receptors, and at histaminergic H1 receptors. Furthermore, mirtazapine has been shown to acutely inhibit cortisol secretion in healthy subjects.
END QUOTEHaving severe anxiety, I find that SSNRI products like Effexor and Cymbalta make my situation much worse. And have found that SSRI products like Lexapro simplydon't seem to work (not only had severeside effects with nausea and sexual dysfunction, but had "deadened" emotions while I could still readily detect that anxiety still there in the background).
Elroy
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poster:Elroy
thread:507399
URL: http://www.dr-bob.org/babble/20050601/msgs/507399.html