title: The use of mirtazapine in difficult-to-treat patient populations.
abstract: Patients who have failed previous antidepressant treatment present substantial clinical management challenges. Similarly, elderly patients require special attention. Three recent studies have shown that mirtazapine has a role to play in the management of these patients. Mirtazapine has proved effective in the treatment of patients who were resistant or intolerant to selective serotonin reuptake inhibitors (SSRIs) and the switch to mirtazapine could be made immediately without the necessity for a taper period. In a double-blind study in patients who were resistant to SSRI treatment, mirtazapine had a more rapid onset of action than sertraline. Mirtazapine has also proved effective in elderly depressed patients and again showed a faster onset of action than another of the SSRIs, paroxetine.
authors.affiliation: University of Texas, Galveston, Texas, USA. rohirsch@utmb.edu
authors.forename: Robert M A
authors.initials: RM
authors.lastname: Hirschfeld
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D000928:Antidepressive Agents; D008803:Mianserin; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors