Mirtazapine is associated with less anxiolytic use among elderly depressed patients in long-term care facilities.
BACKGROUND
Depression is a common, treatable disorder among nursing facility residents.


OBJECTIVE
The purpose of this study was to examine medication use and cost between two groups of patients: (1) persons treated with mirtazapine, as compared with (2) persons taking other antidepressants.


METHODS
This study was a retrospective chart review of long-term care patients. Consultant pharmacists collected data on patients who were receiving selective serotonin reuptake inhibitors (SSRIs), venlafaxine, nefazodone, or mirtazapine.


METHODS
Nursing facilities that were geographically dispersed throughout the United States.


METHODS
We studied patients greater than 65 years of age with major depressive disorder or a depression-related diagnosis and receiving antidepressant treatment for at least 3 months. Patients with bipolar-induced depression were excluded as well as those receiving tricyclic antidepressants.


RESULTS
The two groups were similar in terms of age, but those receiving mirtazapine had lower body weight and body mass index. Patients on mirtazapine were less likely to be taking a sedative/hypnotic (P = 0.006). This was primarily the result of fewer patients in the mirtazapine group taking lorazepam (P = 0.03). There was no difference between the two groups regarding their use of other psychotropic medications, including multiple antidepressants, antipsychotics, anticonvulsants, acetylcholinesterase inhibitors, or appetite stimulants. Monthly medication costs were less for those patients receiving mirtazapine ($82.83) as compared with other antidepressants ($97.03) (P <0.0001).


CONCLUSIONS
The results of this study suggest that patients receiving mirtazapine are less likely to be on anxiolytic/hypnotic agents. The findings also suggest that medication costs are less when mirtazapine is used compared with other antidepressants.
College of Pharmacy, The University of Arizona, Tucson, AZ, USA. gardner@pharmacy.arizona.edu
Marie E
ME
Gardner
Daniel C
DC
Malone
Mark
M
Sey
Maude A
MA
Babington
D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000191:economics / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use*; D019167:Appetite Stimulants / Q000627:therapeutic use; D003511:Cyclohexanols / Q000627:therapeutic use; D003704:Dementia / Q000150:complications; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D019587:Dietary Supplements / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008134:Long-Term Care; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D000078785:Mirtazapine; D010879:Piperazines; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D014481:United States; D000069470:Venlafaxine Hydrochloride
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D019167:Appetite Stimulants; D003511:Cyclohexanols; D008803:Mianserin; D000078785:Mirtazapine; D010879:Piperazines; D017367:Selective Serotonin Reuptake Inhibitors; D014230:Triazoles; D000069470:Venlafaxine Hydrochloride; C051752:nefazodone