title: Comparative clinical profile of mirtazapine and duloxetine in practical clinical settings in Japan: a 4-week open-label, parallel-group study of major depressive disorder.
abstract: No studies have compared mirtazapine with duloxetine in patients with major depressive disorder (MDD). Fifty-six patients were nonrandomly assigned to a 4-week treatment with either 15 to 45 mg/day of mirtazapine (n = 22) or 20 to 60 mg/day of duloxetine (n = 34). The primary efficacy measurements were the Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Åsberg Depression 6-point Rating Scale (MADRS) scores. The second efficacy measurements were the response and remission rates of treatment. Tolerability assessments were also performed. Fifty-six patients (43 male; age, 43.6 years) were recruited. There was no significant difference in the discontinuation rate between the mirtazapine and duloxetine treatment groups (P = 0.867). Both mirtazapine and duloxetine significantly improved the HRSD and MADRS scores from baseline (P < 0.0001-0.0004). While mirtazapine was superior to duloxetine in the reduction of HRSD scores (P = 0.0421), there was no significant change in MADRS scores in terms of between-group differences (P = 0.171). While more somnolence was observed with mirtazapine (P = 0.0399), more nausea was associated with duloxetine (P = 0.0089). No serious adverse events were observed for either antidepressant. Mirtazapine and duloxetine were safe and well-tolerated treatments for Japanese patients with MDD. Double-blind controlled studies are needed to further explore the efficacy and safety of mirtazapine and duloxetine in Japanese patients with MDD.
authors.affiliation: Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan ; Department of Psychiatry, The Jindai Hospital, Toyota, Aichi, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nagao
authors.forename: Taro
authors.initials: T
authors.lastname: Kishi
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Moriwaki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Fujita
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hirano
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamanouchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Funahashi
authors.forename: Nakao
authors.initials: N
authors.lastname: Iwata
keywords: duloxetine; major depressive disorder; mirtazapine