title: A Review of the Literature of Mirtazapine in Co-Occurring Depression and an Alcohol Use Disorder.
abstract: BACKGROUND
  Prior medication studies involving individuals with major depression in combination with an alcohol use disorder (MDD/AUD) have mainly focused on SSRI and tricyclic antidepressants, with generally ineffective results. Consequently, effective treatments for that common comorbid condition remain elusive. Mirtazapine is an antidepressant medicine with a unique pharmacological profile, whose effectiveness for treating non-comorbid depression reportedly may exceed that of SSRIs.
  
  
  OBJECTIVE
  We now review the published literature regarding the tolerability and efficacy of mirtazapine for the treatment of the depression and the pathological alcohol ingestion of individuals with co-occurring MDD/AUD, including a review of four of our own small studies and two studies conducted outside the United States.
  
  
  CONCLUSIONS
  The findings of these studies suggest that mirtazapine is well tolerated among persons with comorbid MDD/AUD. Results also provide some evidence of efficacy for mirtazapine for decreasing the level of depression of persons with co-occurring MDD/AUD, and suggest that decreases in depression may occur relatively quickly after starting treatment, but provide no evidence of effectiveness for decreasing the level of alcohol ingestion. Large-scale double-blind, placebo-controlled studies are warranted to further clarify the tolerability and efficacy of mirtazapine among individuals with MDD/AUD.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Cornelius
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Douaihy
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, USA.
authors.forename: L
authors.initials: L
authors.lastname: Kirisci
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, USA.
authors.forename: J
authors.initials: J
authors.lastname: Glance
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kmiec
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Wesesky
authors.affiliation: University of Miami, Miami, USA.
authors.forename: D
authors.initials: D
authors.lastname: FitzGerald
authors.affiliation: University of Miami, Miami, USA.
authors.forename: I
authors.initials: I
authors.lastname: Salloum
keywords: Alcohol use disorder; Comorbid; Major depression; Mirtazapine