Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Dual-dual action? Combining venlafaxine and mirtazapine in the treatment of depression
Author: Malhi, G.
Ng, F.
Berk, M.
Citation: Australian and New Zealand Journal of Psychiatry, 2008; 42(4):346-349
Publisher: Blackwell Publishing Asia
Issue Date: 2008
ISSN: 0004-8674
Statement of
Gin S. Malhi, Felicity Ng and Michael Berk
Abstract: Objective: Venlafaxine and mirtazapine in combination are increasingly used in clinical practice to treat treatment-refractory depression. Putative efficacy for this combination of antidepressants, beyond that of monotherapy, stems from their synergistic actions. This paper describes a prospective case series that examined the efficacy of the venlafaxine–mirtazapine combination in the treatment of depressed patients who had failed at least one antidepressant trial. Method: Twenty-two depressed patients with major depression were treated with venlafaxine and mirtazapine in combination for an average of just under 8weeks. Baseline ratings on the 17-item Hamilton Depression Rating Scale (HAM-D17), Montgomery–Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impression–Severity Scale (CGI-S) were repeated at end-point, determined by the naturalistic termination of the depressive treatment episode or the discontinuation of the combination treatment due to adverse effects. The length of treatment until end-point was documented for each patient. Descriptive statistics were used on the collated data. Results: At baseline, mean scores were 28.8 (SD=3.8) for HAM-D17, 30.1 (SD=5.8) for MADRS, and 4.5 (SD=0.5) for CGI-S, reflecting a cohort at the moderate to severe end of the spectrum. At end-point, mean absolute scores were 10.2 (SD=4.7) for HAM-D17, 10.8 (SD=4.6) for MADRS, and 2.3 (SD=0.6) for CGI-S. Mean change from baseline was 18.6 (SD=6.4) for HAM-D17, 19.3 (SD=6.8) for MADRS, and 2.3 (SD=0.6) for CGI-S. Mean duration of treatment was approximately 8weeks, producing a response rate of 81.8% and a remission rate of 27.3%. Only one patient was unable to tolerate the combination although nearly half (10) had significant side-effects during treatment. Conclusion: This study demonstrates relatively high response and remission rates that are encouraging and contribute to the efficacy database for this antidepressant combination. Further studies using randomized controlled designs are needed.
Keywords: Humans
Antidepressive Agents, Second-Generation
Antidepressive Agents, Tricyclic
Treatment Outcome
Drug Therapy, Combination
Remission Induction
Severity of Illness Index
Cohort Studies
Prospective Studies
Depressive Disorder
Psychiatric Status Rating Scales
Drug Synergism
Middle Aged
Venlafaxine Hydrochloride
DOI: 10.1080/00048670701881587
Published version:
Appears in Collections:Aurora harvest 5
Psychiatry publications

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.