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Mirtazapine adjunct for people with schizophrenia
Luke A Perry1, Dhruvesh Ramson, Suzanne Stricklin
1Monash University, Melbourne, Australia.
The Cochrane Database of Systematic Reviews
|May 27, 2018
Summary
Mirtazapine as an add-on treatment for schizophrenia showed no clear benefit for negative symptoms. However, it may improve overall mental state and akathisia, but increases risks of weight gain and sedation.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Schizophrenia presents with positive, cognitive, and negative symptoms.
- Antipsychotic medications offer partial efficacy, especially for negative symptoms.
- Mirtazapine, an antidepressant, is explored as an adjunct therapy for negative symptoms.
Purpose of the Study:
- To systematically evaluate the efficacy of mirtazapine as an adjunct treatment for individuals diagnosed with schizophrenia.
Main Methods:
- Searched trial registries for randomized controlled trials (RCTs) up to May 2018.
- Included nine RCTs with 310 participants comparing mirtazapine adjunct to placebo adjunct.
- Analyzed data using risk ratios and mean differences with fixed-effect models.
Main Results:
- No clear difference in response for negative symptoms (RR 0.81, 95% CI 0.57 to 1.14).
- A potential positive effect on overall mental state (RR 0.69, 95% CI 0.51 to 0.92) and akathisia (RR 0.33, 95% CI 0.20 to 0.52).
- Increased risk of weight gain and sedation/drowsiness observed with mirtazapine adjunct.
Conclusions:
- Evidence quality is predominantly very low, limiting firm conclusions.
- Mirtazapine adjunct shows no clear effect on negative symptoms but may benefit overall mental state and akathisia.
- Further high-quality research is needed to clarify the role of mirtazapine in schizophrenia treatment.
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