Add-on mirtazapine enhances antipsychotic effect of first generation antipsychotics in schizophrenia: A double-blind, randomized, placebo-controlled trial

More evidence on additive antipsychotic effect of adjunctive mirtazapine in schizophrenia: an extension phase of a randomized controlled trial

“…In double-blind phase results reported earlier (Joffe et al, 2009), mirtazapine outperformed placebo on almost all measures. For the PANSS total scores, the effect size was large, 1.0 (CI95% 0.34-1.67) (Cohen, 1988).…”

“…The results of the double-blind phase of this study are reported elsewhere (Joffe et al, 2009). Here we give the data (including those for double-blind phase) only for patients who participated in the extension phase, i.e., this new population differed from the doubleblind population reported earlier-even though the retention rate was high, only few patients were not enrolled into the open-label phase, and the difference between these two populations was hence quantatively subtle.…”

“…Other psychiatric or medical conditions or medications that could endanger patient's safety or jeopardize the interpretation of the data formed the exclusion criteria. For other details, see Joffe et al (2009). Completers of double-blind phase who volunteered to continue with open-label mirtazapine were included in extension phase.…”

“…We have previously reported (Joffe et al, 2009) a robust favorable effect of mirtazapine added to different FGAs on both negative and positive symptoms, with an effect size of 1.0 on the total Positive and Negative Syndrome Scale (PANSS) score (Kay et al, 1987). To the best of our knowledge, that 6 week randomized controlled trial (RCT) was the first report of a clear-cut additive antipsychotic effect with an addon antidepressant.…”

Pharmacological Profile of 2-Bromoterguride at Human Dopamine D2, Porcine Serotonin 5-Hydroxytryptamine 2A, and α2C-Adrenergic Receptors, and Its Antipsychotic-Like Effects in Rats

“…In contrast to a 2A -adrenoceptors, which are widely distributed in the brain, a 2C -adrenoceptors are predominantly located in the striatum (Scheinin et al, 1994;Uhlén et al, 1997;Fagerholm et al, 2008). Animal experiments and clinical studies have demonstrated that the therapeutic effect of an antipsychotic drug can be enhanced by the addition of idazoxan or mirtazapine, drugs that block a 2C -and a 2A -adrenoceptors (Litman et al, 1996;Hertel et al, 1999;Wadenberg et al, 2007;Joffe et al, 2009;Marcus et al, 2010). Antipsychotics such as clozapine, olanzapine, risperidone, and quetiapine exhibited higher affinities for a 2C -over a 2A -adrenoceptors (Kalkman and Loetscher, 2003;Kroeze et al, 2003).…”