Mirtazapine add‐on therapy in the treatment of schizophrenia with atypical antipsychotics: a double‐blind, randomised, placebo‐controlled clinical trial

Abstract

This trial does not confirm previous research supporting the use of mirtazapine adjunctive to atypical antipsychotic treatment for schizophrenia.

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

“…In their recent study, Berk et al (2009) did not find beneficial effects of add-on mirtazapine in schizophrenia. Their patients were, however, treated with SGAs, mostly clozapine, which prevents these studies from direct comparison and our results from extrapolation on SGAs-treated, especially clozapine-resistant schizophrenia.…”

“…Add-on mirtazapine also improved the tolerability of FGAs (Poyurovsky et al, 2003). The role of add-on mirtazapine in schizophrenia remains, however, equivocal, since in a recent study of Berk et al (2009) mirtazapine failed to show superiority over placebo in terms of negative and positive symptoms in schizophrenia treated with second generation antipsychotics (SGAs).…”

Pharmacological Augmentation Strategies for Schizophrenia Patients With Insufficient Response to Clozapine: A Quantitative Literature Review

“…There was very high heterogeneity among these studies for total symptom score as well as for negative symptoms. On both measures, Zoccali et al 60 showed large effect sizes, while Berk et al 61 did not. Detailed inspection of the methods applied in the 2 RCTs could not identify a reason for this extreme discrepancy.…”

Pharmacological Strategies for Enhancing Cognition in Schizophrenia

“…Mirtazapine is a dual-acting antidepressant that has antagonist effects at the a 2 -adrenergic, 5-HT 2 and 5-HT 3 receptors, as well as indirect agonist effects at the 5-HT 1a receptor. The logic for the use of this drug as a potential enhancer of cognition in schizophrenia stems from the argument that clozapine (which may also have adrenergic and serotonin effects) has shown evidence of enhanced efficacy for negative symptoms in schizophrenia (Berk et al 2009;Delle Chiaie et al 2007). The first open-label study with mirtazapine showed beneficial effects on RBANS total scale scores as well as immediate and delayed memory scores (Delle Chiaie et al 2007).…”