Mirtazapine and paroxetine in major depression: A comparison of monotherapy versus their combination from treatment initiation

Blier, Pierre; Gobbi, Gabriella; Turcotte, Julie; Montigny, Claude de; Boucher, Nathalie; Hébert, Chantal; Debonnel, Guy

doi:10.1016/j.euroneuro.2009.01.015

Cited by 129 publications

(87 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…112 Combinations of antidepressants have also been investigated as comedications in the initial treatment of MDD. While initial pilot studies were encouraging, 113,114 largesample RCTs found no differences in efficacy with the combination of bupropion þ escitalopram over each agent alone 115 or with the combinations of escitalopram þ bupropion SR and mirtazapine þ venlafaxine XR over escitalopram alone. 116 In addition, adverse effects were higher in the combination treatments.…”

mentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ''Pharmacological Treatments'' is the third of six sections of the 2016 guidelines. With little new information on older medications, treatment recommendations focus on second-generation antidepressants.Results: Evidence-informed responses are given for 21 questions under 4 broad categories: 1) principles of pharmacological management, including individualized assessment of patient and medication factors for antidepressant selection, regular and

show abstract

mentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Drug combinations at adequate regimens have nevertheless pushed up the remission rate when used from treatment initiation in proof of concept studies. These include combinations of SSRIs or the serotonin and norepinephrine reuptake inhibitor venlafaxine with the noradrenergic TCA desipramine or mirtazapine [39,40,43]. While such combinations act on more than one 5-HT neuronal target, they also exert noradrenergic effects, such as blocking the NE reuptake or presynaptic a 2 -adrenoceptors.…”

Section: Combination Of 5-ht Targets To Improve Effectiveness Of Treamentioning

confidence: 99%

Serotonin and beyond: therapeutics for major depression

Blier

Mansari

2013

Phil. Trans. R. Soc. B

Self Cite

203

131

View full text Add to dashboard Cite

The serotonin (5-HT, 5-hydroxytryptamine) system has been implicated in the pathogenesis of major depressive disorder (MDD). The case for its contribution to the therapeutic efficacy of a wide variety of antidepressant treatments is, however, much stronger. All antidepressant strategies have been shown to enhance 5-HT transmission in the brain of laboratory animals. Catecholamines, norepinephrine (NE) and dopamine (DA) can also play a pivotal role in the mechanism of action of certain antidepressant strategies. The enhancement of 5-HT transmission by selective serotonin reuptake inhibitors, which leads to a dampening of the activity of NE and DA neurons, may account in part for the low remission rate achieved with these medications and/or the residuals symptoms after remission is achieved. The functional connectivity between the 5-HT, NE and DA systems can be used to understand the mechanism of action of a wide variety of augmentation strategies in treatment-resistant MDD. Proof-of-concept studies have shown that antidepressant medications with complementary mechanisms of action on monoaminergic systems can double the remission rate achieved in a trial of standard duration. Novel approaches are also being used to treat MDD, which also appear to involve the monoaminergic system(s) to a varying extent.

show abstract

“…Blier et al (2010) showed that three combination therapies (fluoxetine+mirtazapine, venlafaxine+mirtazapine, bupropion+mirtazapine) were all superior to fluoxetine monotherapy. In an earlier study, Blier et al (2009) found that the combination of mirtazapine and paroxetine was more effective than mirtazapine or paroxetine as monotherapy. In the STAR*D study a combination of citalopram and bupropion showed a significant larger decrease of the Inventory of Depressive Symptoms (IDS) than a citalopram-buspiron combination, but the difference in the number of patients attaining remission was not significantly different (Gilmer et al, 2008).…”

Section: Combinationmentioning

confidence: 99%