Does Mirtazapine Work in OCD?

Obsessive-compulsive disorder (OCD) is disabling and often refractory to treatment. Behavioral therapies are quite effective, even more so than the only effective medication type, serotonin reuptake inhibitors. Still, many patients are too symptomatic and distressed to pursue behavioral treatments, which can be difficult to tolerate. In a two-part, manufacturer-sponsored, pilot study, researchers examined the possible efficacy of the novel serotonergic and noradrenergic antidepressant mirtazapine.

First, 30 subjects with OCD (15 treatment-naive and 15 with one SRI treatment failure) were openly treated with mirtazapine for 12 weeks (initial dose, 30 mg, with titration as tolerated to 60 mg). Subjects had been ill for at least a year and had …