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Evidence is mixed about potential benefits of adding mirtazapine to selective serotonin reuptake inhibitors (SSRIs) or serotonin–noradrenaline reuptake inhibitors (SNRIs) in primary care patients with treatment-resistant depression. In this randomized trial, U.K. researchers investigated the effectiveness of adding mirtazapine in 480 adults (mean age, 50) who remained depressed after at least 6 weeks of treatment with an SSRI or an SNRI.
Patients were randomized to mirtazapine (15 mg daily for 2 weeks, then 30 mg daily) or placebo in addition to their usual SSRI or SNRI. At 12 weeks, scores on the Beck Depression Inventory II had improved from baseline in both groups (mirtazapine group, 18; placebo group, 20), but between-groups difference w…