An overview of the clinical efficacy of mirtazapine

Mirtazapine shows a significantly earlier onset of action compared to selective serotonin reuptake inhibitors (SSRIs).

• Mirtazapine is at least as effective as tricyclic antidepressants and trazodone for patients with moderate to severe depression.
• In severely depressed melancholic patients, mirtazapine is at least as effective as venlafaxine.
• Early improvement in symptoms is a highly sensitive predictor of later stable response for both mirtazapine and paroxetine.
• The positive predictive value of early improvement is significantly higher for mirtazapine than for paroxetine.
• The negative predictive value for mirtazapine approaches maximum levels by week 2, while for paroxetine it is by week 3.

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