Goodnick P J, Puig A, DeVane C L, Freund B V
Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Fla. 33136, USA.
J Clin Psychiatry. 1999 Jul;60(7):446-8. doi: 10.4088/jcp.v60n0705.
A high proportion of patients with generalized anxiety disorder (GAD) have comorbid depressive illness. The presence of anxiety in depression has significant prognostic implications. Because of mirtazapine's early anxiolytic effects, the present study was undertaken as a preliminary investigation in patients with a diagnosis of major depression with comorbid GAD.
Mirtazapine was administered to 10 patients with DSM-IV major depressive disorder and comorbid GAD in an 8-week open-label study. Mirtazapine was increased from an initial daily dose of 15 mg to a maximum daily dose of 45 mg.
Patients were found to have significant reductions in Hamilton Rating Scale for Depression scores, Hamilton Rating Scale for Anxiety scores, and Beck Depression Inventory scores, with improvement noted after the first week of therapy and continuing improvement over the 8 weeks of study.
These positive preliminary findings support the further investigation of mirtazapine's potential value as a treatment for generalized anxiety disorder in addition to its established efficacy as an antidepressant drug.
广泛性焦虑症（GAD）患者中很大一部分伴有抑郁性疾病。抑郁症中焦虑的存在具有重要的预后意义。由于米氮平具有早期抗焦虑作用，本研究作为对诊断为伴有GAD的重度抑郁症患者的初步调查而开展。
在一项为期8周的开放标签研究中，对10例符合DSM-IV重度抑郁症且伴有GAD的患者给予米氮平治疗。米氮平初始日剂量从15毫克增至最大日剂量45毫克。
发现患者的汉密尔顿抑郁量表评分、汉密尔顿焦虑量表评分和贝克抑郁量表评分显著降低，治疗第一周后即有改善，并在8周的研究期间持续改善。
这些积极的初步研究结果支持进一步研究米氮平除了作为一种已确立疗效的抗抑郁药物外，作为广泛性焦虑症治疗药物的潜在价值。
