Hannan Noel, Hamzah Zaf, Akinpeloye Henry Omoniyi, Meagher David
Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland.
J Psychopharmacol. 2007 Mar;21(2):161-4. doi: 10.1177/0269881107065738.
The combination of mirtazapine and venlafaxine has been suggested as a treatment option for difficult to treat depressive illness. We describe 32 patients with persistent depressive illness (44% male; mean age 42 years; mean 2.5 previous antidepressant trials) that received mirtazapine and venlafaxine in combination at some point over the 3 year period between 2002 and 2005. Clinical response rates (CGI-improvement score of two or less) were 44% at 4 weeks and 50% at 8 weeks. At 6 month review, 18 patients (56% of the original cohort and 75% of those still receiving treatment) had significantly responded. Clinical response typically occurred at moderate and high dose treatment with both agents. A total of 44% experienced some adverse effects with sedation (19%) and weight gain (19%) most frequent. Five patients discontinued treatment due to these effects. No serious adverse effects were linked to the combination treatment. We discuss the implications of these findings for the use of venlafaxine and mirtazapine in combination in more difficult to treat patients with depression.
米氮平与文拉法辛联合使用已被提议作为治疗难治性抑郁症的一种选择。我们描述了32例持续性抑郁症患者（44%为男性；平均年龄42岁；之前平均接受过2.5次抗抑郁药试验），他们在2002年至2005年的3年期间的某个时间接受了米氮平与文拉法辛联合治疗。4周时的临床缓解率（临床总体印象改善评分为2分或更低）为44%，8周时为50%。在6个月的复查中，18例患者（占初始队列的56%，仍在接受治疗患者的75%）有显著反应。临床反应通常发生在两种药物的中高剂量治疗时。共有44%的患者出现了一些不良反应，最常见的是镇静（19%）和体重增加（19%）。5例患者因这些不良反应而停药。联合治疗未导致严重不良反应。我们讨论了这些发现对于在更难治的抑郁症患者中联合使用文拉法辛和米氮平的意义。
