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The Tolerability of Mirtazapine Augmentation in Schizophrenic Patients Treated with Risperidone: A Preliminary Randomized Placebo-controlled Trial.

Lee J, Cho SJ, Lee KS, Yook K, Choe AY, Lee S, Kim B, Kim KH, Choi TK, Lee SH - Clin Psychopharmacol Neurosci (2011)

Bottom Line: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS).However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05).These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

ABSTRACT

Objective: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI).

Methods: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo.

Results: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05).

Conclusion: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.

No MeSH data available.


Related in: MedlinePlus

Changes of akathisia, extrapyramidal symptom, body mass index and weight over time between mirtazapine and placebo groups.
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Figure 1: Changes of akathisia, extrapyramidal symptom, body mass index and weight over time between mirtazapine and placebo groups.

Mentions: During this eight-week trial, there was no significant difference between mirtazapine and placebo groups with respect to BAS scores or SAS scores (Table 2, Fig. 1). Additionally, when we compared BAS scores or SAS scores within groups between the baseline and week eight using paired t-test in each group, no significant differences were found (mirtazapine group, BAS: p=0.234, SAS: p=0.126; placebo group, BAS: p=0.549, SAS: p=0.362). Also, when we compared between group effects at week eight using independent t-test, no significant differences were found (BAS: p=0.327, SAS: p=0.096). In terms of weight, five patients gained weight in the mirtazapine group. The mean body weight increased 5.83 kg during the study in the mirtazapine group. An increase of body weight and BMI from baseline to week eight was observed over time (body weight F=12, df=1.18, p<0.05; BMI F=9.34, df=3, p=0.01), an effect that was significantly different statistically from that of the placebo group after considering the timeƗtreatment interactions (body weight F=3.3, df=1.18, p<0.05; BMI F=4.17, df=4, p=0.023). Although a similar outcome was expected for abdominal circumference, there was no difference between groups (Table 3, Fig. 1). The other side effects are reported in Table 4.


The Tolerability of Mirtazapine Augmentation in Schizophrenic Patients Treated with Risperidone: A Preliminary Randomized Placebo-controlled Trial.

Lee J, Cho SJ, Lee KS, Yook K, Choe AY, Lee S, Kim B, Kim KH, Choi TK, Lee SH - Clin Psychopharmacol Neurosci (2011)

Changes of akathisia, extrapyramidal symptom, body mass index and weight over time between mirtazapine and placebo groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569079&req=5

Figure 1: Changes of akathisia, extrapyramidal symptom, body mass index and weight over time between mirtazapine and placebo groups.
Mentions: During this eight-week trial, there was no significant difference between mirtazapine and placebo groups with respect to BAS scores or SAS scores (Table 2, Fig. 1). Additionally, when we compared BAS scores or SAS scores within groups between the baseline and week eight using paired t-test in each group, no significant differences were found (mirtazapine group, BAS: p=0.234, SAS: p=0.126; placebo group, BAS: p=0.549, SAS: p=0.362). Also, when we compared between group effects at week eight using independent t-test, no significant differences were found (BAS: p=0.327, SAS: p=0.096). In terms of weight, five patients gained weight in the mirtazapine group. The mean body weight increased 5.83 kg during the study in the mirtazapine group. An increase of body weight and BMI from baseline to week eight was observed over time (body weight F=12, df=1.18, p<0.05; BMI F=9.34, df=3, p=0.01), an effect that was significantly different statistically from that of the placebo group after considering the timeƗtreatment interactions (body weight F=3.3, df=1.18, p<0.05; BMI F=4.17, df=4, p=0.023). Although a similar outcome was expected for abdominal circumference, there was no difference between groups (Table 3, Fig. 1). The other side effects are reported in Table 4.

Bottom Line: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS).However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05).These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

ABSTRACT

Objective: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI).

Methods: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo.

Results: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05).

Conclusion: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.

No MeSH data available.


Related in: MedlinePlus