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Mirtazapina versus otros agentes antidepresivos para la depresión

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Referencias

Referencias de los estudios incluidos en esta revisión

Ir a:

Amini 2005 {published data only}

Amini H, Aghayan S, Jalili SA, Akhondzadeh S, Yahyazadeh O, Pakravan‐Nejad M. Comparison of mirtazapine and fluoxetine in the treatment of major depressive disorder: a double‐blind, randomized trial. Journal of Clinical Pharmacy and Therapeutics 2005;30(2):133‐8.

Behnke 2003 {published data only}

Baker R, Schutte AJ. NR326 More rapid onset of sleep‐improving effects with mirtazapine FDT versus sertraline. 158th Annual Meeting of the American Psychiatric Association ; 2005 May 21‐26. Atlanta, GA, 2005.
Behnke K, Sogaard J, Martin S, Bauml J, Ravindran AV, Agren H, et al. Mirtazapine orally disintegrating tablet versus sertraline: a prospective onset of action study. Journal of Clinical Psychopharmacology 2003;23(4):358‐64 [Erratum appears in Journal of Clinical Psychopharmacology 2003;23(6):682].

Benkert 2000 {published data only}

Benkert O, Szegedi A, Kohnen R. Mirtazapine compared with paroxetine in major depression. Journal of Clinical Psychiatry 2000;61(9):656‐63.

Benkert 2006 {published data only}

Benkert O, Szegedi A, Philipp M, Kohnen R, Heinrich C, Heukels A, et al. Mirtazapine orally disintegrating tablets versus venlafaxine extended release. Journal of Clinical Psychopharmacology 2006;26(1):75‐8.

Bremner 1995 {published data only}

Bremner JD. A double‐blind comparison of Org 3770, amitriptyline, and placebo in major depression. Journal of Clinical Psychiatry 1995;56(11):519‐25.

Brunnauer 2008 {published data only}

Brunnauer A, Laux G, David I, Fric M, Hermisson I, Moller HJ. The impact of reboxetine and mirtazapine on driving simulator performance and psychomotor function in depressed patients. Journal of Clinical Psychiatry 2008;69(12):1880‐6. [PUBMED: 19203476]

Debonnel 2000a {published data only}

Debonnel G, Gobbi G, Turcotte J, Boucher N, Hebert C, de Montigny C, Blier P. Effects of mirtazapine, paroxetine and their combination: a double‐blind study in major depression. European Neuropsychopharmacology 2000;10(Suppl 3):S252.

Fava 2006 {published data only}

Fava M, Rush AJ, Wisniewski SR, Nierenberg AA, Alpert JE, McGrath PJ, et al. A comparison of mirtazapine and nortriptyline following two consecutive failed medication treatments for depressed outpatients: a STAR*D report. American Journal of Psychiatry 2006;163(7):1161‐72.

Guelfi 2000 {published data only}

Guelfi JD, Ansseau M, Timmerman L, Korsgaard S. Mirtazapine versus venlafaxine in hospitalized severely depressed patients with melancholic features. Journal of Clinical Psychopharmacology 2001;21(4):425‐31.

Halikas 1995 {published data only}

Halikas JA. Org 3770 (mirtazapine) versus trazodone: A placebo controlled trial in depressed elderly patients. Human Psychopharmacology 1995;10 Suppl:125‐33.

Hong 2003 {published data only}

Hong CJ, Hu WH, Chen CC, Hsiao CC, Tsai SJ, Ruwe FJL. A double‐blind, randomized, group‐comparative study of the tolerability and efficacy of 6 weeks' treatment with mirtazapine or fluoxetine in depressed Chinese patients. Journal of Clinical Psychiatry 2003;64(8):921‐6.

Hoyberg 1996 {published data only}

Hoyberg OJ, Maragakis B, Mullin J, Norum D, Stordall E, Ekdahl P, et al. A double‐blind multicentre comparison of mirtazapine and amitriptyline in elderly depressed patients. Acta Psychiatrica Scandinavica 1996;93(3):184‐90.

Leinonen 1999 {published data only}

Agren H, Skarstein J, Behke K, Schutte A‐J, Leinonen E. Efficacy and tolerability of mirtazapine versus citalopram in major depression: a double‐blind, randomized study. 152nd Annual Meeting of the American Psychiatric Association. Washington DC, USA, 1999:NR476.
Leinonen E, Skarstein J, Behnke K, Agren H, Helsdingen JT. Efficacy and tolerability of mirtazapine versus citalopram: a double‐blind, randomized study in patients with major depressive disorder. International Clinical Psychopharmacology 1999;14(6):228.

Marttila 1995 {published data only}

Marttila M, Jaaskelainen J, Jarvi R, Romanov M, Miettinen E, Sorri P, et al. A double‐blind study comparing the efficacy and tolerability of mirtazapine and doxepin in patients with major depression. European Neuropsychopharmacology 1995;5(4):441‐6.

Mullin 1996 {published data only}

Mullin J, Lodge A, Bennie E, McCreadie R, Bhatt GS, Fenton G. A multicentre, double‐blind, amitriptyline‐controIled study of mirtazapine in patients with major depression. Journal of Psychopharmacology 1996;10(3):235‐40.
Roland A, Margakis P, Mullin J, Haug JO, Stordal E, Ekdal P, et al. Double‐blind, multicentre comparison of remergon and amitriptyline in elderly depressed patients. Clinical Neuropharmacology 1992;15(1 Pt B):182.

Organon 85146 {unpublished data only}

Zivkov M, Roes KCB, Pols AG. Efficacy of Org 3770 (mirtazapine) vs amitriptyline in patients with major depressive disorder: a meta‐analysis. Human Psychopharmacology 1995;10(suppl 2):S135‐S145.

Richou 1995 {published data only}

Richou H, Ruimy P, Charbaut J, Delisle J P, Brunner H, Patris M, et al. A multicentre, double‐blind, clomipramine‐controlled efficacy and safety study of Org 3770. Human Psychopharmacology 1995;10(4):263‐71.
Ruimy P, Delisle J, Richou H, Charbaut J, Patris M, Brunner H, De Jongh GD. Remergon efficacy in major depressive episode: A randomized, double‐blind, clomipramine‐controlled study in 174 French hospitalized patients. Clinical Neuropharmacology 1992;15(suppl 1 pt B):237.

Schatzberg 2002 {published data only}

Murphy GM. Pharmacogenetics of mirtazapine and paroxetine in the treatment of geriatric major depression. 39th Annual Meeting of the American College of Neuropsychopharmacology. 2000; Dec 10‐14. San Juan; Puerto Rico, 2000:235.
Murphy GM. Pharmacokinetic and pharmacodynamic genetic predictors of antidepressant tolerability and efficacy. 45th Annual NCDEU (New Clinical Drug Evaluation Unit) Meeting; 2005 June 6 ‐ 9. Boca Raton, FL, 2005:50.
Murphy GM, Hollander SB, Rodrigues HE, Kremer C, Schatzberg AF. Effects of the serotonin transporter gene promoter polymorphism on mirtazapine and paroxetine efficacy and adverse events in geriatric major depression. Archives of General Psychiatry 2004;61(11):1163‐9.
Murphy GM, Kremer C, Rodrigues HE, Schatzberg AF. Pharmacogenetics of antidepressant medication intolerance. American Journal of Psychiatry 2003;160(10):1830‐5.
Murphy GM, Kremer C, Rodrigues H, Schatzberg AF. The apolipoprotein E epsilon4 allele and antidepressant efficacy in cognitively intact elderly depressed patients. Biological Psychiatry 2003;54(7):665‐73.
O'Hara R, Schatzberg AF, Murphy GM. The impact on cognition of pharmacological treatment for late‐life depression. 155th Annual Meeting of the American Psychiatric Association; 2002 May 18‐23. Philadelphia, PA, 2002:No. 15B.
O’Hara R, Hollander SB, Lapp W, Boyle L, Rodrigues H, Kraemer HC, et al. ApoE4 Allele influences antidepressants’ cognitive effects in the elderly. 157th Annual Meeting of the American Psychiatric Association; 2004 May 1‐6. New York, NY, 2004:NR876.
Sarginson JE, Lazzeroni LC, Ryan HS, Schatzberg AF, Murphy GM. FKBP5 polymorphisms and antidepressant response in geriatric depression. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics: the Official Publication of the International Society of Psychiatric Genetics 2010;153B(2):554‐60.
Schatzberg AF, Kremer C, Rodrigues H. Mirtazapine and paroxetine in elderly depressed patients. 52nd Institute on Psychiatric Services; 2000 October 25‐29th. Philadelphia, PA, 2000.
Schatzberg AF, Kremer C, Rodrigues H. Mirtazapine versus paroxetine in elderly depressed patients. 14th Annual Meeting of the American Association for Geriatric Psychiatry; 2001 23rd‐26th February. San Francisco, Ca, USA, 2001.
Schatzberg AF, Kremer C, Rodrigues H. Mirtazapine versus paroxetine in elderly depressed patients. 154th Annual Meeting of the American Psychiatric Association; 2001 May 5‐10. Orleans LA, 2001:NR478.
Schatzberg AF, Kremer C, Rodrigues HE. Mirtazapine versus paroxetine in elderly depressed patients. 39th Annual Meeting of the American College of Neuropsychopharmacology. 2000; Dec 10‐14. San Juan; Puerto Rico, 2000:97.
Schatzberg AF, Kremer C, Rodrigues HE, Murphy GM, The Mirtazapine vs. Paroxetine Study Group. Double‐blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients. American Journal of Geriatric Psychiatry 2002;10(5):541‐50.

Schoemaker 2002 {unpublished data only}

Schoemaker J, Gailledreau J, Hoyberg OJ. First, randomized, double‐blind comparison of mirtazapine (15‐45 mg) and fluvoxamine (50‐150 mg) in the treatment of depression. International Journal of Neuropsychopharmacology 2002;5(suppl 1):140.
Schoemaker JH, The Mirtazapine Bridging Study Group. Double‐blind comparison of mirtazapine versus fluvoxamine in patients with major depressive disorder (DSM‐IV). In preparation.

Schule 2006 {published data only}

Schule C, Baghai TC, Eser D, Zwanzger P, Jordan M, Buechs R, et al. Time course of hypothalamic‐pituitary‐adrenocortical axis activity during treatment with reboxetine and mirtazapine in depressed patients. Psychopharmacology 2006;186(4):601‐11. [PUBMED: 16758243]

Smith 1990 {published data only}

Smith WT, Glaudin V, Panagides J, Gilvary E. Mirtazapine vs amitriptyline vs placebo in the treatment of major depressive disorder. Psychopharmacology Bulletin 1990;26(2):191‐6.

Thase 2000 {published data only}

Thase ME, Kremer C, Rodrigues H. Mirtazapine versus sertraline after SSRI non‐response. 39th Annual Meeting of the American College of Neuropsychopharmacology. 2000; Dec 10‐14. San Juan; Puerto Rico, 2000:260.
Thase ME, Kremer C, Rodrigues H. Mirtazapine versus sertraline after SSRI nonresponse. 52nd Institute on Psychiatric Services; 2000 October 25‐29th. Philadelphia, PA, 2000.
Thase ME, Simmons JH, Howland RH, Fava M. Double‐blind, randomized comparison of mirtazapine and sertraline in depressed patients who had not responded to SSRI treatment. In preparation.

Turan 2000a {published data only}

Turan M, Askin R, Telcioglu M, Cilli AS. Mirtazapine versus amitriptyline in treatment of major depressive disorder. European Neuropsychopharmacology 2000;10(Suppl 3):S228.

van Moffaert 1995 {published data only}

Van Moffaert M. Efficacy and safety of mirtazapine vs trazodone in hospitalised depressed patients. 8th ECNP (European College of Neuropsychopharmacology) Congress. Venice, Italy, 1995.
de Wilde J, Dierick M, Van Moffaert M, Vereecken A, Mendlewicz J, Evrard J, et al. Remergon efficacy in major depressive episode: A randomized, double‐blind, trazodon‐controlled study in 200 Belgian patients. Clinical Neuropharmacology 1992;15(1 Pt B):237.
van Moffaert M, de Wilde J, Vereecken A, Dierick M, Evrard JL, Wilmotte J, et al. Mirtazapine is more effective than trazodone: a double‐blind controlled study in hospitalized patients with major depression. International Clinical Psychopharmacology 1995;10(1):3‐9.

Versiani 2005 {published data only}

Versiani M, Moreno R, Ramakers‐van Moorsel CJ, Schutte AJ. Comparison of the effects of mirtazapine and fluoxetine in severely depressed patients. CNS Drugs 2005;19(2):137‐46.

Wade 2003 {published data only}

Wade A, Crawford GM, Angus M, Wilson R, Hamilton L. A randomized, double‐blind, 24‐week study comparing the efficacy and tolerability of mirtazapine and paroxetine in depressed patients in primary care. International Clinical Psychopharmacology 2003;18(3):133‐41.

Wheatley 1998 {published data only}

Wheatley DP, van Moffaert M, Timmerman L, Kremer CM. Mirtazapine: efficacy and tolerability in comparison with fluoxetine in patients with moderate to severe major depressive disorder. Journal of Clinical Psychiatry 1998;59(6):306‐12.

Winokur 2003 {published data only}

Winokur A, DeMartinis NA, McNally DP, Gary EM, Cormier JL, Gary KA. Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia. Journal of Clinical Psychiatry 2003;64(10):1224‐9.

Zivkov 1995 {published data only}

Zivkov M, De Jongh GD. Org 3770 versus amitriptyline: a 6‐week randomized double‐blind multicentre trial in hospitalized depressed patients. Human Psychopharmacology 1995;10(3):173‐80.

Referencias de los estudios excluidos de esta revisión

Ir a:

Blier 2004 {unpublished data only}

Blier P, Ward HE, Jacobs W, Herbert C, O'Hara SA, Pigott TA. Combining two antidepressants from treatment start: a preliminary analysis. New research program and abstracts, American Psychiatric Association 157th Annual Meeting. 2004:157.

Bruijin 1996 {published data only}

Bruijn JA, Moleman P, Mulder PG, Van den Broek WW. Treatment of mood‐congruent psychotic depression with imipramine. Journal of Affective Disorders 2001;66:165‐74.
Bruijn JA, Moleman P, Mulder PG, van den Broek WW. Comparison of 2 treatment strategies for depressed inpatients: Imipramine and lithium addition or mirtazapine and lithium addition. Journal of Clinical Psychiatry 1998;59(12):657‐63.
Bruijn JA, Moleman P, Mulder PG, van den Broek WW. Depressed in‐patients respond differently to imipramine and mirtazapine. Pharmacopsychiatry 1999;32(3):87‐92.
Bruijn JA, Moleman P, Mulder PGH, van den Broek WW, van Hulst AM, van der Mast RC, et al. A double‐blind, fixed blood‐level study comparing mirtazapine with imipramine in depressed in‐patients. Pharmacology 1996;127:231‐7.
Bruijn JA, Moleman P, van den Broek WW, Mulder PG. Trait anxiety and the effect of a single high dose of diazepam in unipolar depression. Journal of Psychiatric Research 2001;35(6):331‐7.

Kasper 1997a {published data only}

Kasper S. Efficacy of antidepressants in the treatment of severe depression: the place of mirtazapine. Journal of Clinical Psychopharmacology 1997;17 Suppl 1:19S‐28S.

Kasper 1997b {published data only}

Kasper S, Zivkov M, Roses KCB, Pols AG. Pharmacological treatment of severely depressed patients: a meta‐analysis comparing efficacy of mirtazapine and amitriptyline. European Neuropsychopharmacology 1997;7:115‐24.

Kremer 1995 {unpublished data only}

Kremer CME, Helsdingen JTH, Schutte JA, Vester E. Tolerability of mirtazapine vs SSRIs in short term treatment of major depression. European Neuropsychopharmacology 1999;9(5):S229.

Peyron 1996 {published data only}

Peyron E. Efficacy of mirtazapine vs clomipramine in severely depressed, hospitalized patients. European Neuropsychopharmacology 1996;6 Suppl 3:46‐7.

Tulen 1996 {published data only}

Tulen JHM, Bruijn JA, de Man KJ, Pepplinkhuizen L, van den Meiracker AH, Man AJ, et al. Cardiovascular variability in major depressive disorder and effects of imipramine or mirtazapine. Journal of Clinical Psychopharmacology 1996;16(2):135‐45.

Zourkova 2001 {published data only}

Zourkova A. Effect of mirtazapine and paroxetine on residual symptoms of depressive disorders and their effect on P450 CYP 2D6 activity. Homeostasis in Health and Disease 2001;41(6):242‐9.

Referencias de los estudios en espera de evaluación

Ir a:

Blier 2009 {published data only}

Blier P, Gobbi G, Turcotte JE, de Montigny C, Boucher N, Hebert C, et al. Mirtazapine and paroxetine in major depression: A comparison of monotherapy versus their combination from treatment initiation. European Neuropsychopharmacology 2009;19(7):457‐65.

Catterson 1996a {unpublished data only}

Catterson ML, Preskorn SH. Double‐blind crossover study of mirtazapine, amitriptyline and placebo in patient with major depression. 149th Annual Meeting of the American Psychiatric Association; 1996 May 4‐9. New York, NY, 1996:0157.

Chang 2006 {published data only}

Chang FW, Ma YP, Yan F, Wang CH. Comparative study of mirtazapine vs clomipramine in treatment of dysthymic disorder. Chinese Journal of New Drugs and Clinical Remedies 2006;25(1):55‐7.

Chen 2002 {published data only}

Chen X, Tan L, Zhao J, Li L, Chen Y. Randomized controlled clinical trials of remeron and fluoxetine in depressive patients. Chinese Journal of Clinical Psychology 2002;10(2):100‐2, 142.

Chen 2003 {published data only}

Chen G, Gu G, Li C, et al. A study of mirtazapine and venlafaxine in the treatment of depression. Journal of Clinical Psychological Medicine 2003;13(2):77‐9.

Chen 2004 {published data only}

Chen Z, Zhang J, Li Z, et al. Efficacy of mirtazapine and sertraline in the treatment of depression with anxiety symptoms. Chinese Mental Health Journal 2004;18(5):358‐9.

Chen 2004a {published data only}

Chen Z, Zhang J, Li Z, Zhang H, Mu X. Mirtazapine vs. sertraline in treating depressive disorder associated with anxiety. Chinese Journal of New Drugs and Clinical Remedies 2004;23(2):90‐2.

Chen 2005 {published data only}

Chen Q. The control study of mirtazapine versus fluoxetine in the treatment of depression. Chinese Journal of Health Psychology 2005;13(1):25‐6.

Fang 2010 {published data only}

Fang Y, Yuan C, Xu Y, Chen J, Wu Z, Cao L, et al. Comparisons of the Efficacy and Tolerability of Extended‐Release Venlafaxine, Mirtazapine, and Paroxetine in Treatment‐Resistant Depression: A Double‐Blind, Randomized Pilot Study in a Chinese Population. Journal of Clinical Psychopharmacology 2010;30(4):357‐64.

Gong 2005 {published data only}

Gong C, Xu H, Xiang D, Zhou X. Comparative study on depression treated by citalopram or mirtazapine. Journal of Clinical Psychological Medicine 2005;15(3):154‐5.

Guo 2005 {published data only}

Guo HR, Ren YM, Li SY. Controlled study of mirtazapine and mianserine in the treatment of senile depression. Chinese Mental Health Journal 2005;19(7):489‐91.

Guo 2005a {published data only}

Guo P, Guo H, Jia J. Comparison of mirtazapine versus clomipramine in maintenance treatment of depression. Journal of Clinical Psychological Medicine 2005;15(3):152‐3.

Guo 2006 {published data only}

Guo P. Clinical evaluation of mirtazapine and clomipramine for the treatment of depressive disorder associated with anxiety. Evaluation and Analysis of Drug‐Use in Hospitals of China 2006;6(2):79‐81.

Guo 2006a {published data only}

Guo JH, Cao CA, Liao CP. Effect of Mirtazapine and Clomipramine on the Life Quality of Patients. Chinese Mental Health Journal 2006;20(6):413‐5.

Hang 2005 {published data only}

Hang R, Xu P, Wang R. A comparative study of mirtazapine and paroxetine in the treatment of depression. Shandong Archives of Psychiatry 2005;18(4):225‐6.

Hu 2004 {published data only}

Hu S, Xu Y, Wei N, et al. A comparative study of treatment of depression: Mirtazapine vs. fluoxetine. Zhejiang Medical Journal 2004;26(12):885‐7.

Huang 2007 {published data only}

Huang X‐J, Gong M‐E, Tang Z‐Y. Comparison of mirtazapine and paroxetine in patients with first‐episode climacteric depression. Chinese Mental Health Journal 2007;21(6):428‐30.

Kang 2009 {published data only}

Kang E‐H, Lee I‐S, Chung S‐K, Lee S‐Y, Kim E‐J, Hong J‐P, et al. Mirtazapine versus venlafaxine for the treatment of somatic symptoms associated with major depressive disorder: A randomized, open‐labelled trial. Psychiatry Research 2009;169(2):118‐23.

Kim 2011 {published data only}

Kim JE, Yoon SJ, Kim J, Jung JY, Jeong HS, Cho HB, et al. Efficacy and tolerability of mirtazapine in treating major depressive disorder with anxiety symptoms: An 8‐week open‐label randomised paroxetine‐controlled trial. International Journal of Clinical Practice 2011;65(3):323‐9.

Li 2005 {published data only}

Li Jing, Meng Hua‐Qing, Deng Wei. Mirtazapine and fluoxetine in the treatment of cardiovascular neurosis with depression. Chinese Mental Health Journal 2005;19(9):637‐9.

Liang 2006 {published data only}

Liang K. Comparative study of mirtazapine and sertraline in treatment of elderly depressive patient. Journal of Heze Medical College 2006;18(2):5‐7.

Lin 2005 {published data only}

Lin Z, Chen Y. A study of mirtazapine and paroxetine in the treatment of anxiety. Sichuan Medical Journal 2005;26(11):1229‐30.

Liu 2004 {published data only}

Liu P. A study of mirtazapine and venlafaxine in the treatment of depression. Health Psychology Journal 2004;12(1):15‐6.

Ma 2003 {published data only}

Ma ZW, Li MX, Yang FS, et al. Comparative study on the efficacy and safety of mirtazapine and amitriptyline in treatment of depression. Chinese Journal of New Drugs 2003;12(10):858‐60.

Ning 2004 {published data only}

Ning J, Lu D. Observation of the clinical efficacy and safety of mirtazapine on elder depression treatment. Clnical Pharmaceuticals 2004;13(5):63‐4.

Niu 2004 {published data only}

Niu F, Shen X, Sun S. Comparison of efficacy of mirtazapine and fluoxetine in treatment of depression with generalized anxiety disorder. Chinese Journal of New Drugs and Clinical Remedies 2004;23(12):853‐5.

Paslakis 2010 {published data only}

Paslakis G, Luppa P, Gilles M, Kopf D, Hamann Weber B, Lederbogen F, et al. Venlafaxine and mirtazapine treatment lowers serum concentrations of dehydroepiandrosterone‐sulfate in depressed patients remitting during the course of treatment. Journal of Psychiatric Research 2010;44(8):556‐60.

Peng 2004 {published data only}

Peng J, Xu Y, Piao S, et al. A comparative study of mirtazapine and paroxetine for depressed patients. Medical Journal of Chinese People Health 2004;16(11):664‐5.

Ren 2004 {published data only}

Ren H, Guo Q, Cheng M. A study of mirtazapine and paroxetine in the treatment of depression. Journal of Clinical Psychological Medicine 2004;14(2):88‐9.

Sarginson 2010 {published data only}

Sarginson JE, Lazzeroni LC, Ryan HS, Ershoff BD, Schatzberg AF, Murphy GM. ABCB1 (MDR1) polymorphisms and antidepressant response in geriatric depression. Pharmacogenetics and Genomics 2010;20(8):467‐75.

Scharnholz 2010 {published data only}

Scharnholz B, Weber‐Hamann B, Lederbogen F, Schilling C, Gilles M, Onken V, et al. Antidepressant treatment with mirtazapine, but not venlafaxine, lowers cortisol concentrations in saliva: A randomised open trial. Psychiatry Research 2010;177(1‐2):109‐2.

Su 2005 {published data only}

Su H, Lei D, Yu H. Comparative study of mirtazapine and paroxetine in the treatment of depression. Modern Medicine and Health 2005;21(12):1480‐1.

Tang 2005 {published data only}

Tang Z, Li M. Mirtazapine compared with paroxetine in depressed patients with anxiety symptoms. Chinese Mental Health Journal 2005;19(9):643‐5.

Tao 2004 {published data only}

Tao M, Gao JF, Tang WX, et al. Clinical efficacy and compliance of mirtazapine in the treatment of depression. Chinese Mental Health Journal 2004;18(5):360‐2.

Wang 2006 {published data only}

Wang A, Zhu W. Efficacy and safety of mirtazapine versus clomipramine in patients with depression and anxiety. Shanghai Archives of Psychiatry 2006;18(1):24‐6.

Weng 2001 {published data only}

Weng S, Li H, Zhao J, Zhang H, Li T, Shu L, et al. Mirtazapine vs. fluoxetine in treatment of major depressive disorder: a multicenter clinical trial. Chinese Journal of New Drugs and Clinical Remedies 2001;20(5):329‐33.

Wu 2006 {published data only}

Wu Y. Controlled study of mirtazapine vs. venlafaxine in the treatment of depression. Journal of Clinical Psychosomatic Diseases 2006;12(2):111‐2.

Xie 2002 {published data only}

Xie K. Venlafaxine vs buspirone in treating depression associated with anxiety. Health Psychology Journal 2002;10(4):252‐3.

Xie 2004 {published data only}

Xie N, Yan Y, Di L, et al. A comparative study of mirtazapine and efexor XR for depressive patients. Medical Journal of Chinese People Health 2004;16(2):75‐6.

Xie 2004a {published data only}

Xie N, Zhao H, Di L, et al. A comparative study of mirtazapine and fluoxetine for depressive patients. Sichuan Mental Health 2004;17(1):32‐4.

Xie 2005 {published data only}

Xie K, Hai Y, Zhang D, et al. A comparative study of venlafaxine, maprotiline and buspirone in the treatment of depression. Chinese Journal of Health Psychology 2005;13(1):71‐3.

Xiong 2003 {published data only}

Xiong P, Xuan X, Wang J. A comparative study of mirtazapine and imipramine for depressive patients. Shanghai Archives of Psychiatry 2003;15(2):93‐5.

Yang 2005 {published data only}

Yang L, Yang K, Li Y. Clinical comparative study on mirtazapine and venlafaxine used in treating depression. Nervous Diseases and Mental Health 2005;5(4):271‐3.

Yao 2006 {published data only}

Yao X. Study of the treatment of depression with mirtazapine, trazodone and maprotiline. Chinese Journal of Pharmacoepidemiology 2006;15(4):202‐3.

Ye 2005 {published data only}

Ye C, Zhou F. Mirtazapine in the treatment of depression associated with anxiety. Herald of Medicine. 2005;24(10):893‐5.

Yu 2004 {published data only}

Yu G, Ding G, Li X. Mirtazapine and amitriptyline in the maintenance treatment of depressed patients: Comparison of efficacy and compliance. Chinese Mental Health Journal 2004;18(5):356‐7.

Zhang 2003 {published data only}

Zhang J, Liu T, Zhao J, et al. The control study of mirtazapine versus fluoxetine in the treatment of depression. Shanghai Archives of Psychiatry 2003;15(6):351‐4.

Zhang 2003a {published data only}

Zhang J, Liu T, Zhao J, Hao W, Xie G, Su L, et al. Control study of mirtazapine and fluoxetine in therapy of depression. Chinese Journal of Clinical Rehabilitation 2003;7(30):4102‐4.

Zhang 2004 {published data only}

Zhang J, Wang Y, Li Z. A controlled study of mirtazapine and amitriptyline in depression. Journal of Clinical Psychosomatic Diseases 2004;10(3):184‐6.

Zheng 2005 {published data only}

Zheng H. Control study on clinical effect of mirtazapine in treatment depression. Chinese Journal of Health Psychology 2005;13(6):440‐2.

Zhu 2003 {published data only}

Zhu H, Yu J, Zheng H. A study of switching to mirtazapine for treatment‐resistant depression. Shanghai Archives of Psychiatry 2003;15(6):355‐7.

Zhu 2005 {published data only}

Zhu J, Jiang X, Zhou D, Zhang F. Comparative study of mirtazapine vs. fluoxetine in treatment of elderly depressive patients. Journal of Clinical Psychological Medicine 2005;15(5):277‐8.

Zhu 2006 {published data only}

Zhu J. Comparative study of mirtazapine and fluoxetine in the treatment of senile depression. China Journal of Health Psychology 2006;14(5):546‐7.

Zou 2006 {published data only}

Zou J, Jing Y, Song K, Hu Y. Comparative study on mirtazapine and paroxetine in the treatment of depression. Journal of Clinical Psychological Medicine 2006;16(4):235‐6.

Als‐Nielsen 2003

Als‐Nielsen B, Chen W, Gluud C, Kjaergard LL. Association of funding and conclusions in randomized drug trials: a reflection of treatment effect or adverse events?. JAMA 2003;290(7):921‐8.

Altman 1996

Altman DG, Bland JM. Detecting skewness from summary information. BMJ 1996;313(7066):1200.

Anderson 2000

Anderson IM, Nutt DJ, Deakin JF. Evidence‐based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. Journal of Psychopharmacology 2000;14(1):3‐20.

Anttila 2001

Anttila SA, Leinonen EV. A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Reviews 2001;7(3):249‐64.

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American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐III). 3rd Edition. Washington, DC: American Psychiatric Association, 1980.

APA 1987

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐III‐R). 3rd Edition. Washington, DC: American Psychiatric Association, 1987.

APA 1994

American Psychiatric Association. .. Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV). 4th Edition. Washington, DC: American Psychiatric Association, 1994.

APA 2000

American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). American Journal of Psychiatry 2000;157 Suppl(4):1‐45.

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Referencias de otras versiones publicadas de esta revisión

Ir a:

Watanabe 2008

Watanabe N, Omori IM, Nakagawa A, Cipriani A, Barbui C, McGuire H, et al. Mirtazapine versus other antidepressants in the acute‐phase treatment of adults with major depression: systematic review and meta‐analysis. Journal of Clinical Psychiatry 2008;69(9):1404‐15.

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Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Amini 2005

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 30 mg/day, N = 18

2. Fluoxetine: 20 mg/day, N = 18

Fixed dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: None

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes are reported in the figures with the actual numbers of the participants who achieved these.

Free of Sponsorship bias?

Unclear risk

The funding source is not described.
Behnke 2003

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Unclear

Interventions

1. Mirtazapine: 30‐45 mg/day, N = 176

2. Sertraline: 50‐150 mg/day, N = 170

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Improvement, CGI‐Severity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes are reported in the figures with the actual numbers of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Benkert 2000

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐45 mg/day, N = 139

2. Paroxetine: 20‐40 mg/day, N = 136

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: HAM‐A, BDI, Welzil‐Kohnen Colored Scales, Short Form‐36, CGI‐Improvement, CGI‐severity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes at end of the acute‐phase treatment are reported with the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Benkert 2006

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 45 mg/day, N = 130

2. Venlafaxine: 225 mg/day, N = 128

Fixed dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Improvement, CGI‐Severity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes at end of the acute‐phase treatment are reported with the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Bremner 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 5‐35 mg/day, N = 50

2. Amitriptlyline: 40‐280 mg/day, N = 50

3. Placebo, N = 50

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Improvement, CGI‐Severity, Zung Self‐Rating Depression Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Brunnauer 2008

Methods

2 week randomised study

Participants

Diagnosis: DSM‐IV major depressive disorder, single episode

Setting: Psychiatric inpatients

Interventions

1. Mirtazapine: mean 38.2 (SD 9.0) mg/day, N = 20

2. Reboxetine: mean 6.6 (SD 1.9) mg/day, N = 20

Flexible dosing scheduling

Outcomes

The measure used for primary outcome: Performance in driving simulator

Other measures: HAM‐D, BDI

Notes

Only information about attrition of the participants is available for the present review.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Unclear risk

No useful information in terms of depression severity at the end of treatment is provide.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of the comparator drug.
Debonnel 2000a

Methods

4 week randomised study

Participants

Diagnosis: DSM‐IV major depression

Setting: Unclear

Interventions

1. Mirtazapine: 30‐45 mg/day, N = 20

2. Paroxetine: 20‐30 mg/day, N = 20

3. Combination of mirtazapine and paroxetine

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: Unclear

Other measures: MADRS

Notes

We were unable to retrieve usable information for the meta‐analysis and to contact the author because the principal author passed away.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Low risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No information of attrition to permit judgement is provided.

Selective reporting (reporting bias)

Unclear risk

No information to permit judgement is provided.

Free of Sponsorship bias?

Unclear risk

No information to permit judgement is provided.
Fava 2006

Methods

14 week randomised study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐60 mg/day, N = 114

2. Nortriptyline: 25‐150 mg/day, N = 121

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 16‐item Quick Inventory of Depressive Symptomatology

Other measures: 17‐item HAM‐D, Short‐Form Health Survey, Work Productivity and Activity Impairment Questionnaire, Work and Social Adjustment Scale, Quality of Life Enjoyment and Satisfaction Questionnaire

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "random assignment"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

High risk

Comment: Both the participants and the clinicians knew the treatment status.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No information of attrition to permit judgement is provided.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes are reported in figures with the proportion of the participants who achieved these.

Free of Sponsorship bias?

Low risk

The funding source is National Institute of Mental Health.
Guelfi 2000

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Inpatients

Interventions

1. Mirtazapine: 45‐60 mg/day, N = 78

2. Venlafaxine: 75‐375 mg/day, N = 79

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: The Quality of Life, Enjoyment, and Satisfaction Questionnaire and Quality of Life in Depression Scale, Quality of Life in Depression Scales

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Quote: "participants were randomised to receive treatment with either mirtazapine or venlafaxine orally for 8 weeks, prepared as indistinguishable capsules, according to a centrally prepared randomization list"

Comment: No further information about actual central randomisation provided.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

Both the response and the remission outcomes at end of the acute‐phase treatment are reported with the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Halikas 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Outpatients over 55 years of age

Interventions

1. Mirtazapine: 5‐35 mg/day, N = 50

2. Trazodone: 40‐280 mg/day, N = 50

3. Placebo, N = 50

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures: MADRS, CGI‐Severity, Zung Self‐Rating Scale for Depression

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Hong 2003

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐40 mg/day, N = 66

2. Fluoxetine: 20‐40 mg/day, N = 66

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: CGI‐Severity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response and remission outcomes at the end of acute‐phase treatment are provided as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Hoyberg 1996

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 15‐45 mg/day, N = 56

2. Amitriptyline: 30‐90 mg/day, N = 59

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures: MADRS, CGI‐Improvement, CGI‐Severity, Brief Cognitive Rating Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the mirtazapine arm dropped out during the study.

Selective reporting (reporting bias)

High risk

Neither the response or remission outcomes at the end of acute‐phase treatment are provided. They needed to be imputed in the analysis.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Leinonen 1999

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 15‐40 mg/day, N = 66

2. Fluoxetine: 20‐40 mg/day, N = 66

Flexiblie dosing scheduling

Outcomes

The measure used for response and remission in the review: MADRS

Other measures: HAM‐A, CGI‐Improvement, CGI‐Severity, Leeds Sleep Evaluation Questionnaire ‐adapted, Quality of Life Enjoyment and Satisfaction Questionnaire

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Quote: "participants were allocated to treatment with either mirtazapine or citalopram, according to the centrally prepared randomization list".

Comment: No further information about actual central randomisation provided.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Marttila 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: Research Diagnostic criteria major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 20‐60 mg/day, N =83

2. Doxepin: 75‐300 mg/day, N = 80

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, Brief Psychiatric Rating Scale, Global Assessment Score, Beck Depression Inventory, Newcastle Endogenous / Reactive Depression Rating Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the comparator arm dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Mullin 1996

Methods

5 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 20‐60 mg/day, N = 79

2. Amitriptyline: 75‐225 mg/day, N = 77

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, Brief Psychiatric Rating Scale, General Assessment Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the comparator arm dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Organon 85146

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Inpatients

Interventions

1. Mirtazapine: 20‐60 mg/day, N = 103

2. Amitriptyline: 75‐225 mg/day, N = 104

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Improvement

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomly allocated"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Richou 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Inpatients

Interventions

1. Mirtazapine: 20‐80 mg/day, N = 87

2. Clomipramine: 50‐200 mg/day, N = 87

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures: MADRS, Brief Psychiatric Rating Scale, General Assessment Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomly allocated"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Schatzberg 2002

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐40 mg/day, N = 128

2. Paroxetine: 20‐40 mg/day, N = 126

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: CGI‐Severity, CGI‐Improvement

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The information of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the comparator arm dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response and remission outcomes at the end of acute‐phase treatment are provided as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Schoemaker 2002

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐45 mg/day, N = 205

2. Fluvoxamine: 50‐150 mg/day, N = 207

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: 21‐item HAM‐D

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the comparator arm dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Schule 2006

Methods

5 week randomised study

Participants

Diagnosis: DSM‐IV major depressive episode (bipolar disorder not included)

Setting: Psychiatric inpatients

Interventions

1. Mirtazapine: 45 mg/day, N = 20

2. Reboxetine: 8 mg/day, N = 20

Fixed dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures: Hypothalamic‐pituitary‐adrenocortical axis activity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

High risk

Quote: "We abstained from blinding the medication because the side effect profiles of reboxetine and mirtazapine markedly differ".

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the numbers of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Smith 1990

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: ‐35 mg/day, N = 50

2. Amitriptyline: ‐280 mg/day, N = 50

3. Placebo, N = 50

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Improvement, CGI‐Severity, Zung Self‐Rating Depression Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

The numbers of dropouts in the both arms are not specified.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Thase 2000

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients

Interventions

1. Mirtazapine: 15‐45 mg/day, N = 124

2. Sertraline: 50‐200 mg/day, N = 126

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: Inventory of Depressive Symptomatology ‐ Self‐Report Scale, Social Adaptation Self‐evaluation Scale, CGI‐Severity, CGI‐Efficacy

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response and remission outcomes at the end of acute‐phase treatment are provided as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Turan 2000a

Methods

60 day randomised study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Unclear

Interventions

1. Mirtazapine: unclear dose, N = 25

2. Amitriptyline: unclear dose, N = 27

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐I

Notes

We were unable to retrieve usable information for the meta‐analysis and to obtain replies from the author.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of concealment is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information to permit judgement is provided.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Less than 20% of the participants dropped out and missing outcome data are balanced in numbers across intervention groups, with similar reasons of missing data across groups.

Selective reporting (reporting bias)

Unclear risk

No information to permit judgement is provided.

Free of Sponsorship bias?

Unclear risk

No information to permit judgement is provided.
van Moffaert 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Inpatients

Interventions

1. Mirtazapine: 24‐72 mg/day, N = 100

2. Trazodone: 150‐450 mg/day, N = 100

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, Brief Psychiatric Rating Scale, General Psychiatric Impression Global Assessment Scale, Beck Depression Inventory

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Versiani 2005

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 30‐60 mg/day, N = 147

2. Fluoxetine: 20‐40 mg/day, N = 152

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: MADRS, CGI‐Severity, Leeds Sleep Evaluation Questionnaire, Quality of Life, Enjoyment and Satisfaction Questionnaire, Changes in Sezual Functioning Questionnaire

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

The numbers of dropouts in the both arms are not specified.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided in the figure as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Wade 2003

Methods

24 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Outpatients (in general practitioner clinics)

Interventions

1. Mirtazapine: 30‐45 mg/day, N = 99

2. Paroxetine: 20‐30 mg/day, N = 98

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: CGI‐Improvement, CGI‐Severity, CGI‐Patient Global Evaluation

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Quote: "Randomization was performed according to centrally prepared randomization lists".

Comment: No further information about actual central randomization provided.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response and remission outcomes at the end of acute‐phase treatment are provided in the figures as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Wheatley 1998

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III‐R major depressive disorder

Setting: In‐ and outpatients

Interventions

1. Mirtazapine: 15‐60 mg/day, N = 66

2. Fluoxetine: 20‐40 mg/day, N = 67

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 17‐item HAM‐D

Other measures: CGI‐Severity, the Visual Analogue Mood Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Quote: "participants were allocated to treatment with either mirtazapine or fluoxetine, according to the centrally prepared randomization list".

Comment: No further information about actual central randomization provided.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response and remission outcomes at the end of acute‐phase treatment are provided in the figures as the proportion of the participants who achieved these.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Winokur 2003

Methods

8 week randomised double blind study

Participants

Diagnosis: DSM‐IV major depressive disorder

Setting: Unclear

Interventions

1. Mirtazapine: 45 mg/day, N = 9

2. Fluoxetine: 40 mg/day, N = 13

Fixed dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures: CGI‐Severity, polysomnographic data, multiple sleep latency testing, performance vigilance testing, Epworth Sleepiness Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomly assigned"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to the comparator arm dropped out during the study.

Selective reporting (reporting bias)

High risk

Neither the response nor remission outcomes at the end of acute‐phase treatment are provided. They needed to be imputed in the analysis.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.
Zivkov 1995

Methods

6 week randomised double blind study

Participants

Diagnosis: DSM‐III major depressive disorder

Setting: Inpatients

Interventions

1. Mirtazapine: 20‐60 mg/day, N = 125

2. Amitriptyline: 75‐225 mg/day, N = 126

Flexible dosing scheduling

Outcomes

The measure used for response and remission in the review: 21‐item HAM‐D

Other measures; Brief Psychiatric Rating Scale, General Assessment Scale

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Quote: "randomised"

Comment: No further information provided.

Allocation concealment (selection bias)

Unclear risk

Comment: The method of allocation is not described.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Quote: "double‐blind"

Comment: No further information provided.

Incomplete outcome data (attrition bias)
All outcomes

High risk

More than 20% of the allocated participants to both of the intervention arms dropped out during the study.

Selective reporting (reporting bias)

Low risk

The response outcome at the end of acute‐phase treatment is provided as the proportion of the participants who achieved this.

Free of Sponsorship bias?

High risk

The funding source is the pharmaceutical company of mirtazapine.

Abbreviations: CGI = Clinical Global Impression, HAM‐D = Hamilton Rating Scale for Depression, MADRS = Montgomery‐Asberg Depression Rating Scale, RDC = Research Diagnostic Criteria

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Blier 2004

Mirtazapine was combined with another antidepressant.

Bruijin 1996

A review of other studies.

Kasper 1997a

A review of other studies.

Kasper 1997b

A review of other studies.

Kremer 1995

Not a relevant diagnostic status.

Peyron 1996

Not a relevant diagnostic status.

Tulen 1996

Not a relevant diagnostic status.

Zourkova 2001

Not employing random allocation.

Data and analyses

Open in table viewer
Comparison 1. Mirtazapine versus TCAs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

8

1294

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.64, 1.13]
Analysis 1.1
Comparison 1 Mirtazapine versus TCAs, Outcome 1 Primary outcome (response) at 2 weeks.

Comparison 1 Mirtazapine versus TCAs, Outcome 1 Primary outcome (response) at 2 weeks.

1.1 vs Amitriptyline

5

722

Odds Ratio (M‐H, Random, 95% CI)

0.77 [0.54, 1.12]

1.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

1.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.11 [0.58, 2.12]

1.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.22, 3.22]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

9

1501

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.72, 1.10]
Analysis 1.2
Comparison 1 Mirtazapine versus TCAs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Comparison 1 Mirtazapine versus TCAs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

2.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.69, 1.17]

2.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

2.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.44, 1.63]

2.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.53, 1.55]

3 Secondary outcome (remission) at 2 weeks Show forest plot

8

1294

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.55, 1.32]
Analysis 1.3
Comparison 1 Mirtazapine versus TCAs, Outcome 3 Secondary outcome (remission) at 2 weeks.

Comparison 1 Mirtazapine versus TCAs, Outcome 3 Secondary outcome (remission) at 2 weeks.

3.1 vs Amitriptyline

5

722

Odds Ratio (M‐H, Random, 95% CI)

0.67 [0.35, 1.29]

3.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.34, 2.31]

3.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.54, 3.00]

3.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.12, 4.28]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

9

1501

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.69, 1.08]
Analysis 1.4
Comparison 1 Mirtazapine versus TCAs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

Comparison 1 Mirtazapine versus TCAs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

4.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.65, 1.16]

4.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.77 [0.41, 1.45]

4.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.50, 1.74]

4.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.46, 1.56]

5 Secondary outcome (depression severity) at 2 weeks Show forest plot

2

361

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.11, 0.31]
Analysis 1.5
Comparison 1 Mirtazapine versus TCAs, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

Comparison 1 Mirtazapine versus TCAs, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

5.1 vs Amitritpyline

2

361

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.11, 0.31]

6 Secondary outcome (depression severity) at end of the acute‐phase treatment Show forest plot

1

144

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.21, 0.45]
Analysis 1.6
Comparison 1 Mirtazapine versus TCAs, Outcome 6 Secondary outcome (depression severity) at end of the acute‐phase treatment.

Comparison 1 Mirtazapine versus TCAs, Outcome 6 Secondary outcome (depression severity) at end of the acute‐phase treatment.

6.1 vs Amitritpyline

1

144

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.21, 0.45]

7 Secondary outcome (Social adjustment) at 2 weeks Show forest plot

1

138

Mean Difference (IV, Random, 95% CI)

1.60 [‐1.98, 5.18]
Analysis 1.7
Comparison 1 Mirtazapine versus TCAs, Outcome 7 Secondary outcome (Social adjustment) at 2 weeks.

Comparison 1 Mirtazapine versus TCAs, Outcome 7 Secondary outcome (Social adjustment) at 2 weeks.

7.1 vs Amitriptyline

1

138

Mean Difference (IV, Random, 95% CI)

1.60 [‐1.98, 5.18]

8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment Show forest plot

3

440

Std. Mean Difference (IV, Random, 95% CI)

0.02 [‐0.17, 0.21]
Analysis 1.8
Comparison 1 Mirtazapine versus TCAs, Outcome 8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment.

Comparison 1 Mirtazapine versus TCAs, Outcome 8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment.

8.1 vs Amitriptyline

1

114

Std. Mean Difference (IV, Random, 95% CI)

0.03 [‐0.34, 0.40]

8.2 vs Clomipramine

1

163

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.19, 0.43]

8.3 vs Doxepin

1

163

Std. Mean Difference (IV, Random, 95% CI)

‐0.09 [‐0.39, 0.22]

9 Secondary outcome (withdrawal due to any reason) Show forest plot

7

1166

Odds Ratio (M‐H, Random, 95% CI)

0.83 [0.63, 1.10]
Analysis 1.9
Comparison 1 Mirtazapine versus TCAs, Outcome 9 Secondary outcome (withdrawal due to any reason).

Comparison 1 Mirtazapine versus TCAs, Outcome 9 Secondary outcome (withdrawal due to any reason).

9.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.65, 1.25]

9.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.42, 1.54]

9.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.51 [0.22, 1.19]

10 Secondary outcome (withdrawal due to adverse events) Show forest plot

8

1266

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.41, 1.03]
Analysis 1.10
Comparison 1 Mirtazapine versus TCAs, Outcome 10 Secondary outcome (withdrawal due to adverse events).

Comparison 1 Mirtazapine versus TCAs, Outcome 10 Secondary outcome (withdrawal due to adverse events).

10.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.60 [0.35, 1.03]

10.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.42, 3.10]

10.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.30 [0.06, 1.56]

11 Secondary outcome (having some adverse events) Show forest plot

2

442

Odds Ratio (M‐H, Random, 95% CI)

1.06 [0.54, 2.10]
Analysis 1.11
Comparison 1 Mirtazapine versus TCAs, Outcome 11 Secondary outcome (having some adverse events).

Comparison 1 Mirtazapine versus TCAs, Outcome 11 Secondary outcome (having some adverse events).

11.1 vs Amitriptyline

1

207

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.16, 3.37]

11.2 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.55, 2.49]

12 Hypertension/Tachycardia Show forest plot

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.44 [0.24, 0.81]
Analysis 1.12
Comparison 1 Mirtazapine versus TCAs, Outcome 12 Hypertension/Tachycardia.

Comparison 1 Mirtazapine versus TCAs, Outcome 12 Hypertension/Tachycardia.

12.1 vs Amitriptyline

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.44 [0.24, 0.81]

13 Hypotension/Bradycardia Show forest plot

2

215

Odds Ratio (M‐H, Random, 95% CI)

0.46 [0.12, 1.81]
Analysis 1.13
Comparison 1 Mirtazapine versus TCAs, Outcome 13 Hypotension/Bradycardia.

Comparison 1 Mirtazapine versus TCAs, Outcome 13 Hypotension/Bradycardia.

13.1 vs Amitriptyline

2

215

Odds Ratio (M‐H, Random, 95% CI)

0.46 [0.12, 1.81]

14 Sweating Show forest plot

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.05, 3.24]
Analysis 1.14
Comparison 1 Mirtazapine versus TCAs, Outcome 14 Sweating.

Comparison 1 Mirtazapine versus TCAs, Outcome 14 Sweating.

14.1 vs Amitriptyline

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.05, 3.24]

15 Constipation Show forest plot

6

1003

Odds Ratio (M‐H, Random, 95% CI)

0.72 [0.46, 1.12]
Analysis 1.15
Comparison 1 Mirtazapine versus TCAs, Outcome 15 Constipation.

Comparison 1 Mirtazapine versus TCAs, Outcome 15 Constipation.

15.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.72 [0.40, 1.29]

15.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.26, 1.48]

16 Dry mouth/Decreased salivation Show forest plot

8

1266

Odds Ratio (M‐H, Random, 95% CI)

0.52 [0.24, 1.14]
Analysis 1.16
Comparison 1 Mirtazapine versus TCAs, Outcome 16 Dry mouth/Decreased salivation.

Comparison 1 Mirtazapine versus TCAs, Outcome 16 Dry mouth/Decreased salivation.

16.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.14, 0.92]

16.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.39, 1.69]

16.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

2.86 [1.18, 6.94]

17 Nausea/Vomiting/Gastric distress Show forest plot

4

581

Odds Ratio (M‐H, Random, 95% CI)

0.29 [0.05, 1.59]
Analysis 1.17
Comparison 1 Mirtazapine versus TCAs, Outcome 17 Nausea/Vomiting/Gastric distress.

Comparison 1 Mirtazapine versus TCAs, Outcome 17 Nausea/Vomiting/Gastric distress.

17.1 vs Amitriptyline

3

407

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.04, 2.59]

17.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.16 [0.02, 1.33]

18 Weight gain/Increased appetite Show forest plot

3

463

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.58, 1.86]
Analysis 1.18
Comparison 1 Mirtazapine versus TCAs, Outcome 18 Weight gain/Increased appetite.

Comparison 1 Mirtazapine versus TCAs, Outcome 18 Weight gain/Increased appetite.

18.1 vs Amitriptyline

3

463

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.58, 1.86]

19 Sexual dysfunction Show forest plot

2

351

Odds Ratio (M‐H, Random, 95% CI)

0.41 [0.06, 2.61]
Analysis 1.19
Comparison 1 Mirtazapine versus TCAs, Outcome 19 Sexual dysfunction.

Comparison 1 Mirtazapine versus TCAs, Outcome 19 Sexual dysfunction.

19.1 vs Amitriptyline

2

351

Odds Ratio (M‐H, Random, 95% CI)

0.41 [0.06, 2.61]

20 Anxiety/Agitation Show forest plot

2

307

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.34, 2.19]
Analysis 1.20
Comparison 1 Mirtazapine versus TCAs, Outcome 20 Anxiety/Agitation.

Comparison 1 Mirtazapine versus TCAs, Outcome 20 Anxiety/Agitation.

20.1 vs Amitriptyline

2

307

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.34, 2.19]

21 Dizziness/Vertigo/Faintness Show forest plot

7

1166

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.43, 1.28]
Analysis 1.21
Comparison 1 Mirtazapine versus TCAs, Outcome 21 Dizziness/Vertigo/Faintness.

Comparison 1 Mirtazapine versus TCAs, Outcome 21 Dizziness/Vertigo/Faintness.

21.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.35, 1.17]

21.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.21, 2.29]

21.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

3.04 [0.59, 15.53]

22 Fatigue/Tiredness/Asthenia Show forest plot

4

673

Odds Ratio (M‐H, Random, 95% CI)

1.25 [0.71, 2.21]
Analysis 1.22
Comparison 1 Mirtazapine versus TCAs, Outcome 22 Fatigue/Tiredness/Asthenia.

Comparison 1 Mirtazapine versus TCAs, Outcome 22 Fatigue/Tiredness/Asthenia.

22.1 vs Amitriptyline

4

673

Odds Ratio (M‐H, Random, 95% CI)

1.25 [0.71, 2.21]

23 Headache Show forest plot

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.31, 1.74]
Analysis 1.23
Comparison 1 Mirtazapine versus TCAs, Outcome 23 Headache.

Comparison 1 Mirtazapine versus TCAs, Outcome 23 Headache.

23.1 vs Amitriptyline

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.31, 1.74]

24 Tremor Show forest plot

7

1103

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.22, 0.57]
Analysis 1.24
Comparison 1 Mirtazapine versus TCAs, Outcome 24 Tremor.

Comparison 1 Mirtazapine versus TCAs, Outcome 24 Tremor.

24.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.20, 0.62]

24.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.15, 0.88]

25 Sleep disturbance Show forest plot

1

207

Odds Ratio (M‐H, Random, 95% CI)

1.43 [0.69, 2.98]
Analysis 1.25
Comparison 1 Mirtazapine versus TCAs, Outcome 25 Sleep disturbance.

Comparison 1 Mirtazapine versus TCAs, Outcome 25 Sleep disturbance.

25.1 vs Amitriptyline

1

207

Odds Ratio (M‐H, Random, 95% CI)

1.43 [0.69, 2.98]

26 Sleepiness/Drowsiness/Somnolence Show forest plot

6

841

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.66, 1.27]
Analysis 1.26
Comparison 1 Mirtazapine versus TCAs, Outcome 26 Sleepiness/Drowsiness/Somnolence.

Comparison 1 Mirtazapine versus TCAs, Outcome 26 Sleepiness/Drowsiness/Somnolence.

26.1 vs Amitriptyline

5

678

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.58, 1.14]

26.2 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.86 [0.82, 4.21]

27 Suicide attempt Show forest plot

5

935

Odds Ratio (M‐H, Random, 95% CI)

1.77 [0.47, 6.58]
Analysis 1.27
Comparison 1 Mirtazapine versus TCAs, Outcome 27 Suicide attempt.

Comparison 1 Mirtazapine versus TCAs, Outcome 27 Suicide attempt.

27.1 vs Amitriptyline

2

363

Odds Ratio (M‐H, Random, 95% CI)

2.08 [0.27, 16.29]

27.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 16.25]

27.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.01, 7.91]

27.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

9.90 [0.53, 185.90]

28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients Show forest plot

2

425

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.50, 1.32]
Analysis 1.28
Comparison 1 Mirtazapine versus TCAs, Outcome 28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients.

Comparison 1 Mirtazapine versus TCAs, Outcome 28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients.

28.1 vs Amitriptyline

1

251

Odds Ratio (M‐H, Random, 95% CI)

0.73 [0.36, 1.48]

28.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients Show forest plot

3

632

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.64, 1.23]
Analysis 1.29
Comparison 1 Mirtazapine versus TCAs, Outcome 29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients.

Comparison 1 Mirtazapine versus TCAs, Outcome 29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients.

29.1 vs Amitriptyline

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.88 [0.60, 1.29]

29.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

30 Sensitivity analysis: Response at 2 weeks: Studies without imputation Show forest plot

7

1179

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.64, 1.15]
Analysis 1.30
Comparison 1 Mirtazapine versus TCAs, Outcome 30 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

Comparison 1 Mirtazapine versus TCAs, Outcome 30 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

30.1 vs Amitriptyline

4

607

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.51, 1.13]

30.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

30.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.11 [0.58, 2.12]

30.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.22, 3.22]

31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation Show forest plot

8

1386

Odds Ratio (M‐H, Random, 95% CI)

0.93 [0.74, 1.15]
Analysis 1.31
Comparison 1 Mirtazapine versus TCAs, Outcome 31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

Comparison 1 Mirtazapine versus TCAs, Outcome 31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

31.1 vs Amitriptyline

5

814

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.72, 1.26]

31.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

31.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.44, 1.63]

31.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.53, 1.55]

32 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks Show forest plot

Other data

No numeric data
Analysis 1.32

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Hoyberg 1996

Amitriptyline

HAMD‐21 change score

‐4.7

4.5

54

‐5.2

4.4

59

Comparison 1 Mirtazapine versus TCAs, Outcome 32 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks.

33 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Analysis 1.33

Study

Comparator

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

Note

Hoyberg 1996

Amitriptyline

HAMD‐21 change score

‐11.1

7.9

54

‐13.1

7.5

59

Marttila 1995

Doxepin

HAMD‐17

9.15

7.5

83

9.0

6.35

80

Mullin 1996

Amitriptyline

HAMD‐17

11.7

7.3

71

10.7

6.8

71

Zivkov 1995

Amitriptyline

HAMD‐21

12.8

10.1

113

12.0

10.0

111

Comparison 1 Mirtazapine versus TCAs, Outcome 33 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

Open in table viewer
Comparison 2. Mirtazapine versus SSRIs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.57 [1.30, 1.88]
Analysis 2.1
Comparison 2 Mirtazapine versus SSRIs, Outcome 1 Primary outcome (response) at 2 weeks.

Comparison 2 Mirtazapine versus SSRIs, Outcome 1 Primary outcome (response) at 2 weeks.

1.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.01 [0.93, 4.35]

1.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.86, 1.85]

1.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.39 [1.42, 4.02]

1.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.45 [1.04, 2.02]

1.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.90, 2.13]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.19 [1.01, 1.39]
Analysis 2.2
Comparison 2 Mirtazapine versus SSRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Comparison 2 Mirtazapine versus SSRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

2.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.38, 1.52]

2.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.55 [1.07, 2.23]

2.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.94, 1.70]

2.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.35]

2.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.76, 1.70]

3 Primary outcome (response) at end of the continuation treatment Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.60 [0.91, 2.81]
Analysis 2.3
Comparison 2 Mirtazapine versus SSRIs, Outcome 3 Primary outcome (response) at end of the continuation treatment.

Comparison 2 Mirtazapine versus SSRIs, Outcome 3 Primary outcome (response) at end of the continuation treatment.

3.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.60 [0.91, 2.81]

4 Secondary outcome (remission) at 2 weeks Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.82 [1.36, 2.44]
Analysis 2.4
Comparison 2 Mirtazapine versus SSRIs, Outcome 4 Secondary outcome (remission) at 2 weeks.

Comparison 2 Mirtazapine versus SSRIs, Outcome 4 Secondary outcome (remission) at 2 weeks.

4.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.48 [0.47, 13.02]

4.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.63 [0.81, 3.27]

4.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.31 [1.04, 5.11]

4.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.94 [1.19, 3.15]

4.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.46 [0.77, 2.76]

5 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.98, 1.40]
Analysis 2.5
Comparison 2 Mirtazapine versus SSRIs, Outcome 5 Secondary outcome (remission) at end of the acute‐phase treatment.

Comparison 2 Mirtazapine versus SSRIs, Outcome 5 Secondary outcome (remission) at end of the acute‐phase treatment.

5.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.55, 1.52]

5.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.12 [0.80, 1.57]

5.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.58 [1.16, 2.15]

5.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.18 [0.82, 1.71]

5.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.57, 1.23]

6 Secondary outcome (remission) at end of the continuation treatment Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.89 [1.01, 3.54]
Analysis 2.6
Comparison 2 Mirtazapine versus SSRIs, Outcome 6 Secondary outcome (remission) at end of the continuation treatment.

Comparison 2 Mirtazapine versus SSRIs, Outcome 6 Secondary outcome (remission) at end of the continuation treatment.

6.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.89 [1.01, 3.54]

7 Secondary outcome (withdrawal due to any reason) Show forest plot

11

2327

Odds Ratio (M‐H, Random, 95% CI)

1.12 [0.89, 1.40]
Analysis 2.7
Comparison 2 Mirtazapine versus SSRIs, Outcome 7 Secondary outcome (withdrawal due to any reason).

Comparison 2 Mirtazapine versus SSRIs, Outcome 7 Secondary outcome (withdrawal due to any reason).

7.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.36 [0.99, 5.64]

7.2 vs Fluoxetine

4

323

Odds Ratio (M‐H, Random, 95% CI)

1.09 [0.67, 1.78]

7.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.58, 1.10]

7.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.47 [1.01, 2.13]

7.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.20 [0.75, 1.93]

8 Secondary outcome (withdrawal due to adverse events) Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.85, 1.86]
Analysis 2.8
Comparison 2 Mirtazapine versus SSRIs, Outcome 8 Secondary outcome (withdrawal due to adverse events).

Comparison 2 Mirtazapine versus SSRIs, Outcome 8 Secondary outcome (withdrawal due to adverse events).

8.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.0 [0.59, 6.81]

8.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.62, 1.78]

8.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.45, 1.21]

8.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

2.88 [1.43, 5.77]

8.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.66 [0.86, 3.21]

9 Secondary outcome (having some adverse events) Show forest plot

7

1773

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.81, 1.26]
Analysis 2.9
Comparison 2 Mirtazapine versus SSRIs, Outcome 9 Secondary outcome (having some adverse events).

Comparison 2 Mirtazapine versus SSRIs, Outcome 9 Secondary outcome (having some adverse events).

9.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.82 [0.49, 1.37]

9.2 vs Fluoxetine

2

431

Odds Ratio (M‐H, Random, 95% CI)

1.42 [0.97, 2.09]

9.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.66, 1.32]

9.4 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.55, 1.34]

10 Hypotension/Bradycardia Show forest plot

1

133

Odds Ratio (M‐H, Random, 95% CI)

5.41 [0.61, 47.62]
Analysis 2.10
Comparison 2 Mirtazapine versus SSRIs, Outcome 10 Hypotension/Bradycardia.

Comparison 2 Mirtazapine versus SSRIs, Outcome 10 Hypotension/Bradycardia.

10.1 vs Fluoxetine

1

133

Odds Ratio (M‐H, Random, 95% CI)

5.41 [0.61, 47.62]

11 Sweating Show forest plot

5

1342

Odds Ratio (M‐H, Random, 95% CI)

0.25 [0.15, 0.44]
Analysis 2.11
Comparison 2 Mirtazapine versus SSRIs, Outcome 11 Sweating.

Comparison 2 Mirtazapine versus SSRIs, Outcome 11 Sweating.

11.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.13 [0.04, 0.44]

11.2 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.17, 0.62]

11.3 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

0.21 [0.04, 0.97]

12 Constipation Show forest plot

5

1109

Odds Ratio (M‐H, Random, 95% CI)

1.20 [0.79, 1.82]
Analysis 2.12
Comparison 2 Mirtazapine versus SSRIs, Outcome 12 Constipation.

Comparison 2 Mirtazapine versus SSRIs, Outcome 12 Constipation.

12.1 vs Fluoxetine

2

168

Odds Ratio (M‐H, Random, 95% CI)

2.14 [0.81, 5.66]

12.2 vs Paroxetine

2

529

Odds Ratio (M‐H, Random, 95% CI)

1.07 [0.59, 1.95]

12.3 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.48, 2.12]

13 Diarrhoea Show forest plot

8

2040

Odds Ratio (M‐H, Random, 95% CI)

0.57 [0.41, 0.80]
Analysis 2.13
Comparison 2 Mirtazapine versus SSRIs, Outcome 13 Diarrhoea.

Comparison 2 Mirtazapine versus SSRIs, Outcome 13 Diarrhoea.

13.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.47 [0.14, 1.60]

13.2 vs Fluoxetine

1

36

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.33]

13.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.55, 1.46]

13.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.37 [0.21, 0.67]

13.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.13, 0.87]

14 Dry mouth/Decreased salivation Show forest plot

10

2305

Odds Ratio (M‐H, Random, 95% CI)

1.80 [1.37, 2.36]
Analysis 2.14
Comparison 2 Mirtazapine versus SSRIs, Outcome 14 Dry mouth/Decreased salivation.

Comparison 2 Mirtazapine versus SSRIs, Outcome 14 Dry mouth/Decreased salivation.

14.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

1.72 [0.81, 3.68]

14.2 vs Fluoxetine

3

301

Odds Ratio (M‐H, Random, 95% CI)

3.68 [1.52, 8.91]

14.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.73 [0.81, 3.70]

14.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.53 [0.92, 2.55]

14.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.48 [0.77, 2.85]

15 Nausea/Vomiting/Gastric distress Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.26, 0.43]
Analysis 2.15
Comparison 2 Mirtazapine versus SSRIs, Outcome 15 Nausea/Vomiting/Gastric distress.

Comparison 2 Mirtazapine versus SSRIs, Outcome 15 Nausea/Vomiting/Gastric distress.

15.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.45 [0.22, 0.90]

15.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.14, 0.81]

15.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.16, 0.44]

15.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.16, 0.48]

15.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.29 [0.16, 0.53]

16 Weight gain/Increased appetite Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

4.23 [2.93, 6.11]
Analysis 2.16
Comparison 2 Mirtazapine versus SSRIs, Outcome 16 Weight gain/Increased appetite.

Comparison 2 Mirtazapine versus SSRIs, Outcome 16 Weight gain/Increased appetite.

16.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

3.83 [1.49, 9.82]

16.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

5.23 [2.15, 12.76]

16.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

3.92 [1.19, 12.92]

16.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

6.67 [3.30, 13.49]

16.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

2.51 [0.87, 7.26]

17 Weight loss/Anorexia Show forest plot

4

576

Odds Ratio (M‐H, Random, 95% CI)

0.35 [0.10, 1.18]
Analysis 2.17
Comparison 2 Mirtazapine versus SSRIs, Outcome 17 Weight loss/Anorexia.

Comparison 2 Mirtazapine versus SSRIs, Outcome 17 Weight loss/Anorexia.

17.1 vs Fluoxetine

3

301

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.11, 1.62]

17.2 vs Paroxetine

1

275

Odds Ratio (M‐H, Random, 95% CI)

0.14 [0.01, 2.67]

18 Sexual dysfunction Show forest plot

4

907

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.13, 0.74]
Analysis 2.18
Comparison 2 Mirtazapine versus SSRIs, Outcome 18 Sexual dysfunction.

Comparison 2 Mirtazapine versus SSRIs, Outcome 18 Sexual dysfunction.

18.1 vs Fluoxetine

1

36

Odds Ratio (M‐H, Random, 95% CI)

0.15 [0.02, 1.47]

18.2 vs Paroxetine

1

275

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.06, 0.59]

18.3 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.43 [0.10, 1.82]

19 Anxiety/Agitation Show forest plot

4

1134

Odds Ratio (M‐H, Random, 95% CI)

1.46 [0.59, 3.65]
Analysis 2.19
Comparison 2 Mirtazapine versus SSRIs, Outcome 19 Anxiety/Agitation.

Comparison 2 Mirtazapine versus SSRIs, Outcome 19 Anxiety/Agitation.

19.1 vs Paroxetine

2

472

Odds Ratio (M‐H, Random, 95% CI)

0.71 [0.32, 1.60]

19.2 vs Sertraline

1

250

Odds Ratio (M‐H, Random, 95% CI)

1.65 [0.69, 3.98]

19.3 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

5.76 [1.65, 20.07]

20 Dizziness/Vertigo/Faintness Show forest plot

10

2568

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.77, 1.41]
Analysis 2.20
Comparison 2 Mirtazapine versus SSRIs, Outcome 20 Dizziness/Vertigo/Faintness.

Comparison 2 Mirtazapine versus SSRIs, Outcome 20 Dizziness/Vertigo/Faintness.

20.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.03 [0.74, 5.58]

20.2 vs Fluoxetine

3

564

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.54, 1.56]

20.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.47, 1.50]

20.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.16 [0.36, 3.70]

20.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.31 [0.69, 2.48]

21 Fatigue/Tiredness/Asthenia Show forest plot

8

2137

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.08, 2.15]
Analysis 2.21
Comparison 2 Mirtazapine versus SSRIs, Outcome 21 Fatigue/Tiredness/Asthenia.

Comparison 2 Mirtazapine versus SSRIs, Outcome 21 Fatigue/Tiredness/Asthenia.

21.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.44, 1.84]

21.2 vs Fluoxetine

1

133

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.30, 6.40]

21.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.71 [0.94, 3.11]

21.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

2.31 [1.32, 4.04]

21.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.44, 2.00]

22 Headache Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

0.69 [0.56, 0.86]
Analysis 2.22
Comparison 2 Mirtazapine versus SSRIs, Outcome 22 Headache.

Comparison 2 Mirtazapine versus SSRIs, Outcome 22 Headache.

22.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.63 [0.30, 1.33]

22.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.54, 1.36]

22.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.57 [0.36, 0.89]

22.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.67 [0.44, 1.01]

22.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.46, 1.53]

23 Tremor Show forest plot

5

996

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.18, 0.66]
Analysis 2.23
Comparison 2 Mirtazapine versus SSRIs, Outcome 23 Tremor.

Comparison 2 Mirtazapine versus SSRIs, Outcome 23 Tremor.

23.1 vs Fluoxetine

3

467

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.17, 1.07]

23.2 vs Paroxetine

2

529

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.11, 0.70]

24 Sleep disturbance Show forest plot

5

1346

Odds Ratio (M‐H, Random, 95% CI)

0.52 [0.31, 0.86]
Analysis 2.24
Comparison 2 Mirtazapine versus SSRIs, Outcome 24 Sleep disturbance.

Comparison 2 Mirtazapine versus SSRIs, Outcome 24 Sleep disturbance.

24.1 vs Fluoxetine

1

299

Odds Ratio (M‐H, Random, 95% CI)

0.53 [0.21, 1.38]

24.2 vs Paroxetine

2

451

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.25, 1.85]

24.3 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.37 [0.16, 0.85]

25 Sleepiness/Drowsiness/Somnolence Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.81 [1.39, 2.37]
Analysis 2.25
Comparison 2 Mirtazapine versus SSRIs, Outcome 25 Sleepiness/Drowsiness/Somnolence.

Comparison 2 Mirtazapine versus SSRIs, Outcome 25 Sleepiness/Drowsiness/Somnolence.

25.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

1.36 [0.53, 3.51]

25.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.59 [0.97, 2.61]

25.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.24 [0.84, 1.83]

25.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

3.07 [1.89, 4.99]

25.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.45, 3.77]

26 Suicide attempt Show forest plot

1

346

Odds Ratio (M‐H, Random, 95% CI)

4.89 [0.23, 102.51]
Analysis 2.26
Comparison 2 Mirtazapine versus SSRIs, Outcome 26 Suicide attempt.

Comparison 2 Mirtazapine versus SSRIs, Outcome 26 Suicide attempt.

26.1 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

4.89 [0.23, 102.51]

27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

4.38 [1.69, 11.35]
Analysis 2.27
Comparison 2 Mirtazapine versus SSRIs, Outcome 27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care.

Comparison 2 Mirtazapine versus SSRIs, Outcome 27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care.

27.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

4.38 [1.69, 11.35]

28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.66, 2.10]
Analysis 2.28
Comparison 2 Mirtazapine versus SSRIs, Outcome 28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care.

Comparison 2 Mirtazapine versus SSRIs, Outcome 28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care.

28.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.66, 2.10]

29 Sensitivity analysis: Response at 2 weeks: Studies without imputation Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.58 [1.31, 1.90]
Analysis 2.29
Comparison 2 Mirtazapine versus SSRIs, Outcome 29 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

Comparison 2 Mirtazapine versus SSRIs, Outcome 29 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

29.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.01 [0.93, 4.35]

29.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.86, 1.88]

29.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.39 [1.42, 4.02]

29.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.45 [1.04, 2.02]

29.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.90, 2.13]

30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.17 [1.00, 1.38]
Analysis 2.30
Comparison 2 Mirtazapine versus SSRIs, Outcome 30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

Comparison 2 Mirtazapine versus SSRIs, Outcome 30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

30.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.38, 1.52]

30.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.46 [1.04, 2.04]

30.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.94, 1.70]

30.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.35]

30.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.76, 1.70]

31 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks Show forest plot

Other data

No numeric data
Analysis 2.31

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schoemaker 2002

Fluvoxamine

HAMD‐17

‐9.2

5.86

199

‐7.3

6.11

203

Winokur 2003

Fluoxetine

HAMD‐21

16.1

5.7

8

18.0

9.6

11

Comparison 2 Mirtazapine versus SSRIs, Outcome 31 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks.

32 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Analysis 2.32

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schoemaker 2002

Fluvoxamine

HAMD‐17

‐14.3

7.33

199

‐13.7

7.68

203

Thase 2000

Sertraline

HAMD‐17

8.7

7.6

119

10.5

7.2

124

Winokur 2003

Fluoxetine

HAMD‐21

7.1

3.7

8

12.2

9.2

11

Comparison 2 Mirtazapine versus SSRIs, Outcome 32 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

Open in table viewer
Comparison 3. Mirtazapine versus SNRIs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.29 [1.45, 3.59]
Analysis 3.1
Comparison 3 Mirtazapine versus SNRIs, Outcome 1 Primary outcome (response) at 2 weeks.

Comparison 3 Mirtazapine versus SNRIs, Outcome 1 Primary outcome (response) at 2 weeks.

1.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.29 [1.45, 3.59]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.03, 2.25]
Analysis 3.2
Comparison 3 Mirtazapine versus SNRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Comparison 3 Mirtazapine versus SNRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

2.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.03, 2.25]

3 Secondary outcome (remission) at 2 weeks Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.07, 5.13]
Analysis 3.3
Comparison 3 Mirtazapine versus SNRIs, Outcome 3 Secondary outcome (remission) at 2 weeks.

Comparison 3 Mirtazapine versus SNRIs, Outcome 3 Secondary outcome (remission) at 2 weeks.

3.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.07, 5.13]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.55 [0.98, 2.47]
Analysis 3.4
Comparison 3 Mirtazapine versus SNRIs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

Comparison 3 Mirtazapine versus SNRIs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

4.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.55 [0.98, 2.47]

5 Secondary outcome (withdrawal due to any reason) Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.43, 0.99]
Analysis 3.5
Comparison 3 Mirtazapine versus SNRIs, Outcome 5 Secondary outcome (withdrawal due to any reason).

Comparison 3 Mirtazapine versus SNRIs, Outcome 5 Secondary outcome (withdrawal due to any reason).

5.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.43, 0.99]

6 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.55 [0.24, 1.24]
Analysis 3.6
Comparison 3 Mirtazapine versus SNRIs, Outcome 6 Secondary outcome (withdrawal due to adverse events).

Comparison 3 Mirtazapine versus SNRIs, Outcome 6 Secondary outcome (withdrawal due to adverse events).

6.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.55 [0.24, 1.24]

7 Secondary outcome (having some adverse events) Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.51 [0.76, 3.00]
Analysis 3.7
Comparison 3 Mirtazapine versus SNRIs, Outcome 7 Secondary outcome (having some adverse events).

Comparison 3 Mirtazapine versus SNRIs, Outcome 7 Secondary outcome (having some adverse events).

7.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.51 [0.76, 3.00]

8 Hypotension/Bradycardia Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.02, 1.68]
Analysis 3.8
Comparison 3 Mirtazapine versus SNRIs, Outcome 8 Hypotension/Bradycardia.

Comparison 3 Mirtazapine versus SNRIs, Outcome 8 Hypotension/Bradycardia.

8.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.02, 1.68]

9 Sweating Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.03 [0.00, 0.45]
Analysis 3.9
Comparison 3 Mirtazapine versus SNRIs, Outcome 9 Sweating.

Comparison 3 Mirtazapine versus SNRIs, Outcome 9 Sweating.

9.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.03 [0.00, 0.45]

10 Constipation Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.22 [0.06, 0.83]
Analysis 3.10
Comparison 3 Mirtazapine versus SNRIs, Outcome 10 Constipation.

Comparison 3 Mirtazapine versus SNRIs, Outcome 10 Constipation.

10.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.22 [0.06, 0.83]

11 Dry mouth/Decreased salivation Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

8.61 [0.35, 211.85]
Analysis 3.11
Comparison 3 Mirtazapine versus SNRIs, Outcome 11 Dry mouth/Decreased salivation.

Comparison 3 Mirtazapine versus SNRIs, Outcome 11 Dry mouth/Decreased salivation.

11.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

8.61 [0.35, 211.85]

12 Nausea/Vomiting/Gastric distress Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.11 [0.00, 9.34]
Analysis 3.12
Comparison 3 Mirtazapine versus SNRIs, Outcome 12 Nausea/Vomiting/Gastric distress.

Comparison 3 Mirtazapine versus SNRIs, Outcome 12 Nausea/Vomiting/Gastric distress.

12.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.11 [0.00, 9.34]

13 Anxiety/Agitation Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.24, 4.20]
Analysis 3.13
Comparison 3 Mirtazapine versus SNRIs, Outcome 13 Anxiety/Agitation.

Comparison 3 Mirtazapine versus SNRIs, Outcome 13 Anxiety/Agitation.

13.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.24, 4.20]

14 Fatigue/Tiredness/Asthenia Show forest plot

1

258

Odds Ratio (M‐H, Random, 95% CI)

2.43 [1.30, 4.55]
Analysis 3.14
Comparison 3 Mirtazapine versus SNRIs, Outcome 14 Fatigue/Tiredness/Asthenia.

Comparison 3 Mirtazapine versus SNRIs, Outcome 14 Fatigue/Tiredness/Asthenia.

14.1 vs Venlafaxine

1

258

Odds Ratio (M‐H, Random, 95% CI)

2.43 [1.30, 4.55]

15 Headache Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.53, 1.72]
Analysis 3.15
Comparison 3 Mirtazapine versus SNRIs, Outcome 15 Headache.

Comparison 3 Mirtazapine versus SNRIs, Outcome 15 Headache.

15.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.53, 1.72]

16 Sleep disturbance Show forest plot

1

258

Odds Ratio (M‐H, Random, 95% CI)

0.02 [0.00, 0.41]
Analysis 3.16
Comparison 3 Mirtazapine versus SNRIs, Outcome 16 Sleep disturbance.

Comparison 3 Mirtazapine versus SNRIs, Outcome 16 Sleep disturbance.

16.1 vs Venlafaxine

1

258

Odds Ratio (M‐H, Random, 95% CI)

0.02 [0.00, 0.41]

17 Sleepiness/Drowsiness/Somnolence Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.56 [0.42, 5.77]
Analysis 3.17
Comparison 3 Mirtazapine versus SNRIs, Outcome 17 Sleepiness/Drowsiness/Somnolence.

Comparison 3 Mirtazapine versus SNRIs, Outcome 17 Sleepiness/Drowsiness/Somnolence.

17.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.56 [0.42, 5.77]

18 Completed suicide Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.31]
Analysis 3.18
Comparison 3 Mirtazapine versus SNRIs, Outcome 18 Completed suicide.

Comparison 3 Mirtazapine versus SNRIs, Outcome 18 Completed suicide.

18.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.31]
Open in table viewer
Comparison 4. Mirtazapine versus heterocyclic antidepressants

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.64, 2.04]
Analysis 4.1
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

1.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.64, 2.04]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.95, 2.37]
Analysis 4.2
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

2.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.95, 2.37]

3 Secondary outcome (remission) at 2 weeks Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.36, 2.80]
Analysis 4.3
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

3.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.36, 2.80]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.76, 2.52]
Analysis 4.4
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

4.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.76, 2.52]

5 Secondary outcome (withdrawal due to any reason) Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.72]
Analysis 4.5
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 5 Secondary outcome (withdrawal due to any reason).

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 5 Secondary outcome (withdrawal due to any reason).

5.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.72]

6 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.61 [0.25, 1.51]
Analysis 4.6
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 6 Secondary outcome (withdrawal due to adverse events).

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 6 Secondary outcome (withdrawal due to adverse events).

6.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.61 [0.25, 1.51]

7 Hypertension/Tachycardia Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.06, 1.59]
Analysis 4.7
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 7 Hypertension/Tachycardia.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 7 Hypertension/Tachycardia.

7.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.06, 1.59]

8 Hypotension/Bradycardia Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.03, 1.00]
Analysis 4.8
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 8 Hypotension/Bradycardia.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 8 Hypotension/Bradycardia.

8.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.03, 1.00]

9 Constipation Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.26, 1.83]
Analysis 4.9
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 9 Constipation.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 9 Constipation.

9.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.26, 1.83]

10 Dry mouth/Decreased salivation Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.39 [0.11, 1.37]
Analysis 4.10
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 10 Dry mouth/Decreased salivation.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 10 Dry mouth/Decreased salivation.

10.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.39 [0.11, 1.37]

11 Nausea/Vomiting/Gastric distress Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.20, 2.32]
Analysis 4.11
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 11 Nausea/Vomiting/Gastric distress.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 11 Nausea/Vomiting/Gastric distress.

11.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.20, 2.32]

12 Weight gain/Increased appetite Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

4.95 [1.30, 18.81]
Analysis 4.12
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 12 Weight gain/Increased appetite.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 12 Weight gain/Increased appetite.

12.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

4.95 [1.30, 18.81]

13 Weight loss/Anorexia Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.21]
Analysis 4.13
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 13 Weight loss/Anorexia.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 13 Weight loss/Anorexia.

13.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.21]

14 Anxiety/Agitation Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.19, 1.96]
Analysis 4.14
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 14 Anxiety/Agitation.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 14 Anxiety/Agitation.

14.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.19, 1.96]

15 Dizziness/Vertigo/Faintness Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.30, 1.39]
Analysis 4.15
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 15 Dizziness/Vertigo/Faintness.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 15 Dizziness/Vertigo/Faintness.

15.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.30, 1.39]

16 Headache Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.23, 1.87]
Analysis 4.16
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 16 Headache.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 16 Headache.

16.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.23, 1.87]

17 Sleep disturbance Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.13, 1.42]
Analysis 4.17
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 17 Sleep disturbance.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 17 Sleep disturbance.

17.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.13, 1.42]

18 Sleepiness/Drowsiness/Somnolence Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.29, 1.36]
Analysis 4.18
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 18 Sleepiness/Drowsiness/Somnolence.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 18 Sleepiness/Drowsiness/Somnolence.

18.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.29, 1.36]

19 Completed suicide Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

3.03 [0.12, 75.28]
Analysis 4.19
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 19 Completed suicide.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 19 Completed suicide.

19.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

3.03 [0.12, 75.28]

20 Suicide attempt Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

2.02 [0.18, 22.65]
Analysis 4.20
Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 20 Suicide attempt.

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 20 Suicide attempt.

20.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

2.02 [0.18, 22.65]
Open in table viewer
Comparison 5. Mirtazapine versus newer antidepressants

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.18, 5.67]
Analysis 5.1
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

1.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.18, 5.67]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.27, 3.67]
Analysis 5.2
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

2.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.27, 3.67]

3 Secondary outcome (remission) at 2 weeks Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.18]
Analysis 5.3
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

3.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.18]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.33, 4.73]
Analysis 5.4
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

4.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.33, 4.73]

5 Secondary outcome (depression severity) at 2 weeks Show forest plot

1

40

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐1.00, 0.25]
Analysis 5.5
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

5.1 vs Reboxetine

1

40

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐1.00, 0.25]

6 Secondary outcome (withdrawal due to any reason) Show forest plot

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]
Analysis 5.6
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 6 Secondary outcome (withdrawal due to any reason).

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 6 Secondary outcome (withdrawal due to any reason).

6.1 vs Reboxetine

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]
Analysis 5.7
Comparison 5 Mirtazapine versus newer antidepressants, Outcome 7 Secondary outcome (withdrawal due to adverse events).

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 7 Secondary outcome (withdrawal due to adverse events).

7.1 vs Reboxetine

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Analysis 5.8

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schule 2006

Reboxetine

21‐item HAM‐D

10.87

6.91

20

11.17

6.17

20

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 8 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

Open in table viewer
Comparison 6. Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 vs all compounds Show forest plot

26

4882

Risk Ratio (M‐H, Fixed, 99% CI)

1.05 [0.99, 1.12]
Analysis 6.1
Comparison 6 Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment, Outcome 1 vs all compounds.

Comparison 6 Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment, Outcome 1 vs all compounds.

1.1 vs Amitriptyline

6

929

Risk Ratio (M‐H, Fixed, 99% CI)

0.95 [0.82, 1.11]

1.2 vs Clomipramine

1

174

Risk Ratio (M‐H, Fixed, 99% CI)

0.97 [0.74, 1.26]

1.3 vs Doxepin

1

163

Risk Ratio (M‐H, Fixed, 99% CI)

0.95 [0.71, 1.26]

1.4 vs Nortriptyline

1

235

Risk Ratio (M‐H, Fixed, 99% CI)

0.94 [0.59, 1.49]

1.5 vs Citalolpram

1

270

Risk Ratio (M‐H, Fixed, 99% CI)

0.96 [0.85, 1.09]

1.6 vs Fluoxetine

5

622

Risk Ratio (M‐H, Fixed, 99% CI)

1.18 [1.00, 1.39]

1.7 vs Paroxetine

3

726

Risk Ratio (M‐H, Fixed, 99% CI)

1.13 [0.93, 1.38]

1.8 vs Sertraline

2

596

Risk Ratio (M‐H, Fixed, 99% CI)

0.99 [0.83, 1.17]

1.9 vs Fluvoxamine

1

412

Risk Ratio (M‐H, Fixed, 99% CI)

1.05 [0.86, 1.28]

1.10 vs Venlafaxine

2

415

Risk Ratio (M‐H, Fixed, 99% CI)

1.24 [0.96, 1.60]

1.11 vs Trazodone

2

300

Risk Ratio (M‐H, Fixed, 99% CI)

1.21 [0.91, 1.61]

1.12 vs Reboxetine

1

40

Risk Ratio (M‐H, Fixed, 99% CI)

1.0 [0.55, 1.82]

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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original image
Figuras y tablas -
Figure 2
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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 3

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Forest plot of comparison: 1 MIRTAZAPINE vs TCAs, outcome: 1.1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 MIRTAZAPINE vs TCAs, outcome: 1.1 Primary outcome (response) at 2 weeks.

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Forest plot of comparison: 1 MIRTAZAPINE vs TCAs, outcome: 1.2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 MIRTAZAPINE vs TCAs, outcome: 1.2 Primary outcome (response) at end of the acute‐phase treatment.

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Forest plot of comparison: 2 MIRTAZAPINE vs SSRIs, outcome: 2.1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Figure 6

Forest plot of comparison: 2 MIRTAZAPINE vs SSRIs, outcome: 2.1 Primary outcome (response) at 2 weeks.

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Forest plot of comparison: 2 MIRTAZAPINE vs SSRIs, outcome: 2.2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Figure 7

Forest plot of comparison: 2 MIRTAZAPINE vs SSRIs, outcome: 2.2 Primary outcome (response) at end of the acute‐phase treatment.

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Funnel plot of comparison: 6 Funnel plot analysis: Primary outcome (response) at end of the acute‐phase treatment, outcome: 6.1 vs all compounds.
Figuras y tablas -
Figure 8

Funnel plot of comparison: 6 Funnel plot analysis: Primary outcome (response) at end of the acute‐phase treatment, outcome: 6.1 vs all compounds.

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Comparison 1 Mirtazapine versus TCAs, Outcome 1 Primary outcome (response) at 2 weeks.
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Analysis 1.1

Comparison 1 Mirtazapine versus TCAs, Outcome 1 Primary outcome (response) at 2 weeks.

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Comparison 1 Mirtazapine versus TCAs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 1.2

Comparison 1 Mirtazapine versus TCAs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

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Comparison 1 Mirtazapine versus TCAs, Outcome 3 Secondary outcome (remission) at 2 weeks.
Figuras y tablas -
Analysis 1.3

Comparison 1 Mirtazapine versus TCAs, Outcome 3 Secondary outcome (remission) at 2 weeks.

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Comparison 1 Mirtazapine versus TCAs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.
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Analysis 1.4

Comparison 1 Mirtazapine versus TCAs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

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Comparison 1 Mirtazapine versus TCAs, Outcome 5 Secondary outcome (depression severity) at 2 weeks.
Figuras y tablas -
Analysis 1.5

Comparison 1 Mirtazapine versus TCAs, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

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Comparison 1 Mirtazapine versus TCAs, Outcome 6 Secondary outcome (depression severity) at end of the acute‐phase treatment.
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Analysis 1.6

Comparison 1 Mirtazapine versus TCAs, Outcome 6 Secondary outcome (depression severity) at end of the acute‐phase treatment.

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Comparison 1 Mirtazapine versus TCAs, Outcome 7 Secondary outcome (Social adjustment) at 2 weeks.
Figuras y tablas -
Analysis 1.7

Comparison 1 Mirtazapine versus TCAs, Outcome 7 Secondary outcome (Social adjustment) at 2 weeks.

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Comparison 1 Mirtazapine versus TCAs, Outcome 8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment.
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Analysis 1.8

Comparison 1 Mirtazapine versus TCAs, Outcome 8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment.

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Comparison 1 Mirtazapine versus TCAs, Outcome 9 Secondary outcome (withdrawal due to any reason).
Figuras y tablas -
Analysis 1.9

Comparison 1 Mirtazapine versus TCAs, Outcome 9 Secondary outcome (withdrawal due to any reason).

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Comparison 1 Mirtazapine versus TCAs, Outcome 10 Secondary outcome (withdrawal due to adverse events).
Figuras y tablas -
Analysis 1.10

Comparison 1 Mirtazapine versus TCAs, Outcome 10 Secondary outcome (withdrawal due to adverse events).

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Comparison 1 Mirtazapine versus TCAs, Outcome 11 Secondary outcome (having some adverse events).
Figuras y tablas -
Analysis 1.11

Comparison 1 Mirtazapine versus TCAs, Outcome 11 Secondary outcome (having some adverse events).

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Comparison 1 Mirtazapine versus TCAs, Outcome 12 Hypertension/Tachycardia.
Figuras y tablas -
Analysis 1.12

Comparison 1 Mirtazapine versus TCAs, Outcome 12 Hypertension/Tachycardia.

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Comparison 1 Mirtazapine versus TCAs, Outcome 13 Hypotension/Bradycardia.
Figuras y tablas -
Analysis 1.13

Comparison 1 Mirtazapine versus TCAs, Outcome 13 Hypotension/Bradycardia.

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Comparison 1 Mirtazapine versus TCAs, Outcome 14 Sweating.
Figuras y tablas -
Analysis 1.14

Comparison 1 Mirtazapine versus TCAs, Outcome 14 Sweating.

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Comparison 1 Mirtazapine versus TCAs, Outcome 15 Constipation.
Figuras y tablas -
Analysis 1.15

Comparison 1 Mirtazapine versus TCAs, Outcome 15 Constipation.

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Comparison 1 Mirtazapine versus TCAs, Outcome 16 Dry mouth/Decreased salivation.
Figuras y tablas -
Analysis 1.16

Comparison 1 Mirtazapine versus TCAs, Outcome 16 Dry mouth/Decreased salivation.

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Comparison 1 Mirtazapine versus TCAs, Outcome 17 Nausea/Vomiting/Gastric distress.
Figuras y tablas -
Analysis 1.17

Comparison 1 Mirtazapine versus TCAs, Outcome 17 Nausea/Vomiting/Gastric distress.

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Comparison 1 Mirtazapine versus TCAs, Outcome 18 Weight gain/Increased appetite.
Figuras y tablas -
Analysis 1.18

Comparison 1 Mirtazapine versus TCAs, Outcome 18 Weight gain/Increased appetite.

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Comparison 1 Mirtazapine versus TCAs, Outcome 19 Sexual dysfunction.
Figuras y tablas -
Analysis 1.19

Comparison 1 Mirtazapine versus TCAs, Outcome 19 Sexual dysfunction.

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Comparison 1 Mirtazapine versus TCAs, Outcome 20 Anxiety/Agitation.
Figuras y tablas -
Analysis 1.20

Comparison 1 Mirtazapine versus TCAs, Outcome 20 Anxiety/Agitation.

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Comparison 1 Mirtazapine versus TCAs, Outcome 21 Dizziness/Vertigo/Faintness.
Figuras y tablas -
Analysis 1.21

Comparison 1 Mirtazapine versus TCAs, Outcome 21 Dizziness/Vertigo/Faintness.

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Comparison 1 Mirtazapine versus TCAs, Outcome 22 Fatigue/Tiredness/Asthenia.
Figuras y tablas -
Analysis 1.22

Comparison 1 Mirtazapine versus TCAs, Outcome 22 Fatigue/Tiredness/Asthenia.

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Comparison 1 Mirtazapine versus TCAs, Outcome 23 Headache.
Figuras y tablas -
Analysis 1.23

Comparison 1 Mirtazapine versus TCAs, Outcome 23 Headache.

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Comparison 1 Mirtazapine versus TCAs, Outcome 24 Tremor.
Figuras y tablas -
Analysis 1.24

Comparison 1 Mirtazapine versus TCAs, Outcome 24 Tremor.

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Comparison 1 Mirtazapine versus TCAs, Outcome 25 Sleep disturbance.
Figuras y tablas -
Analysis 1.25

Comparison 1 Mirtazapine versus TCAs, Outcome 25 Sleep disturbance.

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Comparison 1 Mirtazapine versus TCAs, Outcome 26 Sleepiness/Drowsiness/Somnolence.
Figuras y tablas -
Analysis 1.26

Comparison 1 Mirtazapine versus TCAs, Outcome 26 Sleepiness/Drowsiness/Somnolence.

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Comparison 1 Mirtazapine versus TCAs, Outcome 27 Suicide attempt.
Figuras y tablas -
Analysis 1.27

Comparison 1 Mirtazapine versus TCAs, Outcome 27 Suicide attempt.

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Comparison 1 Mirtazapine versus TCAs, Outcome 28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients.
Figuras y tablas -
Analysis 1.28

Comparison 1 Mirtazapine versus TCAs, Outcome 28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients.

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Comparison 1 Mirtazapine versus TCAs, Outcome 29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients.
Figuras y tablas -
Analysis 1.29

Comparison 1 Mirtazapine versus TCAs, Outcome 29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients.

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Comparison 1 Mirtazapine versus TCAs, Outcome 30 Sensitivity analysis: Response at 2 weeks: Studies without imputation.
Figuras y tablas -
Analysis 1.30

Comparison 1 Mirtazapine versus TCAs, Outcome 30 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

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Comparison 1 Mirtazapine versus TCAs, Outcome 31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.
Figuras y tablas -
Analysis 1.31

Comparison 1 Mirtazapine versus TCAs, Outcome 31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

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Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Hoyberg 1996

Amitriptyline

HAMD‐21 change score

‐4.7

4.5

54

‐5.2

4.4

59

Figuras y tablas -
Analysis 1.32

Comparison 1 Mirtazapine versus TCAs, Outcome 32 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks.

Ir a la figura de la revisión

Study

Comparator

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

Note

Hoyberg 1996

Amitriptyline

HAMD‐21 change score

‐11.1

7.9

54

‐13.1

7.5

59

Marttila 1995

Doxepin

HAMD‐17

9.15

7.5

83

9.0

6.35

80

Mullin 1996

Amitriptyline

HAMD‐17

11.7

7.3

71

10.7

6.8

71

Zivkov 1995

Amitriptyline

HAMD‐21

12.8

10.1

113

12.0

10.0

111

Figuras y tablas -
Analysis 1.33

Comparison 1 Mirtazapine versus TCAs, Outcome 33 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

Ir a la figura de la revisión

Comparison 2 Mirtazapine versus SSRIs, Outcome 1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Analysis 2.1

Comparison 2 Mirtazapine versus SSRIs, Outcome 1 Primary outcome (response) at 2 weeks.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 2.2

Comparison 2 Mirtazapine versus SSRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 3 Primary outcome (response) at end of the continuation treatment.
Figuras y tablas -
Analysis 2.3

Comparison 2 Mirtazapine versus SSRIs, Outcome 3 Primary outcome (response) at end of the continuation treatment.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 4 Secondary outcome (remission) at 2 weeks.
Figuras y tablas -
Analysis 2.4

Comparison 2 Mirtazapine versus SSRIs, Outcome 4 Secondary outcome (remission) at 2 weeks.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 5 Secondary outcome (remission) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 2.5

Comparison 2 Mirtazapine versus SSRIs, Outcome 5 Secondary outcome (remission) at end of the acute‐phase treatment.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 6 Secondary outcome (remission) at end of the continuation treatment.
Figuras y tablas -
Analysis 2.6

Comparison 2 Mirtazapine versus SSRIs, Outcome 6 Secondary outcome (remission) at end of the continuation treatment.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 7 Secondary outcome (withdrawal due to any reason).
Figuras y tablas -
Analysis 2.7

Comparison 2 Mirtazapine versus SSRIs, Outcome 7 Secondary outcome (withdrawal due to any reason).

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Comparison 2 Mirtazapine versus SSRIs, Outcome 8 Secondary outcome (withdrawal due to adverse events).
Figuras y tablas -
Analysis 2.8

Comparison 2 Mirtazapine versus SSRIs, Outcome 8 Secondary outcome (withdrawal due to adverse events).

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Comparison 2 Mirtazapine versus SSRIs, Outcome 9 Secondary outcome (having some adverse events).
Figuras y tablas -
Analysis 2.9

Comparison 2 Mirtazapine versus SSRIs, Outcome 9 Secondary outcome (having some adverse events).

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Comparison 2 Mirtazapine versus SSRIs, Outcome 10 Hypotension/Bradycardia.
Figuras y tablas -
Analysis 2.10

Comparison 2 Mirtazapine versus SSRIs, Outcome 10 Hypotension/Bradycardia.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 11 Sweating.
Figuras y tablas -
Analysis 2.11

Comparison 2 Mirtazapine versus SSRIs, Outcome 11 Sweating.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 12 Constipation.
Figuras y tablas -
Analysis 2.12

Comparison 2 Mirtazapine versus SSRIs, Outcome 12 Constipation.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 13 Diarrhoea.
Figuras y tablas -
Analysis 2.13

Comparison 2 Mirtazapine versus SSRIs, Outcome 13 Diarrhoea.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 14 Dry mouth/Decreased salivation.
Figuras y tablas -
Analysis 2.14

Comparison 2 Mirtazapine versus SSRIs, Outcome 14 Dry mouth/Decreased salivation.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 15 Nausea/Vomiting/Gastric distress.
Figuras y tablas -
Analysis 2.15

Comparison 2 Mirtazapine versus SSRIs, Outcome 15 Nausea/Vomiting/Gastric distress.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 16 Weight gain/Increased appetite.
Figuras y tablas -
Analysis 2.16

Comparison 2 Mirtazapine versus SSRIs, Outcome 16 Weight gain/Increased appetite.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 17 Weight loss/Anorexia.
Figuras y tablas -
Analysis 2.17

Comparison 2 Mirtazapine versus SSRIs, Outcome 17 Weight loss/Anorexia.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 18 Sexual dysfunction.
Figuras y tablas -
Analysis 2.18

Comparison 2 Mirtazapine versus SSRIs, Outcome 18 Sexual dysfunction.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 19 Anxiety/Agitation.
Figuras y tablas -
Analysis 2.19

Comparison 2 Mirtazapine versus SSRIs, Outcome 19 Anxiety/Agitation.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 20 Dizziness/Vertigo/Faintness.
Figuras y tablas -
Analysis 2.20

Comparison 2 Mirtazapine versus SSRIs, Outcome 20 Dizziness/Vertigo/Faintness.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 21 Fatigue/Tiredness/Asthenia.
Figuras y tablas -
Analysis 2.21

Comparison 2 Mirtazapine versus SSRIs, Outcome 21 Fatigue/Tiredness/Asthenia.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 22 Headache.
Figuras y tablas -
Analysis 2.22

Comparison 2 Mirtazapine versus SSRIs, Outcome 22 Headache.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 23 Tremor.
Figuras y tablas -
Analysis 2.23

Comparison 2 Mirtazapine versus SSRIs, Outcome 23 Tremor.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 24 Sleep disturbance.
Figuras y tablas -
Analysis 2.24

Comparison 2 Mirtazapine versus SSRIs, Outcome 24 Sleep disturbance.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Mirtazapine versus SSRIs, Outcome 25 Sleepiness/Drowsiness/Somnolence.
Figuras y tablas -
Analysis 2.25

Comparison 2 Mirtazapine versus SSRIs, Outcome 25 Sleepiness/Drowsiness/Somnolence.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 26 Suicide attempt.
Figuras y tablas -
Analysis 2.26

Comparison 2 Mirtazapine versus SSRIs, Outcome 26 Suicide attempt.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care.
Figuras y tablas -
Analysis 2.27

Comparison 2 Mirtazapine versus SSRIs, Outcome 27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care.
Figuras y tablas -
Analysis 2.28

Comparison 2 Mirtazapine versus SSRIs, Outcome 28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 29 Sensitivity analysis: Response at 2 weeks: Studies without imputation.
Figuras y tablas -
Analysis 2.29

Comparison 2 Mirtazapine versus SSRIs, Outcome 29 Sensitivity analysis: Response at 2 weeks: Studies without imputation.

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Comparison 2 Mirtazapine versus SSRIs, Outcome 30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.
Figuras y tablas -
Analysis 2.30

Comparison 2 Mirtazapine versus SSRIs, Outcome 30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schoemaker 2002

Fluvoxamine

HAMD‐17

‐9.2

5.86

199

‐7.3

6.11

203

Winokur 2003

Fluoxetine

HAMD‐21

16.1

5.7

8

18.0

9.6

11

Figuras y tablas -
Analysis 2.31

Comparison 2 Mirtazapine versus SSRIs, Outcome 31 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks.

Ir a la figura de la revisión

Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schoemaker 2002

Fluvoxamine

HAMD‐17

‐14.3

7.33

199

‐13.7

7.68

203

Thase 2000

Sertraline

HAMD‐17

8.7

7.6

119

10.5

7.2

124

Winokur 2003

Fluoxetine

HAMD‐21

7.1

3.7

8

12.2

9.2

11

Figuras y tablas -
Analysis 2.32

Comparison 2 Mirtazapine versus SSRIs, Outcome 32 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

Ir a la figura de la revisión

Comparison 3 Mirtazapine versus SNRIs, Outcome 1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Analysis 3.1

Comparison 3 Mirtazapine versus SNRIs, Outcome 1 Primary outcome (response) at 2 weeks.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 3.2

Comparison 3 Mirtazapine versus SNRIs, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 3 Secondary outcome (remission) at 2 weeks.
Figuras y tablas -
Analysis 3.3

Comparison 3 Mirtazapine versus SNRIs, Outcome 3 Secondary outcome (remission) at 2 weeks.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 3.4

Comparison 3 Mirtazapine versus SNRIs, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 5 Secondary outcome (withdrawal due to any reason).
Figuras y tablas -
Analysis 3.5

Comparison 3 Mirtazapine versus SNRIs, Outcome 5 Secondary outcome (withdrawal due to any reason).

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Comparison 3 Mirtazapine versus SNRIs, Outcome 6 Secondary outcome (withdrawal due to adverse events).
Figuras y tablas -
Analysis 3.6

Comparison 3 Mirtazapine versus SNRIs, Outcome 6 Secondary outcome (withdrawal due to adverse events).

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Comparison 3 Mirtazapine versus SNRIs, Outcome 7 Secondary outcome (having some adverse events).
Figuras y tablas -
Analysis 3.7

Comparison 3 Mirtazapine versus SNRIs, Outcome 7 Secondary outcome (having some adverse events).

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Comparison 3 Mirtazapine versus SNRIs, Outcome 8 Hypotension/Bradycardia.
Figuras y tablas -
Analysis 3.8

Comparison 3 Mirtazapine versus SNRIs, Outcome 8 Hypotension/Bradycardia.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 9 Sweating.
Figuras y tablas -
Analysis 3.9

Comparison 3 Mirtazapine versus SNRIs, Outcome 9 Sweating.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 10 Constipation.
Figuras y tablas -
Analysis 3.10

Comparison 3 Mirtazapine versus SNRIs, Outcome 10 Constipation.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 11 Dry mouth/Decreased salivation.
Figuras y tablas -
Analysis 3.11

Comparison 3 Mirtazapine versus SNRIs, Outcome 11 Dry mouth/Decreased salivation.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 12 Nausea/Vomiting/Gastric distress.
Figuras y tablas -
Analysis 3.12

Comparison 3 Mirtazapine versus SNRIs, Outcome 12 Nausea/Vomiting/Gastric distress.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 13 Anxiety/Agitation.
Figuras y tablas -
Analysis 3.13

Comparison 3 Mirtazapine versus SNRIs, Outcome 13 Anxiety/Agitation.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 14 Fatigue/Tiredness/Asthenia.
Figuras y tablas -
Analysis 3.14

Comparison 3 Mirtazapine versus SNRIs, Outcome 14 Fatigue/Tiredness/Asthenia.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 15 Headache.
Figuras y tablas -
Analysis 3.15

Comparison 3 Mirtazapine versus SNRIs, Outcome 15 Headache.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 16 Sleep disturbance.
Figuras y tablas -
Analysis 3.16

Comparison 3 Mirtazapine versus SNRIs, Outcome 16 Sleep disturbance.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 17 Sleepiness/Drowsiness/Somnolence.
Figuras y tablas -
Analysis 3.17

Comparison 3 Mirtazapine versus SNRIs, Outcome 17 Sleepiness/Drowsiness/Somnolence.

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Comparison 3 Mirtazapine versus SNRIs, Outcome 18 Completed suicide.
Figuras y tablas -
Analysis 3.18

Comparison 3 Mirtazapine versus SNRIs, Outcome 18 Completed suicide.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Analysis 4.1

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 4.2

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.
Figuras y tablas -
Analysis 4.3

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 4.4

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 5 Secondary outcome (withdrawal due to any reason).
Figuras y tablas -
Analysis 4.5

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 5 Secondary outcome (withdrawal due to any reason).

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 6 Secondary outcome (withdrawal due to adverse events).
Figuras y tablas -
Analysis 4.6

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 6 Secondary outcome (withdrawal due to adverse events).

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 7 Hypertension/Tachycardia.
Figuras y tablas -
Analysis 4.7

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 7 Hypertension/Tachycardia.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 8 Hypotension/Bradycardia.
Figuras y tablas -
Analysis 4.8

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 8 Hypotension/Bradycardia.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 9 Constipation.
Figuras y tablas -
Analysis 4.9

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 9 Constipation.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 10 Dry mouth/Decreased salivation.
Figuras y tablas -
Analysis 4.10

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 10 Dry mouth/Decreased salivation.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 11 Nausea/Vomiting/Gastric distress.
Figuras y tablas -
Analysis 4.11

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 11 Nausea/Vomiting/Gastric distress.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 12 Weight gain/Increased appetite.
Figuras y tablas -
Analysis 4.12

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 12 Weight gain/Increased appetite.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 13 Weight loss/Anorexia.
Figuras y tablas -
Analysis 4.13

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 13 Weight loss/Anorexia.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 14 Anxiety/Agitation.
Figuras y tablas -
Analysis 4.14

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 14 Anxiety/Agitation.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 15 Dizziness/Vertigo/Faintness.
Figuras y tablas -
Analysis 4.15

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 15 Dizziness/Vertigo/Faintness.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 16 Headache.
Figuras y tablas -
Analysis 4.16

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 16 Headache.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 17 Sleep disturbance.
Figuras y tablas -
Analysis 4.17

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 17 Sleep disturbance.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 18 Sleepiness/Drowsiness/Somnolence.
Figuras y tablas -
Analysis 4.18

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 18 Sleepiness/Drowsiness/Somnolence.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 19 Completed suicide.
Figuras y tablas -
Analysis 4.19

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 19 Completed suicide.

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Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 20 Suicide attempt.
Figuras y tablas -
Analysis 4.20

Comparison 4 Mirtazapine versus heterocyclic antidepressants, Outcome 20 Suicide attempt.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.
Figuras y tablas -
Analysis 5.1

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 1 Primary outcome (response) at 2 weeks.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 5.2

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 2 Primary outcome (response) at end of the acute‐phase treatment.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.
Figuras y tablas -
Analysis 5.3

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 3 Secondary outcome (remission) at 2 weeks.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.
Figuras y tablas -
Analysis 5.4

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 4 Secondary outcome (remission) at end of the acute‐phase treatment.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 5 Secondary outcome (depression severity) at 2 weeks.
Figuras y tablas -
Analysis 5.5

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 5 Secondary outcome (depression severity) at 2 weeks.

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 6 Secondary outcome (withdrawal due to any reason).
Figuras y tablas -
Analysis 5.6

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 6 Secondary outcome (withdrawal due to any reason).

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Comparison 5 Mirtazapine versus newer antidepressants, Outcome 7 Secondary outcome (withdrawal due to adverse events).
Figuras y tablas -
Analysis 5.7

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 7 Secondary outcome (withdrawal due to adverse events).

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Study

Comparator drug

Measurement

Mirtazapine: mean

SD

N

Comparator: mean

SD

N

note

Schule 2006

Reboxetine

21‐item HAM‐D

10.87

6.91

20

11.17

6.17

20

Figuras y tablas -
Analysis 5.8

Comparison 5 Mirtazapine versus newer antidepressants, Outcome 8 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment.

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Comparison 6 Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment, Outcome 1 vs all compounds.
Figuras y tablas -
Analysis 6.1

Comparison 6 Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment, Outcome 1 vs all compounds.

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Comparison 1. Mirtazapine versus TCAs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

8

1294

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.64, 1.13]

1.1 vs Amitriptyline

5

722

Odds Ratio (M‐H, Random, 95% CI)

0.77 [0.54, 1.12]

1.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

1.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.11 [0.58, 2.12]

1.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.22, 3.22]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

9

1501

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.72, 1.10]

2.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.69, 1.17]

2.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

2.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.44, 1.63]

2.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.53, 1.55]

3 Secondary outcome (remission) at 2 weeks Show forest plot

8

1294

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.55, 1.32]

3.1 vs Amitriptyline

5

722

Odds Ratio (M‐H, Random, 95% CI)

0.67 [0.35, 1.29]

3.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.34, 2.31]

3.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.54, 3.00]

3.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.12, 4.28]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

9

1501

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.69, 1.08]

4.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.65, 1.16]

4.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.77 [0.41, 1.45]

4.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.50, 1.74]

4.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.46, 1.56]

5 Secondary outcome (depression severity) at 2 weeks Show forest plot

2

361

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.11, 0.31]

5.1 vs Amitritpyline

2

361

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.11, 0.31]

6 Secondary outcome (depression severity) at end of the acute‐phase treatment Show forest plot

1

144

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.21, 0.45]

6.1 vs Amitritpyline

1

144

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.21, 0.45]

7 Secondary outcome (Social adjustment) at 2 weeks Show forest plot

1

138

Mean Difference (IV, Random, 95% CI)

1.60 [‐1.98, 5.18]

7.1 vs Amitriptyline

1

138

Mean Difference (IV, Random, 95% CI)

1.60 [‐1.98, 5.18]

8 Secondary outcome (Social adjustment) at end of the acute‐phase treatment Show forest plot

3

440

Std. Mean Difference (IV, Random, 95% CI)

0.02 [‐0.17, 0.21]

8.1 vs Amitriptyline

1

114

Std. Mean Difference (IV, Random, 95% CI)

0.03 [‐0.34, 0.40]

8.2 vs Clomipramine

1

163

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.19, 0.43]

8.3 vs Doxepin

1

163

Std. Mean Difference (IV, Random, 95% CI)

‐0.09 [‐0.39, 0.22]

9 Secondary outcome (withdrawal due to any reason) Show forest plot

7

1166

Odds Ratio (M‐H, Random, 95% CI)

0.83 [0.63, 1.10]

9.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.65, 1.25]

9.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.42, 1.54]

9.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.51 [0.22, 1.19]

10 Secondary outcome (withdrawal due to adverse events) Show forest plot

8

1266

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.41, 1.03]

10.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.60 [0.35, 1.03]

10.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.42, 3.10]

10.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.30 [0.06, 1.56]

11 Secondary outcome (having some adverse events) Show forest plot

2

442

Odds Ratio (M‐H, Random, 95% CI)

1.06 [0.54, 2.10]

11.1 vs Amitriptyline

1

207

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.16, 3.37]

11.2 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.55, 2.49]

12 Hypertension/Tachycardia Show forest plot

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.44 [0.24, 0.81]

12.1 vs Amitriptyline

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.44 [0.24, 0.81]

13 Hypotension/Bradycardia Show forest plot

2

215

Odds Ratio (M‐H, Random, 95% CI)

0.46 [0.12, 1.81]

13.1 vs Amitriptyline

2

215

Odds Ratio (M‐H, Random, 95% CI)

0.46 [0.12, 1.81]

14 Sweating Show forest plot

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.05, 3.24]

14.1 vs Amitriptyline

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.05, 3.24]

15 Constipation Show forest plot

6

1003

Odds Ratio (M‐H, Random, 95% CI)

0.72 [0.46, 1.12]

15.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.72 [0.40, 1.29]

15.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.26, 1.48]

16 Dry mouth/Decreased salivation Show forest plot

8

1266

Odds Ratio (M‐H, Random, 95% CI)

0.52 [0.24, 1.14]

16.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.14, 0.92]

16.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.39, 1.69]

16.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

2.86 [1.18, 6.94]

17 Nausea/Vomiting/Gastric distress Show forest plot

4

581

Odds Ratio (M‐H, Random, 95% CI)

0.29 [0.05, 1.59]

17.1 vs Amitriptyline

3

407

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.04, 2.59]

17.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.16 [0.02, 1.33]

18 Weight gain/Increased appetite Show forest plot

3

463

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.58, 1.86]

18.1 vs Amitriptyline

3

463

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.58, 1.86]

19 Sexual dysfunction Show forest plot

2

351

Odds Ratio (M‐H, Random, 95% CI)

0.41 [0.06, 2.61]

19.1 vs Amitriptyline

2

351

Odds Ratio (M‐H, Random, 95% CI)

0.41 [0.06, 2.61]

20 Anxiety/Agitation Show forest plot

2

307

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.34, 2.19]

20.1 vs Amitriptyline

2

307

Odds Ratio (M‐H, Random, 95% CI)

0.87 [0.34, 2.19]

21 Dizziness/Vertigo/Faintness Show forest plot

7

1166

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.43, 1.28]

21.1 vs Amitriptyline

5

829

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.35, 1.17]

21.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.21, 2.29]

21.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

3.04 [0.59, 15.53]

22 Fatigue/Tiredness/Asthenia Show forest plot

4

673

Odds Ratio (M‐H, Random, 95% CI)

1.25 [0.71, 2.21]

22.1 vs Amitriptyline

4

673

Odds Ratio (M‐H, Random, 95% CI)

1.25 [0.71, 2.21]

23 Headache Show forest plot

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.31, 1.74]

23.1 vs Amitriptyline

4

522

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.31, 1.74]

24 Tremor Show forest plot

7

1103

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.22, 0.57]

24.1 vs Amitriptyline

6

929

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.20, 0.62]

24.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.15, 0.88]

25 Sleep disturbance Show forest plot

1

207

Odds Ratio (M‐H, Random, 95% CI)

1.43 [0.69, 2.98]

25.1 vs Amitriptyline

1

207

Odds Ratio (M‐H, Random, 95% CI)

1.43 [0.69, 2.98]

26 Sleepiness/Drowsiness/Somnolence Show forest plot

6

841

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.66, 1.27]

26.1 vs Amitriptyline

5

678

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.58, 1.14]

26.2 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.86 [0.82, 4.21]

27 Suicide attempt Show forest plot

5

935

Odds Ratio (M‐H, Random, 95% CI)

1.77 [0.47, 6.58]

27.1 vs Amitriptyline

2

363

Odds Ratio (M‐H, Random, 95% CI)

2.08 [0.27, 16.29]

27.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 16.25]

27.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.01, 7.91]

27.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

9.90 [0.53, 185.90]

28 Subgroup analysis: Response at 2 weeks: Treatment settings: Psychiatric inpatients Show forest plot

2

425

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.50, 1.32]

28.1 vs Amitriptyline

1

251

Odds Ratio (M‐H, Random, 95% CI)

0.73 [0.36, 1.48]

28.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

29 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Psychiatric inpatients Show forest plot

3

632

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.64, 1.23]

29.1 vs Amitriptyline

2

458

Odds Ratio (M‐H, Random, 95% CI)

0.88 [0.60, 1.29]

29.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

30 Sensitivity analysis: Response at 2 weeks: Studies without imputation Show forest plot

7

1179

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.64, 1.15]

30.1 vs Amitriptyline

4

607

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.51, 1.13]

30.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.46, 1.73]

30.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

1.11 [0.58, 2.12]

30.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.22, 3.22]

31 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation Show forest plot

8

1386

Odds Ratio (M‐H, Random, 95% CI)

0.93 [0.74, 1.15]

31.1 vs Amitriptyline

5

814

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.72, 1.26]

31.2 vs Clomipramine

1

174

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.71]

31.3 vs Doxepin

1

163

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.44, 1.63]

31.4 vs Nortriptyline

1

235

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.53, 1.55]

32 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks Show forest plot

Other data

No numeric data

33 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Figuras y tablas -
Comparison 1. Mirtazapine versus TCAs
Ir a la tabla de la revisión
Comparison 2. Mirtazapine versus SSRIs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.57 [1.30, 1.88]

1.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.01 [0.93, 4.35]

1.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.86, 1.85]

1.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.39 [1.42, 4.02]

1.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.45 [1.04, 2.02]

1.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.90, 2.13]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.19 [1.01, 1.39]

2.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.38, 1.52]

2.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.55 [1.07, 2.23]

2.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.94, 1.70]

2.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.35]

2.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.76, 1.70]

3 Primary outcome (response) at end of the continuation treatment Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.60 [0.91, 2.81]

3.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.60 [0.91, 2.81]

4 Secondary outcome (remission) at 2 weeks Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.82 [1.36, 2.44]

4.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.48 [0.47, 13.02]

4.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.63 [0.81, 3.27]

4.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.31 [1.04, 5.11]

4.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.94 [1.19, 3.15]

4.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.46 [0.77, 2.76]

5 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

12

2626

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.98, 1.40]

5.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.55, 1.52]

5.2 vs Fluoxetine

5

622

Odds Ratio (M‐H, Random, 95% CI)

1.12 [0.80, 1.57]

5.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.58 [1.16, 2.15]

5.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.18 [0.82, 1.71]

5.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.57, 1.23]

6 Secondary outcome (remission) at end of the continuation treatment Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.89 [1.01, 3.54]

6.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.89 [1.01, 3.54]

7 Secondary outcome (withdrawal due to any reason) Show forest plot

11

2327

Odds Ratio (M‐H, Random, 95% CI)

1.12 [0.89, 1.40]

7.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.36 [0.99, 5.64]

7.2 vs Fluoxetine

4

323

Odds Ratio (M‐H, Random, 95% CI)

1.09 [0.67, 1.78]

7.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.58, 1.10]

7.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.47 [1.01, 2.13]

7.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.20 [0.75, 1.93]

8 Secondary outcome (withdrawal due to adverse events) Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.85, 1.86]

8.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.0 [0.59, 6.81]

8.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.62, 1.78]

8.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.45, 1.21]

8.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

2.88 [1.43, 5.77]

8.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.66 [0.86, 3.21]

9 Secondary outcome (having some adverse events) Show forest plot

7

1773

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.81, 1.26]

9.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.82 [0.49, 1.37]

9.2 vs Fluoxetine

2

431

Odds Ratio (M‐H, Random, 95% CI)

1.42 [0.97, 2.09]

9.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.66, 1.32]

9.4 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.55, 1.34]

10 Hypotension/Bradycardia Show forest plot

1

133

Odds Ratio (M‐H, Random, 95% CI)

5.41 [0.61, 47.62]

10.1 vs Fluoxetine

1

133

Odds Ratio (M‐H, Random, 95% CI)

5.41 [0.61, 47.62]

11 Sweating Show forest plot

5

1342

Odds Ratio (M‐H, Random, 95% CI)

0.25 [0.15, 0.44]

11.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.13 [0.04, 0.44]

11.2 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.17, 0.62]

11.3 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

0.21 [0.04, 0.97]

12 Constipation Show forest plot

5

1109

Odds Ratio (M‐H, Random, 95% CI)

1.20 [0.79, 1.82]

12.1 vs Fluoxetine

2

168

Odds Ratio (M‐H, Random, 95% CI)

2.14 [0.81, 5.66]

12.2 vs Paroxetine

2

529

Odds Ratio (M‐H, Random, 95% CI)

1.07 [0.59, 1.95]

12.3 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.48, 2.12]

13 Diarrhoea Show forest plot

8

2040

Odds Ratio (M‐H, Random, 95% CI)

0.57 [0.41, 0.80]

13.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.47 [0.14, 1.60]

13.2 vs Fluoxetine

1

36

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.33]

13.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.89 [0.55, 1.46]

13.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.37 [0.21, 0.67]

13.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.13, 0.87]

14 Dry mouth/Decreased salivation Show forest plot

10

2305

Odds Ratio (M‐H, Random, 95% CI)

1.80 [1.37, 2.36]

14.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

1.72 [0.81, 3.68]

14.2 vs Fluoxetine

3

301

Odds Ratio (M‐H, Random, 95% CI)

3.68 [1.52, 8.91]

14.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.73 [0.81, 3.70]

14.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.53 [0.92, 2.55]

14.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.48 [0.77, 2.85]

15 Nausea/Vomiting/Gastric distress Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.26, 0.43]

15.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.45 [0.22, 0.90]

15.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.14, 0.81]

15.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.16, 0.44]

15.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.16, 0.48]

15.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.29 [0.16, 0.53]

16 Weight gain/Increased appetite Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

4.23 [2.93, 6.11]

16.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

3.83 [1.49, 9.82]

16.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

5.23 [2.15, 12.76]

16.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

3.92 [1.19, 12.92]

16.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

6.67 [3.30, 13.49]

16.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

2.51 [0.87, 7.26]

17 Weight loss/Anorexia Show forest plot

4

576

Odds Ratio (M‐H, Random, 95% CI)

0.35 [0.10, 1.18]

17.1 vs Fluoxetine

3

301

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.11, 1.62]

17.2 vs Paroxetine

1

275

Odds Ratio (M‐H, Random, 95% CI)

0.14 [0.01, 2.67]

18 Sexual dysfunction Show forest plot

4

907

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.13, 0.74]

18.1 vs Fluoxetine

1

36

Odds Ratio (M‐H, Random, 95% CI)

0.15 [0.02, 1.47]

18.2 vs Paroxetine

1

275

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.06, 0.59]

18.3 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.43 [0.10, 1.82]

19 Anxiety/Agitation Show forest plot

4

1134

Odds Ratio (M‐H, Random, 95% CI)

1.46 [0.59, 3.65]

19.1 vs Paroxetine

2

472

Odds Ratio (M‐H, Random, 95% CI)

0.71 [0.32, 1.60]

19.2 vs Sertraline

1

250

Odds Ratio (M‐H, Random, 95% CI)

1.65 [0.69, 3.98]

19.3 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

5.76 [1.65, 20.07]

20 Dizziness/Vertigo/Faintness Show forest plot

10

2568

Odds Ratio (M‐H, Random, 95% CI)

1.04 [0.77, 1.41]

20.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.03 [0.74, 5.58]

20.2 vs Fluoxetine

3

564

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.54, 1.56]

20.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.47, 1.50]

20.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.16 [0.36, 3.70]

20.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.31 [0.69, 2.48]

21 Fatigue/Tiredness/Asthenia Show forest plot

8

2137

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.08, 2.15]

21.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.91 [0.44, 1.84]

21.2 vs Fluoxetine

1

133

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.30, 6.40]

21.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.71 [0.94, 3.11]

21.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

2.31 [1.32, 4.04]

21.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.44, 2.00]

22 Headache Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

0.69 [0.56, 0.86]

22.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.63 [0.30, 1.33]

22.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.54, 1.36]

22.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

0.57 [0.36, 0.89]

22.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.67 [0.44, 1.01]

22.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.46, 1.53]

23 Tremor Show forest plot

5

996

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.18, 0.66]

23.1 vs Fluoxetine

3

467

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.17, 1.07]

23.2 vs Paroxetine

2

529

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.11, 0.70]

24 Sleep disturbance Show forest plot

5

1346

Odds Ratio (M‐H, Random, 95% CI)

0.52 [0.31, 0.86]

24.1 vs Fluoxetine

1

299

Odds Ratio (M‐H, Random, 95% CI)

0.53 [0.21, 1.38]

24.2 vs Paroxetine

2

451

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.25, 1.85]

24.3 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.37 [0.16, 0.85]

25 Sleepiness/Drowsiness/Somnolence Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.81 [1.39, 2.37]

25.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

1.36 [0.53, 3.51]

25.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.59 [0.97, 2.61]

25.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.24 [0.84, 1.83]

25.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

3.07 [1.89, 4.99]

25.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.45, 3.77]

26 Suicide attempt Show forest plot

1

346

Odds Ratio (M‐H, Random, 95% CI)

4.89 [0.23, 102.51]

26.1 vs Sertraline

1

346

Odds Ratio (M‐H, Random, 95% CI)

4.89 [0.23, 102.51]

27 Subgroup analysis: Response at 2 weeks: Treatment settings: Outpatients in primary care Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

4.38 [1.69, 11.35]

27.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

4.38 [1.69, 11.35]

28 Subgroup analysis: Response at end of the acute‐phase treatment: Treatment settings: Outpatients in primary care Show forest plot

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.66, 2.10]

28.1 vs Paroxetine

1

197

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.66, 2.10]

29 Sensitivity analysis: Response at 2 weeks: Studies without imputation Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.58 [1.31, 1.90]

29.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

2.01 [0.93, 4.35]

29.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.86, 1.88]

29.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

2.39 [1.42, 4.02]

29.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

1.45 [1.04, 2.02]

29.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.90, 2.13]

30 Sensitivity analysis: Response at end of the acute‐phase treatment: Studies without imputation Show forest plot

11

2604

Odds Ratio (M‐H, Random, 95% CI)

1.17 [1.00, 1.38]

30.1 vs Citalolpram

1

270

Odds Ratio (M‐H, Random, 95% CI)

0.76 [0.38, 1.52]

30.2 vs Fluoxetine

4

600

Odds Ratio (M‐H, Random, 95% CI)

1.46 [1.04, 2.04]

30.3 vs Paroxetine

3

726

Odds Ratio (M‐H, Random, 95% CI)

1.27 [0.94, 1.70]

30.4 vs Sertraline

2

596

Odds Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.35]

30.5 vs Fluvoxamine

1

412

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.76, 1.70]

31 Secondary outcome (SKEWED DATA: depression severity) at 2 weeks Show forest plot

Other data

No numeric data

32 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Figuras y tablas -
Comparison 2. Mirtazapine versus SSRIs
Ir a la tabla de la revisión
Comparison 3. Mirtazapine versus SNRIs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.29 [1.45, 3.59]

1.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.29 [1.45, 3.59]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.03, 2.25]

2.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.53 [1.03, 2.25]

3 Secondary outcome (remission) at 2 weeks Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.07, 5.13]

3.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

2.34 [1.07, 5.13]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.55 [0.98, 2.47]

4.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

1.55 [0.98, 2.47]

5 Secondary outcome (withdrawal due to any reason) Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.43, 0.99]

5.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.43, 0.99]

6 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.55 [0.24, 1.24]

6.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.55 [0.24, 1.24]

7 Secondary outcome (having some adverse events) Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.51 [0.76, 3.00]

7.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.51 [0.76, 3.00]

8 Hypotension/Bradycardia Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.02, 1.68]

8.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.19 [0.02, 1.68]

9 Sweating Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.03 [0.00, 0.45]

9.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.03 [0.00, 0.45]

10 Constipation Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.22 [0.06, 0.83]

10.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.22 [0.06, 0.83]

11 Dry mouth/Decreased salivation Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

8.61 [0.35, 211.85]

11.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

8.61 [0.35, 211.85]

12 Nausea/Vomiting/Gastric distress Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.11 [0.00, 9.34]

12.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.11 [0.00, 9.34]

13 Anxiety/Agitation Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.24, 4.20]

13.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.01 [0.24, 4.20]

14 Fatigue/Tiredness/Asthenia Show forest plot

1

258

Odds Ratio (M‐H, Random, 95% CI)

2.43 [1.30, 4.55]

14.1 vs Venlafaxine

1

258

Odds Ratio (M‐H, Random, 95% CI)

2.43 [1.30, 4.55]

15 Headache Show forest plot

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.53, 1.72]

15.1 vs Venlafaxine

2

415

Odds Ratio (M‐H, Random, 95% CI)

0.95 [0.53, 1.72]

16 Sleep disturbance Show forest plot

1

258

Odds Ratio (M‐H, Random, 95% CI)

0.02 [0.00, 0.41]

16.1 vs Venlafaxine

1

258

Odds Ratio (M‐H, Random, 95% CI)

0.02 [0.00, 0.41]

17 Sleepiness/Drowsiness/Somnolence Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.56 [0.42, 5.77]

17.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

1.56 [0.42, 5.77]

18 Completed suicide Show forest plot

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.31]

18.1 vs Venlafaxine

1

157

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.31]
Figuras y tablas -
Comparison 3. Mirtazapine versus SNRIs
Ir a la tabla de la revisión
Comparison 4. Mirtazapine versus heterocyclic antidepressants

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.64, 2.04]

1.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.14 [0.64, 2.04]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.95, 2.37]

2.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.95, 2.37]

3 Secondary outcome (remission) at 2 weeks Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.36, 2.80]

3.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.36, 2.80]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.76, 2.52]

4.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

1.38 [0.76, 2.52]

5 Secondary outcome (withdrawal due to any reason) Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.72]

5.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.90 [0.47, 1.72]

6 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.61 [0.25, 1.51]

6.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.61 [0.25, 1.51]

7 Hypertension/Tachycardia Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.06, 1.59]

7.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.06, 1.59]

8 Hypotension/Bradycardia Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.03, 1.00]

8.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.03, 1.00]

9 Constipation Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.26, 1.83]

9.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.26, 1.83]

10 Dry mouth/Decreased salivation Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.39 [0.11, 1.37]

10.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.39 [0.11, 1.37]

11 Nausea/Vomiting/Gastric distress Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.20, 2.32]

11.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.20, 2.32]

12 Weight gain/Increased appetite Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

4.95 [1.30, 18.81]

12.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

4.95 [1.30, 18.81]

13 Weight loss/Anorexia Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.21]

13.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 8.21]

14 Anxiety/Agitation Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.19, 1.96]

14.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.19, 1.96]

15 Dizziness/Vertigo/Faintness Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.30, 1.39]

15.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.30, 1.39]

16 Headache Show forest plot

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.23, 1.87]

16.1 vs Trazodone

1

100

Odds Ratio (M‐H, Random, 95% CI)

0.65 [0.23, 1.87]

17 Sleep disturbance Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.13, 1.42]

17.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.13, 1.42]

18 Sleepiness/Drowsiness/Somnolence Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.29, 1.36]

18.1 vs Trazodone

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.29, 1.36]

19 Completed suicide Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

3.03 [0.12, 75.28]

19.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

3.03 [0.12, 75.28]

20 Suicide attempt Show forest plot

1

200

Odds Ratio (M‐H, Random, 95% CI)

2.02 [0.18, 22.65]

20.1 vs Trazodone

1

200

Odds Ratio (M‐H, Random, 95% CI)

2.02 [0.18, 22.65]
Figuras y tablas -
Comparison 4. Mirtazapine versus heterocyclic antidepressants
Ir a la tabla de la revisión
Comparison 5. Mirtazapine versus newer antidepressants

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome (response) at 2 weeks Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.18, 5.67]

1.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.18, 5.67]

2 Primary outcome (response) at end of the acute‐phase treatment Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.27, 3.67]

2.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.27, 3.67]

3 Secondary outcome (remission) at 2 weeks Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.18]

3.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.18]

4 Secondary outcome (remission) at end of the acute‐phase treatment Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.33, 4.73]

4.1 vs Reboxetine

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.33, 4.73]

5 Secondary outcome (depression severity) at 2 weeks Show forest plot

1

40

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐1.00, 0.25]

5.1 vs Reboxetine

1

40

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐1.00, 0.25]

6 Secondary outcome (withdrawal due to any reason) Show forest plot

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.1 vs Reboxetine

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Secondary outcome (withdrawal due to adverse events) Show forest plot

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7.1 vs Reboxetine

2

80

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Secondary outcome (SKEWED DATA: depression severity) at end of the acute‐phase treatment Show forest plot

Other data

No numeric data
Figuras y tablas -
Comparison 5. Mirtazapine versus newer antidepressants
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Comparison 6. Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 vs all compounds Show forest plot

26

4882

Risk Ratio (M‐H, Fixed, 99% CI)

1.05 [0.99, 1.12]

1.1 vs Amitriptyline

6

929

Risk Ratio (M‐H, Fixed, 99% CI)

0.95 [0.82, 1.11]

1.2 vs Clomipramine

1

174

Risk Ratio (M‐H, Fixed, 99% CI)

0.97 [0.74, 1.26]

1.3 vs Doxepin

1

163

Risk Ratio (M‐H, Fixed, 99% CI)

0.95 [0.71, 1.26]

1.4 vs Nortriptyline

1

235

Risk Ratio (M‐H, Fixed, 99% CI)

0.94 [0.59, 1.49]

1.5 vs Citalolpram

1

270

Risk Ratio (M‐H, Fixed, 99% CI)

0.96 [0.85, 1.09]

1.6 vs Fluoxetine

5

622

Risk Ratio (M‐H, Fixed, 99% CI)

1.18 [1.00, 1.39]

1.7 vs Paroxetine

3

726

Risk Ratio (M‐H, Fixed, 99% CI)

1.13 [0.93, 1.38]

1.8 vs Sertraline

2

596

Risk Ratio (M‐H, Fixed, 99% CI)

0.99 [0.83, 1.17]

1.9 vs Fluvoxamine

1

412

Risk Ratio (M‐H, Fixed, 99% CI)

1.05 [0.86, 1.28]

1.10 vs Venlafaxine

2

415

Risk Ratio (M‐H, Fixed, 99% CI)

1.24 [0.96, 1.60]

1.11 vs Trazodone

2

300

Risk Ratio (M‐H, Fixed, 99% CI)

1.21 [0.91, 1.61]

1.12 vs Reboxetine

1

40

Risk Ratio (M‐H, Fixed, 99% CI)

1.0 [0.55, 1.82]
Figuras y tablas -
Comparison 6. Funnel plot analysis: primary outcome (response) at end of the acute‐phase treatment
Ir a la tabla de la revisión