medigraphic.com
Colegio de Medicina Interna de México.

2021, Number 1

<< Back Next >>

Med Int Mex 2021; 37 (1)

Mirtazapine in major depressive disorder: a critical review of scientific evidence

Ramírez-Bermúdez J, Aldrete-Velasco J, Enríquez-Ramos MS, Camacho-Silva B

Language: Spanish
References: 64
Page: 62-77
PDF size: 438.19 Kb.


ABSTRACT

Major depressive disorder is a clinical entity characterized by a clinical pattern with a core of emotional symptoms (depressed mood and anhedonia), accompanied by cognitive and somatic alterations that produce a marked functional disturbance, as well as significant discomfort. This article reviews the neurobiology of the disorder, and the therapeutic effects of mirtazapine, an antidepressant that acts simultaneously on the noradrenergic and serotoninergic systems. Due to the mechanism of action, mirtazapine enhances the release of these neurotransmitters in the central nervous system. Current meta-analysis show that mirtazapine is one of the most effective treatments in the approach to patients with Major depressive disorder. Additionally, its efficacy and safety have been studied in special populations, including the elderly and patients with comorbidities.


REFERENCES

  1. Soleimani L, Lapidus KAB, Iosifescu DV. Diagnosis and treatment of major depressive disorder. Neurol Clin 2011; 29 (1): 177-93; doi. 10.1016/j.ncl.2010.10.010.

  2. Fekadu N, Shibeshi W, Engidawork E. Major depressive disorder: pathophysiology and clinical management. J Depress Anxiety 2017; 06 (01); doi. 10.4172/2167- 1044.1000255.

  3. Fava M, Kendler KS. Major depressive disorder. Neuron 2000; 28 (2): 335-41; doi. 10.1016/S0896-6273(00)00112- 4.

  4. Ramírez‐Bermúdez J. Depresión: la noche más oscura. Penguin-Random House, Ciudad de Mexico, 2020.

  5. American Psychiatric Association (APA). Guía de consulta de los criterios diagnósticos del DSM 5. APA, Arlington (VA), 2013.

  6. Stein D, Szatmari P, Gaebel W, Berk M, et al. Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Medicine 2020; 18 (21). doi.org/10.1186/ s12916-020-1495-2.

  7. World Health Organization (WHO). Depression and other common mental disorders: global health estimates, 2017. Disponible: https://apps.who.int/iris/bitstream/ handle/10665/254610/WHO-MSD-MER-2017.2-eng. pdf?sequence=1%0Ahttp://apps.who.int/iris/bitstream/ handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf; jsessionid=0886B5297E6F5A04AA4F2F2FD5FE36F9?sequ ence=1%0Ahttp://apps.who.int/; consultado: septiembre 01, 2020.

  8. Medina-Mora ME, Borges G, Benjet C, Lara C, et al. Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample. Br J Psychiatry 2007; 190: 521-8. doi. 10.1192/bjp.bp.106.025841.

  9. Centro Nacional de Excelencia Tecnológica en Salud (CENETEC). Guía de Práctica Clínica (GPC): Diagnóstico y tratamiento del trastorno depresivo en el adulto, evidencias y recomendaciones. CENETEC, México, 2015; Catálogo de Guías Maestras de Práctica Clínica, IMSS-161-09.

  10. Castillo Manzano R, Arankowsky Sandoval G. Violencia intrafamiliar como factor de riesgo para trastorno depresivo mayor en mujeres: estudio de casos y controles. Rev Biomédica 2008; 19 (3): 128-36; doi. 10.32776/revbiomed. v19i3.517.

  11. Pérez-Padilla EA, Cervantes-Ramírez VM, Hijuelos-García NA, Pineda-Cortés JC, et al. Prevalencia, causas y tratamiento de la Depresión Mayor. Rev Biomédica 2017; 28 (2): 89-115. doi. 10.32776/revbiomed.v28i2.557.

  12. Caspi A, Sugden K, Moffitt TE, Taylor A, et al. Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 2003; 301 (5631): 386-9. doi. 10.1126/science.1083968.

  13. Steele JD, Kumar P, Ebmeier KP. Blunted response to feedback information in depressive illness. Brain 2007; 130 (9): 2367-74. doi. 10.1093/brain/awm150.

  14. Frodl TS, Koutsouleris N, Bottlender R, Born C, et al. Depression-related variation in brain morphology over 3 years: effects of stress? Arch Gen Psychiatry 2008; 65 (10): 1156-65. doi. 10.1001/archpsyc.65.10.1156.

  15. Shimizu E, Hashimoto K, Okamura N, Koike K, et al. Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biol Psychiatry 2003; 54 (1): 70-5. doi. 10.1016/ S0006-3223(03)00181-1.

  16. Culpepper L, Muskin PR, Stahl SM. Major depressive disorder: understanding the significance of residual symptoms and balancing efficacy with wolerability. Am J Med 2015; 128 (9): S1-15. doi. 10.1016/j.amjmed.2015.07.001.

  17. Mayo Clinic. Depresión (trastorno depresivo mayor). Disponible: www.mayoclinic.org/es-es/diseases-conditions/ depression/symptoms-causes/syc-20356007; consultado: julio 02, 2020.

  18. Parikh SV, Quilty LC, Ravitz P, Rosenbluth M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder. Section 2: Psychological treatments. Can J Psychiatry 2016; 61 (9): 524-39. doi. 10.1177/0706743716659418.

  19. Alberdi-Sudupe J, Taboada O, Castro-Dono C, Vázquez- Ventosos C. Depresión. Guías Clínicas 2006; 6 (11): 1-6.

  20. Martín-García Sancho JC, Hernández-Vera MR (coords.). Guía de práctica clínica de los trastornos depresivos. Consejería de Sanidad-Servicio Murciano de Salud-Subdirección General de Salud Mental, Murcia, 2009.

  21. Sistema Nacional de Salud (SNS), Ministerio de Sanidad, Servicios Sociales e Igualdad. Guía de práctica clínica sobre la depresión mayor en la infancia y adolescencia: actualización. SNS, Madrid, 2018.

  22. Cornelius JR, Chung T, Douaihy AB, Kirisci L, et al. Mirtazapine in comorbid major depression and an alcohol use disorder: a double-blind placebo-controlled pilot trial. Psychiatry Res 2016; 242: 326-30. doi. 10.1016/j. psychres.2016.06.005.

  23. University of Alberta, Departments of Computing Science & Biological Sciences; The Metabolomics Innovation Centre, DrugBank. Mirtazapine. Disponible: www.drugbank.ca/ drugs/DB00370; consultado: enero 31, 2020.

  24. Sado M, Wada M, Ninomiya A, Nohara H, et al. Does the rapid response of an antidepressant contribute to better cost-effectiveness? Comparison between mirtazapine and SSRIs for first-line treatment of depression in Japan. Psychiatry Clin Neurosci 2019; 73 (7): 400-8. doi. 10.1111/ pcn.12851.

  25. Woo HI, Lim SW, Myung W, Kim DK, et al. Differentially expressed genes related to major depressive disorder and antidepressant response: genome-wide gene expression analysis. Exp Mol Med 2018; 50 (8). doi. 10.1038/s12276- 018-0123-0.

  26. Tsutsumi T, Sugawara H, Ito R, Asano M, et al. Identifying predictive clinical characteristics of the treatment efficacy of mirtazapine monotherapy for major depressive disorder. Neuropsychiatr Dis Treat 2016; 12: 2533-8. doi. 10.2147/ NDT.S112901.

  27. Wichniak A, Wierzbicka A, Walęcka M, Jernajczyk W. Effects of antidepressants on sleep. Curr Psychiatry Rep 2017; 19 (9). doi. 10.1007/s11920-017-0816-4.

  28. Song HR, Bahk WM, Woo YS, Jeong JH, et al. Efficacy and tolerability of generic mirtazapine (Mirtax) for major depressive disorder: multicenter, open-label, uncontrolled, prospective study. Clin Psychopharmacol Neurosci 2015; 13 (2): 144-9. doi. 10.9758/cpn.2015.13.2.144.

  29. Jilani T, Gibbons J, Faizy R, Saadabadabi A. Mirtazapine. Stat Peals, Tresaure Island, StatPearls Publishing, 2020.

  30. Cipriani A, Furukawa TA, Salanti G, Chaimani A, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 2018; 391 (10128): 1357–66. doi. 10.1016/S0140-6736(17)32802-7.

  31. Asofarma de México. Información para prescribir (IPP) Comenter ® (mirtazapina, tabletas). Núm. Reg. 153M2005 SSA IV.

  32. PR Vademecum. Mirtazapina. Disponible: https:// mx.prvademecum.com/principio-activo/mirtazapina- 2888/; consultado: enero 31, 2020.

  33. Wang SM, Han C, Bahk WM, Lee SJ, et al. Addressing the side effects of contemporary antidepressant drugs: a comprehensive review. Chonnam Med J 2018; 54: 101-12. doi. 10.4068/cmj.2018.54.2.101.

  34. Anttila SAK, Leinonen EVJ. A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev 2001; 7 (3): 249-64. doi. 10.1111/j.1527-3458.2001.tb00198.x.

  35. Bech P. Meta-analysis of placebo-controlled trials with mirtazapine using the core items of the Hamilton Depression Scale as evidence of a pure antidepressive effect in the short-term treatment of major depression. Int J Neuropsychopharmacol 2001; 4: 337-45. doi. 10.1017/ s1461145701002565.

  36. Papakostas GI, Homberger CH, Fava M. A meta-analysis of clinical trials comparing mirtazapine with selective serotonin reuptake inhibitors for the treatment of major depressive disorder. J Psychopharmacol 2008; 22 (8): 843-8. doi. 10.1177/0269881107083808.

  37. Cipriani A, La Ferla T, Furukawa TA, Signoretti A, et al. Sertraline versus other antidepressive agents for depression. Cochrane Database Syst Rev 2010; (4). doi. 10.1002/14651858.CD006117.pub4.

  38. Watanabe N, Omori IM, Nakagawa A, Cipriani A, et al. Mirtazapine versus other antidepressive agents for depression. Cochrane Database Syst Rev 2011; (12). doi. 10.1002/14651858.CD006528.pub2.

  39. González-Rodríguez A, Gastó-Ferrer C, Navarro-Odriozola V. Efficacy and tolerability of mirtazapine versus paroxetine in the treatment of major depressive disorder. Clin Med Insights: Therapeutics 2012; 4: 57–63.

  40. Ramsberg J, Asseburg C, Henriksson M. Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and costeffectiveness model. PLoS One 2012; 7 (8). doi. 10.1371/ journal.pone.0042003.

  41. Alam A, Voronovich Z, Carley J. A review of therapeutic uses of mirtazapine in psychiatric and medical conditions. Prim Care Companion CNS Disord 2013; 15 (5). doi. 10.4088/ PCC.13r01525.

  42. Park SC, Oh HS, Oh DH, Jung SA, et al. Evidence-based, pharmacological treatment guideline for depression in Korea, revised edition. J Korean Med Sci 2014; 29 (4): 468-4. doi. 10.3346/jkms.2014.29.4.468.

  43. Khouzam HR, Bhatia R, Sowden G. A review of mirtazapine use for primary providers. EC Neurology 2017; 4.4: 119-34.

  44. Fernandez A, Bang SE, Srivathsan K, Vieweg WVR. Cardiovascular side effects of newer antidepressants. Anadolu Kardiyol Derg 2007; 7 (3): 305-9.

  45. Yekehtaz H, Farokhnia M, Akhondzadeh S. Cardiovascular considerations in antidepressant therapy: an evidencebased review. J Tehran Univ Hear Cent 2013; 8 (4): 169-76.

  46. Bostwick J. The heart of depression: treating patients who have cardiovascular disease. Curr Psychiatry 2011; 10 (1): 31-4.

  47. Whooley MA. Depression and cardiovascular disease: healing the broken-hearted. JAMA 2006; 295 (24): 2874-81. doi. 10.1001/jama.295.24.2874.

  48. Vieweg WV, Julius DA, Fernandez A, Wulsin LR, et al. Treatment of depression in patients with coronary heart disease. Am J Med 2006; 119 (7): 567-73. doi. 10.1016/j. amjmed.2006.02.037.

  49. Stimmel GL, Dopheide JA, Stahl SM. Mirtazapine: an antidepressant with noradrenergic and specific serotonergic effects. Pharmacotherapy 1997; 17 (1): 10-21.

  50. Mullish BH, Kabir MS, Thursz MR, Dhar A. Review article: depression and the use of antidepressants in patients with chronic liver disease or liver transplantation. Aliment Pharmacol Ther 2014; 40 (8): 880-92. doi. 10.1111/ apt.12925.

  51. LiverTox: clinical and research information on drug-induced liver injury [Internet], National Institute of Diabetes and Digestive and Kidney Diseases. Mirtazapine. Disponible: www.ncbi.nlm.nih.gov/books/NBK548216/; consultado: julio 22, 2020.

  52. UK Medicines Information (UKMi), National Health Service (NHS). What is the first choice antidepressant for patients with renal impairment? Nov 2017.

  53. BCRenal. Antidepressant use in adults with chronic kidney disease. Disponible: www.bcrenalagency.ca/resourcegallery/ Documents/Antidepressant%20Use%20in%20 Adults%20with%20Chronic%20Kidney%20Disease.pdf; consultado: julio 22, 2020.

  54. Himmerich H, Fulda S, Schaaf L, Beitinger PA, et al. Changes in weight and glucose tolerance during treatment with mirtazapine. Diabetes Care 2006; 29 (1): 170. doi. 10.2337/ diacare.29.01.06.dc05-1762.

  55. Song HR, Woo YS, Wang HR, Shim IH, et al. Does mirtazapine interfere with naturalistic diabetes treatment? J Clin Psychopharmacol 2014; 34 (5): 588-94. doi. 10.1097/ JCP.0000000000000183.

  56. Allen S, Fisher M, Phipps N. The correlation between depression and diabetes. US Pharm 2014; 39 (10, Diabetes Suppl): 12-5.

  57. Alviso-De la Serna L, Ramírez-Abascal M. El paciente con diabetes mellitus y depresión. Residente 2009; 4 (2): 47-50.

  58. Bektur E, Sahin E, Baycu C. Mirtazapine may show antihyperglycemic effect by decreasing GLUT2 through leptin and galanin expressions in the liver of type 1 diabetic rats. Iran J Basic Med Sci 2019; 22 (6): 676-82. doi. 10.22038/ ijbms.2019.34529.8190.

  59. Castellanos-Olivares A, Sánchez-Ruiz J, Gómez-Sánchez G, Salgado-Figueroa M. Prevalencia de comorbilidades en el paciente geriátrico y pronóstico postoperatorio. Rev Mex Anestesiol 2017; 40(Supl. 1): S103-5.

  60. Schroeck JL, Ford J, Conway EL, Kurtzhalts KE, et al. Review of safety and efficacy of sleep medicines in older adults. Clin Ther 2016; 38 (11): 2340-72. doi. 10.1016/j.clinthera. 2016.09.010.

  61. Holland J, Bhogle M. Sertraline and mirtazapine as geriatric antidepressants. Psychiatria Danubina 2013; 25 (Suppl. 2): 286–90.

  62. Schatzberg AF, Kremer C, Rodrigues HE, Murphy GM. Double-blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients. Am J Geriatr Psychiatry 2002; 10 (5): 541-50. doi. 10.1097/00019442- 200209000-00007.

  63. Gardner ME, Malone DC, Sey M, Babington MA. Mirtazapine is associated with less anxiolytic use among elderly depressed patients in long-term care facilities. J Am Med Dir Assoc 2004; 5 (2): 101-6. doi. 10.1016/S1525- 8610(04)70063-8.

  64. Ladino M, Guardiola VD, Paniagua M. Mirtazapine-induced hyponatremia in an elderly hospice patient. J Palliat Med 2006; 9 (2): 258-60. doi. 10.1089/jpm.2006.9.258.




2020     |     www.medigraphic.com