Brief report| Volume 48, ISSUE 1, P75-78, July 01, 2000

Acute effects of mirtazapine on sleep continuity and sleep architecture in depressed patients: a pilot study


      Background: Mirtazapine, a clinically effective antidepressant, acts by antagonizing central α2-adrenergic and 5-HT2/5-HT3 receptors. No data are available regarding mirtazapine’s effects on sleep architecture in patients with major depressive disorder.
      Methods: Six patients meeting criteria for major depressive disorder and scoring ≥4 on the three Hamilton Depression Rating Scale sleep items were studied. Polysomnographic evaluations were performed at baseline and after 1 (15 mg at bedtime) and 2 weeks (30 mg at bedtime) of open-label mirtazapine treatment.
      Results: Mirtazapine significantly decreased sleep latency and significantly increased total sleep time and sleep efficiency from baseline levels during week 1, with similar results observed after week 2. Mirtazapine did not significantly alter rapid eye movement sleep parameters. Clinically, Hamilton Depression Rating Scale and sleep disturbance ratings improved after treatment.
      Conclusions: Mirtazapine significantly improves sleep continuity in major depressive disorder patients with poor sleep quality at weeks 1 and 2 of treatment, while preserving sleep architecture.


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        • Claghorn J.L.
        • Johnstone E.E.
        • Studebaker S.L.
        • Ajeman S.E.
        The effectiveness of Org 3770 in depressed patients.
        Psychopharmacol Bull. 1987; 23: 160-161
        • de Boer T.
        The pharmacologic profile of mirtazapine.
        J Clin Psychiatry. 1996; 57: 19-25
        • Guy W.
        ECDEU Assessment Manual for Psychopharmacology. National Institute of Mental Health, Rockville, MD1976
        • Hamilton M.
        A rating scale for depression.
        J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
        • Idzikowski C.
        • James R.
        • Burton S.W.
        Human SWS is increased dose-dependently by seganserine and ritanserine.
        Sleep Res. 1989; 18: 55
      1. Kupfer DJ, Reynolds CF III (1992): Sleep and affective disorders. In: Paykel ES, editor. Handbook of Affective Disorders, 2nd ed. Edinburgh: Churchill Livingstone, 311–323.

        • Organon
        Remeron—a Novel Pharmacological Treatment for Depression. Organon, West Orange, NJ1996
        • Pinder R.M.
        The pharmacology of mirtazapine.
        J Clin Psychiatry. 1997; 58: 501-502
        • Rechtschaffen A.
        • Kales A.
        A Manual of Standardized Terminology, Techniques, and Scoring for Sleep Stages of Human Subjects. National Institutes of Health, Neurologic Information Network, Bethesda, MD1968
        • Ruigt G.S.
        • Kemp B.
        • Groenhout C.M.
        • Kamphuisen H.A.
        Effect of the antidepressant Org 3770 on human sleep.
        Eur J Clin Pharmacol. 1990; 38: 551-554
        • Rush A.J.
        • Armitage R.
        • Gillin J.C.
        • Yonkers K.A.
        • Winokur A.
        • Moldofsky H.
        • et al.
        Comparative effects of nefazodone and fluoxetine on sleep in outpatients with major depressive disorder.
        Biol Psychiatry. 1998; 44: 3-14
        • Stahl S.
        Essential Psychopharmacology. Cambridge University Press, Cambridge, UK1996
        • Winokur A.
        • Reynolds III, C.F.
        The effects of antidepressants on sleep physiology.
        Primary Psychiatry. 1994; 1: 22-27