CHEN Keyang,HUANG Hanjin,WANG Xiaotong.. Meta-analysis of the efficacy and safety of mirtazapine versus paroxetine for depression in Chinese patients[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(1): 39-43.
Abstract： Objective: To assess the efficacy and safety of mirtazapine and paroxetine on depression in Chinese patients. Methods: The randomized controlled trials (RCT) comparing the efficacy of mirtazapine and paroxetine in the treatment of depression were systematically evaluated. Evidence-based medicine research methods were applied and statistical analysis software Revman 5.2 was used. Results: Fourteen studies of RCT met inclusion criteria. The results of Meta-analysis showed that: ①After 6-weeks treatment, both the efficiency and cure rates had no significant difference between the mirtazapine and the paroxetine groups with [OR=1.15, 95% CI (0.79, 1.68), P=0.46] and [OR=1.17, 95% CI (0.86, 1.58), P=0.24]. The Hamilton Depression Scale (HAMD) scores were significantly lower in mirtazapine group than that in paroxetine group at 1 and 2 weeks after treatment, and there were no significant differences between mirtazapine group and paroxetine group at 4 and 6 weeks after treatment. ②Adverse reactions: The somnolence and weight gain rate of the mirtazapine group were higher than those of the paroxetine group with RR=2.40 and 95% CI 1.33 to 4.32, RR=10.06 and 95% CI 4.55 to 22.22. And paroxetine more easily led to dry mouth, nausea, insomnia and sexual dysfunction with RR=0.45 and 95% CI 0.31 to 0.67; RR=0.07 and 95% CI 0.03 to 0.17; RR=0.12 and 95% CI 0.04 to 0.34; RR=0.11 and 95% CI 0.04 to 0.27 than mirtazapine. The other common side reactions had no significantly different between the two groups. Conclusion: Mirtazapine has similar long term treatment effect as paroxetine, but it has a rapid-action profile. Mirtazapine can more easily induce somnolence and weight gain, and is with lower dry mouth, nausea, insomnia and sexual dysfunction rate when compared with paroxetine. And there is no significant difference between two group in other common side reactions.
