Mirtazapine and Trazodone Efficacy on Major Depressive Disorder (MDD) is Moderated by Patients’ Age and Sex: A Randomized, Controlled Trial

Abstract

Introduction

NaSSA antidepressant mirtazapine and SARI trazodone has proven efficacy on MDD.

Aim

To compare differences in mirtazapine and trazodone efficacy on MDD in different age and sex groups.

Methods

A consecutive sample of 60 MDD outpatients were randomized to mirtazapine 30 mg/day or trazodone 150 mg/day for a 3 months stable dosing period at the department of biological psychiatry and psychogeriatrics of the university psychiatric hospital Vrapče, Croatia. Outcome was relative lowering of HAMD-17 scale result. The study was single blind: rater was blinded, while patients informed regarding prescribed medication.

Results

Overall efficacy of mirtazapine and trazodone was comparable (84% lowering of HAMD–17 in both cases; difference P = 0.754). After adjustment for MDD baseline severity (CGI–S), education, marital and working status, interaction of age and sex significantly moderated two drugs’ efficacies. In patients older than 47 years, in male patients trazodone was significantly more effective, and in female patients significantly less effective than mirtazapine. This effect was increasing by aging.

Conclusion

Mirtazapine and trazodone efficacy on MDD is moderated by patients’ age and sex.

Disclosure of interest

The authors have not supplied their declaration of competing interest.