Therapeutics
Prophylactic mirtazapine may help to prevent post-stroke depression in people with good cognitive function
Niedermaier N, Bohrer E, Schulte K, et al. Prevention and treatment of poststroke depression with mirtazapine in patients with acute stroke. J Clin Psychiatry 2005;65:1619–23.
Q Does treatment with mirtazapine after an ischaemic stroke prevent onset of depression?
Key Words: ischaemic stroke • depression • mirtazapine
| The first 150 words of the full text of this article appear below. |
Design:
Randomised controlled trial.
Allocation:
Not reported.
Blinding:
Not blinded.
Follow up period:
360 days.
Setting:
Stroke unit in academic medical centre in Ludwigshafen, Germany.
Patients:
Seventy people who had suffered an ischaemic stroke, confirmed by MRI or CT scan. People were excluded if they were currently using antidepressants, were depressed in the two weeks before stroke, were less than 18 years old, pregnant or breastfeeding, or had dysphasia that would interfere with psychiatric testing.
Intervention:
Treatment was 30 mg of mirtazapine once daily at bedtime and commenced one day after the occurrence of stroke. People in the control group were given neither mirtazapine nor placebo.
Outcomes:
Major depressive episode (DSM-IV and score 
16 on Hamilton Rating Scale for Depression (HAM-D)); occurrence determined by semistructured interview and severity using HAM-D.
Patient follow up:
89% after 360 days.
The study found that significantly fewer people in the treatment group developed depression
Assistant Professor, Division of Neurology, Faculty of Medicine,
University of Toronto, Canada
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