Meta-analysis In The Efficacy And Security Of Subjective Sleep Disorders For Mirtazapine Treating Depression

Objective:To evaluate the difference in subjective sleep quality as well as se curity of Mirtazapine versus other anti-depressants in the treatment of depressed pat ients. Methods:Reports of all the RCT of mirtazapine versus other anti-depressant s in the treatment of depressed patients accompanied by insomnia were comprehens ive researched in the Chinese and foreign-language literature database as well as ot her sources using the method of combining multiple manual and computer from Ja nuary 1996 to December 2014.Using the "mirtazapine"、"sleep disorders"、"i nsomnia"、"depression"、"depressive disorder" as search term in connection with the free words of database. Referring to Cochrane systematic review quality e valuation criteria Jadad scale,literature included were evaluated of each by two revi ewers independently. Statistical analysis was performed using the Cochrane Collabor ation software RevMan5.2. Result:Finally seven literatures were included, involving a total of 3950 cases of patients, mirtazapine group 1092 cases,2858 cases in th e control group. Meta-analysis showed that:1.Impacts on subjective sleep quality:Th e HAMD sleep disorders factor score were better improved in mirtazapine group th an the control group after treatment of first weekend,fourth weekend as well as the end of treatment{first weekend:MD=-1.37,95%CI[-1.54,-1.20], P< 0.00001; four th weekend:MD=-1.31,95%CI[-1.56,-1.06], P< 0.00001;the end of treatment:MD=-0.98,95%CI [-1.25,-0.72], P< 0.00001}. The PSQI score were better improved i n mirtazapine group than the control group after treatment of first weekend,fourth weekend as well as the end of treatment{first weekend:MD=-3.18,95%CI[-3.51,-2. 84], P< 0.00001; fourth weekend:MD=-3.94,95%CI[-4.21,-3.67], P< 0.00001;the end of treatment:MD=-2.65,95%CI[-2.84,-2.46], P< 0.00001}.2.Security:Weight gain, somnolence were higher in mirtazapine group than the control group{RR=5.1 7,95%CI[1.69,15.78],P=0.004; RR=4.74,95%CI[1.86,12.05], P=0.001}.The i ncidence of nausea was lower than the control group{RR=0.15,95%CI[0.04,0.56], P=0.005}.There were no statistically significant adverse events in dry mouth, dizzin ess, headache, sweating between the two groups{RR=0.84,95%CI [0.46,1.54], P =0.57; RR=1.14,95%CI[0.55,2.38], P=0.72; RR=0.90,95%CI[0.38,2.11], P=0. 81; RR=0.33,95%CI[0.09,1.20], P=0.09}. Conclusion:Mirtazapine can significa ntly rapid and lasting improve subjective sleep quality in depressed patients during antidepressant therapy.2.Adverse reactions, mirtazapine is more prone to weight g ain and somnolence than other drugs, but a low incidence of adverse events of na usea.