The objective was to evaluate the effectiveness of mirtazapine treatment of elderly medically ill patients with major depression. Sixteen elderly subjects with major depression and comorbid serious medical illnesses (e.g. congestive heart failure, cancer, stroke, diabetes) were treated in an open trial for 10 weeks. Efficacy was evaluated by the CGI, Depression outcome measures including the Beck Depression Inventory and Hamilton Rating Scale for Depression (HAM-D), and Medical Outcomes Study Short Form-36 (SF-36). Mirtazapine treatment was associated with significant reductions in primary depression outcome measures (p<0.05) as well as significant improvement in multiple domains of the SF-36, including physical functioning, bodily pain, general health, vitality, social functioning, role emotional, mental health, and mental composite summary (all p<0.05). Three subjects terminated the study prior to collection of any follow-up data and were excluded from the analyses (2 due to side effects and 1 lost to follow-up). Of the remaining 13 subjects included in the analyses, 2 terminated early due to concurrent illness and 1 due to side effects. A carry-forward analysis was used in these cases. No drug-drug interactions or significant changes in vital signs occurred. The mean dose of mirtazapine at end point was 35mg/day. These data suggest that mirtazapine is a good choice for this population.
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