The comparison of amitryptilline and mirtazapine side effects on depression treatment

Objective: In this study, the efficacy of amitriptyline and mirtazapine on depression and anxiety concomitant with depression and their side effects were compared. Method: Sixty-seven of 137 patients with depression according to DSM IV criteria received amitriptyline while the remaining (70 patients) received mirtazapine. Each case was evaluated at the beginning, on the 21st and 56th day. Physical and psychiatric examination findings were recorded at every visit and drug side effects were recorded on the 21st and 56th days. Moreover, all of the patients fulfilled the Beck Depression Inventory and Beck Anxiety Inventory by themselves at every visit. Biochemical, hematological and urine examinations were performed at the onset and the end of the study. Results and Conclusion: Both drugs improved the depression scores when compared to the initial ones. Antidepressive and anxiolytic effects of amitriptyline and mirtazapine were found to be similar. Differences in respect to side effects were as follows: 1- Amitriptyline increased the heart beat rate earlier than mirtazapine, 2- Mirtazapine decreased the diastolic blood pressure, 3- Mirtazapine caused wheight gain in more patients than amitriptyline, 4- At the end of the study SGPT, cholesterol and TG (trigliserid) levels were significantly higher in mirtazapine group than amitriptyline group. 5- In respect to other selected clinical side effects, at the end of the study vertigo, somnolance, tremor, sweating, irritability and pavor nocturnus, were more common in amitriptyline group compared to mirtazapine group. Only paresthesia was more common in mirtazapine group compared to amitriptyline group.