A control study of mirtazapine combined with quetiapine in the treatment of treatment-resistant depression

[Objective]To explore the clinical efficacy and safety of mirtazapine combined with quetiapine in the treatment of treatment-resistant depression(TRD).[Methods]76 TRD patients were randomly divided into the research group and the control group,38 cases in each group.Both two groups received orally mirtazapine,and the research group was given additional quetiapine,for 8 weeks.The clinical efficacy was assessed with the Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA) and Clinical Global Impression(CGI-SI) before treatment and at the end of the 2nd,4th,6th and 8th week of treatment,and adverse reactions were evaluated with Treatment Emergent Symptom Scale(TESS).[Results]After treatment,HAMD scores,HAMA scores and CGI-SI scores of both groups decreased significantly as compared with those before treatment(P0.01),so did in the research group than in the control group at the end of the 2nd,4th,6th and 8th week(P0.05 or P0.01).At the end of the 8th week,the obvious effect rate and total effective rate in the research group(73.7% and 86.8%) were significantly higher than those in the control group(42.1% and 60.5%) significantly(χ2=7.77 and 6.78,P0.01).The incidence rate of adverse reactions in the research group and the control group was 31.6% and 26.3% respectively,the adverse reactions of both groups were mild,and there were no significant differences in the TESS scores in the corresponding period(P0.05).[Conclusion]Quetiapine has a synergistic action in the treatment of TRD.Mirtazapine combined with quetiapine has more obvious efficacy,faster action,higher safety and better compliance as compared with single mirtazapine in the treatment of TRD.