Comparison study of efficacy and safety of mirtazapine and trazodone added to hypnotics-resistant insomnia

AIM:To observe the efficacy and safety of mirtazapine in treating refractory insomnia resistant to hypnotics.METHODS:Thirty outpatients diagnosed insomnia with CCMD-3 criteria resistant to hypnotics were furthermore treated by adding mirtazapine,10-30 mg·d~(-1)and compared with those of adding trazodone,25-200mg·d~(-1)altogether for 8 wk.Efficacy and adverse reactions were assessed by Athens insomnia scale and TESS.RESULTS:The scores of Athens insomnia scale decreased significantly at 1,2,4, 6 and 8 wk after treatment in both mirtazapine and trazodone groups.Fourteen patients in mirtazapine group and 11 patients in trazodone group were clinically remitted(P＞0.05).Four patients in mirtazapine group and 3 pa- tients in trazodone group were dropped out because of adverse reactions or lack of effectiveness.Adverse reactions showed no significant difference between two groups except more frequency of losing appetite in trazodne group. The dose of mirtazapine ranged from 10 to 30 mg·d~(-1)with a mean dose of(22±s 11)mg·d~(-1)and that of trazodone from 25 to 200 mg·d~(-1)with a mean dose of(62±38)mg·d~(-1),were commonly utilized.CONCLUSION: Mirtazapine is effective and safe as trazodone in treating hypnotic resistant insomnia as an additional hypnotics but the optimal dosage should be extensively studied.