A clinical control study of mirtazapine vs.amitriptyline in post-stroke depression

Objective:To explore the efficacy and safety of mirtazapine and amitriptyline in post-stroke depression(PSD).Methods:Sixty-four PSD patients were randomly divided into two groups of 32 ones each,research group was treated with mirtazapine and control group with amitriptyline.Efficacies were assessed with the Hamilton Depression Scale(HAMD) and adverse reactions with the Treatment Emergent Symptom Scale(TESS) before treatment and at the end of the 1st,2nd,4th and 6th week of treatment,main depressive symptoms detected at the end of the 1st and 6th week.Results: There was no significant difference in the HAMD score between two groups before treatment,compared with pretreatment the HAMD scores of each periods of both groups lowered more significantly(P0.05 or 0.01),those did more significantly in the research than in the control group at the end of the 1st and 2nd week(P0.05),and the score-reducing rate of total score heightened more significantly in the research than in the control group(P0.05);the detection rates of self-reproach and suicidal thought at the end of the 6th week had no significant difference from pretreatment in the control group(P0.05),those of other depressive symptoms of both groups were significantly lower compared with pretreatment(P0.01);the incidence of adverse reactions was respectively 21.9% in the research and 46.9% in the control group(x2=4.43,P0.05).Conclusions: Mirtazapine has an efficacy equivalent to amitriptyline in the treatment of post-stroke depression,but the former takes effect more rapidly,has fewer adverse reactions and advantage in improving core symptoms.