외상후 스트레스 장애 환자에서 Mirtazapine과 Sertraline의 치료효과 및 안정성

Efficacy and Tolerability of Mirtazapine and Sertraline in Treatment of Patients with Posttraumatic Stress Disorder with Depression： A Randomized Open Label Trial

Objectives：The aim of this study was to investigate the potential use of mirtazapine in Korean veterans diagnosed with PTSD, by comparing it with sertraline, a drug approved for use in PTSD in the USA. Methods：Efficacy was eveluated by Clinician Adninistered PTSD Scale (CAPS-2), the Hamilton Rating Scale for Depressin (HAMD-17) and the Clinical Global lmpresaion Scale (CGI), at baseline and week 1, 2, 6. Response was defined as a ≥30% decrease in CAPS-2 total score, a ≥50% decrease in total HAMD-17 score, and s CGI-I score<3. Results：51 patients on mirtazapine (measn age/duration of illness：59.1/33.5 yrs) and 49 on sertratine (mean age/duration of illness：60.6/35.6 years) completed the study. Mean daily dosage was 34.1 mg for mirtazapine and 101.5 mg for sertraline. On CAPS-2 total score more patients responded in the mirtazapine group at weak 1 (13 vs. 2%) and week 2 (51vs. 31%). At week 6 this difference was statistically significant (88 vs. 69%, p=0.039), CAPS-2 total score. HAMD-17 total score and CGI-I score decreased significantly in both groups, with no significant differences between groups on all time points. Main side effects for the rnirtazapine group：dry mouth (19.8%) and constipation (19.6%), somnolence (15.7%), weight gain (1.96%). For the sertraline group：indigestion (14.3%), palpitation (6.1%) agitation (2.0%), epigastric soreness (2.0%), insomnia (2.0%), sexual dysfunction (2.0%). Conclusion：Mirtazapine appeared to be an effective and well-tolerated treatment for PTSD in Korean veterans