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KMID : 0870520040080020091
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Journal of Korean Academy of Addiction Psychiatry
2004 Volume.8 No. 2 p.91 ~ p.98
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A Prospective Open-Label Study Comparing the Efficacy of Mirtazapine versus SSRIs in the Treatment of Alcohol Dependence
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Cheon Young-Il
Lee Tae-Kyung
Lee Jong-Il
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Abstract
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Objectives：There have been growing concerns about the pharmacological treatment of alcohol dependence. Serotonergic
medications, particularly the selective serotonin reuptake inhibitors (SSRIs), have been extensively evaluated for the
treatment of alcoholism. Of serotonergic agents, especially the effect of ondansetron, a 5-hydroxytryptamine-3 (5-HT3) antagonist, has also been studied. However mirtazapine, noradrenergic and specific serotonin 5-HT2 and 5-HT3 antagonist, have not yet been investigated. This study was performed to compare the efficacy of mirtazapine versus SSRIs in the treatment of alcohol dependence.
Methods：The subjects were 46 inpatients with alcohol dependence. They were admitted to the Alcohol & Drug Addiction Center in Seoul National Hospital. They were randomly assigned into one of the two groups：mirtazapine group (n=20) or SSRIs group (n=26). All subjects received the psychosocial treatment program for alcoholism. All of the subjects were assessed by scales：The Korean version of Alcohol Use Disorders Identification Test (AUDIT-K), Obsessive Compulsive
Drinking Scale (OCDS), Beck Depression Inventory (BDI), Aggression Questionnaire (AQ), and Three-dimensional Personality Questionnaire (TPQ) at baseline and 8 weeks later.
Results：There were no differences between mirtazapine
group and SSRIs group in baseline BDI, AUDIT-K, OCDS, AQ, TPQ scores and demographic characteristics. After 8-
week treatment period, BDI, AUDIT-K and OCDS scores decreased significantly in total subjects. Mirtazapine group had
a greater reduction of the BDI scores than SSRIs group at week 8. The aggression scores did not decrease significantly
during treatment；the difference between the two groups was not significant. There was no significant change on TPQ.
Conclusion：Both mirtazapine and SSRIs are effective to comorbid depressive symptoms and compulsive drinking of
alcohol dependence. Moreover mirtazapine is resulted to be more effective in treating depressive symptoms of alcohol-dependent patients. Consequently, our results provide evidences that mirtazapine may be an effective pharmacological treatment for alcohol dependence with comorbid depression and compulsive drinking.
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KEYWORD
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Alcohol dependence, Mirtazapine, SSRI
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