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Consult Pharm. 2005 Mar;20(3):217-23.

The impact of mirtazapine compared with non-TCA antidepressants on weight change in nursing facility residents.

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University of Southern California School of Pharmacy/Skilled Care Pharmacy, Los Angeles, California, USA.



To examine weight change associated with the use of mirtazapine compared with other antidepressants in elderly, depressed nursing facility residents.


Retrospective cohort study.


Long-term care nursing facilities in the Southern California region.


One hundred eighty-nine elderly patients (>65 years of age) who had a new episode or diagnosis of depression and stayed in the same facility for at least eight months.


The impact of antidepressant use on weight change and percentage weight change at three months and six months were assessed using Ordinary Least Squares (OLS) regression analysis. Mirtazapine served as the comparator drug.


We found no statistically significant differences in weight change at three months and at six months between mirtazapine and all other nontricyclic antidepressants except for fluoxetine, which was associated with a gain of 3.8 pounds relative to mirtazapine at three months (P = 0.05). However, a hypertension diagnosis was associated with significant weight gain at three months (2.2 lbs., P = 0.04 or +1.7%, P = 0.03) and at six months (3.9 lbs., P = 0.005 or +3%, P = 0.006). A diagnosis of diabetes was associated with weight loss at six months (-3.7 lbs., P = 0.03; -3.2%, P = 0.02). Baseline weight was associated with increased weight loss in women at six months (-0.09 lb (per lb. baseline), P = 0.03).


With the exception of fluoxetine, our study showed that the impact on weight using mirtazapine was not statistically different from other nontricyclic antidepressant users after controlling for factors such as baseline weight, gender, dose, and comorbid diagnoses.


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