The Effects of Mirtazapine on Plasma Lipid Profiles in Healthy Subjects
J Clin Psychiatry 2003;64:883-889
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The novel antidepressant mirtazapine
has been linked to elevated random plasma total cholesterol (TC)
levels. The purpose of this study was to evaluate in a more
controlled and precise approach the putative effects of
mirtazapine on plasma lipids.
Method: In a double-blind design, 50 healthy
subjects (30 women and 20 men) were randomized to receive either
mirtazapine (N = 28) or placebo (N = 22) for a 4-week period. The
study was conducted from June 1997 to September 1998. The initial
dose for the mirtazapine group was 15 mg daily, which was
increased to 30 mg daily at the beginning of the second week.
Body weight and plasma lipoprotein profiles, including TC,
low-density lipoproteins (LDL), high-density lipoproteins (HDL),
and triglycerides, were determined at baseline and at weekly
intervals throughout the study period.
Results: At baseline, there were no group
differences in any of the measures. There was a statistically
significant increase of 2.5% in mean body weight over the course
of the study in the mirtazapine group that appeared to reach a
plateau at 3 weeks, while no increase was observed in the placebo
group. Mirtazapine subjects also showed significantly increased
TC at week 4 (p = .016) and a transient rise in triglycerides
that normalized by week 4. No significant changes in any of the
other lipid parameters, including HDL, LDL, and TC/HDL ratios,
were observed within either group. Changes in TC were
significantly and positively correlated with changes in weight (p
Conclusion: These results suggest that while
mirtazapine may be associated with increased TC, it does not
increase LDL levels or affect the ratio of TC to HDL.