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Mirtazapine, a Sedating Antidepressant, and Improved Driving Safety in Patients With Major Depressive Disorder: A Prospective, Randomized Trial of 28 Patients

J Clin Psychiatry 2009;70(3):370-377
10.4088/JCP.08m04234

Objective: The objectives of the study were to investigate the effects of mirtazapine, a sedating antidepressant, on driving safety in major depressive disorder (MDD) patients and to observe the effect of mirtazapine on daytime alertness.

Method: Twenty-eight patients who met the DSM-IV criteria for MDD completed the study in a university teaching hospital. Half of these patients took mirtazapine 30 mg at bedtime for 30 days. A computerized driving simulator test (DST) and the Maintenance of Wakefulness Test (MWT) were conducted at baseline and on days 2, 9, 16, and 30 after commencement of antidepressant use. Fourteen untreated depressed patients performed a DST and MWT at baseline and on days 2 and 9 to evaluate the possibility of a learning effect. Data collection was from June 2005 through January 2006.

Results: There were significant linear effects of the treatment on road position at All Trials (p =.018) and on the morning sessions at 10:00 a.m. (p

Conclusion: A sedating antidepressant can increase driving safety in MDD patients.

Trial Registration: clinicaltrials.gov Identifier: NCT00385437