Abstract
Introduction: Treatment-resistant depression represents a serious clinical problem and a significant public health challenge. Research highlights the importance of combining selective serotonin reuptake inhibitors (SSRIs) with antidepressants that act as antagonists of presynaptic α2-autoreceptors and α2-heteroreceptors, such as Mianserin, Trazodone, and Mirtazapine.
Aim: to evaluate the effectiveness of combined therapy using Mirtazapine (α2-autoreceptor antagonist) and Sertraline (serotonin reuptake inhibitor) in treating depression.
Materials and Methods: This prospective study included 30 patients of both sexes, aged between 21 and 39 years, diagnosed with depressive disorder (F32). Patients were evaluated at the private psychiatric institution “Dr. Zora Mitic” over a period of three months. Participants were assessed at baseline and after one and three months of treatment with combined antidepressant therapy consisting of Mirtazapine (15-30 mg/day) and Sertraline (50-100 mg/day). Sociodemographic characteristics (age, sex, marital status, education level, and employment) were collected using a specifically designed questionnaire. Depressive symptoms were evaluated using the Hamilton Depression Rating Scale (HDRS), and sexual dysfunction was assessed using the Sexual Dysfunction Scale.
Results: A Wilcoxon signed-rank test indicated a statistically significant decrease in Hamilton Rating Scale (HRS) scores after one month (Z = −4.717, P ≤ 0.001) and three months (Z = −4.787, P ≤ 0.001) of treatment compared to pre-treatment scores. Additionally, the difference in HRS scores between one-month and three-month treatment periods was also significant (Z = −4.717, P ≤ 0.001).
Conclusion: The results of our study demonstrate that initiating combined antidepressant therapy at the outset of treatment is highly effective.