Aim. The aim of the study was the comparison of therapeutical efficacy of mirtazapine and mirtazapine/olanzapine combination with efficacy of ECT in patients with drug-resistant, recur rent, major depression.
Methods. 32 inpatients with treatment-resistant, recurrent, major depression were subjected; 30 patients among them suffered from severe depression (with median 30,5 pt of HDRS). Patients were divided into two groups. In the group I (non-psychotic, drug –resistant depression), 12 patients obtained mirtazapine and 4 were treated with ECT. In the group II (psychotic, drug – resistant depression) 8 patients were treated with mirtazapine/olanzapine combination and 8 with ECT. Referrals for ECT were based on informed (written),.voluntary consent.
Results. Severity of psychotic depression, estimated with HDRS was 32,5 and appeared significantly larger (p = 0,04), in patients treated with ECT than in patients treated with mirtazapine/olanzapine combination (24,0). In patients with non-psychotic depression treated with mirtazepine the decrease of depressive symptoms estimated with HDRS was 66,7% and in ECT group was 70,3% (not statistical significant). Patients with psychotic depression treated with mirtazapine/olanzapine combination the reduction of symptoms in HDRS was 70,8% in comparison to the result of 64,6% in patients treated with ECT (not significant).
Conclusions: There were no differences between therapeutical efficacy of ECT and mirtazapine in patients with non-psychotic depression. In patients with psychotic depression there was also no statistical significant difference in the degree of the improvement after treatment with mirtazapine/olanzapine or ECT.