Treating depression with different galenical drug formulations: Does it make a difference? The comparison of mirtazapine fast dissolving formulation (FDT) with conventional mirtazapine tablets (CT)

Objective. To assess clinical advantages of fast dissolving tablet (FDT) formulation of mirtazapine by comparison to conventional (CT) mirtazapine tablets in the treatment of depressed patients. Methods. A posteriori analyses of pooled data of a total of 30 studies (of at least 6 weeks duration, total N=3510) with CT and FDT in depressed patients was performed. Weight changes were recorded at baseline and regular intervals until the end of the study. Patient preferences for the one or the other formulation, as well as the appraisal of the FDT qualities, were assessed by means of a global internet-based survey including 5,428 patients. Results. Compared with mirtazapine CT, the FDT was associated with an average 0.3 kg less weight increase (P=0.0015) during the 6 weeks of treatment. The qualities and preference for FDT (global survey) were positively evaluated by the majority of patients. Particular advantages of FDT over CT were: better compliance (47.3% of raters), taste, ease and overall convenience of use (75% of raters). Conclusions. The FDT mirtazapine differed from conventional tablets (CT) not only regarding somewhat less weight increase and overall use preference, but more importantly, regarding better compliance with treatment.