Original articleIs mirtazapine augmentation effective for patients with obsessive-compulsive disorder who failed to respond to sertraline monotherapy? A placebo-controlled, double-blind, clinical trialMowla, Arasha; Baniasadipour, Haniyehb Author Information aResearch Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences bSubstance Abuse and Mental Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Received 8 April 2022 Accepted 7 May 2022 Correspondence to Arash Mowla, MD, Substance Abuse and Mental Health Research Center, Hafez Hospital, Shiraz University of Medical Sciences, Chamran Blvd, Shiraz, Iran, Tel: +989173132001; e-mail: [email protected] International Clinical Psychopharmacology: June 09, 2022 - Volume - Issue - 10.1097/YIC.0000000000000415 doi: 10.1097/YIC.0000000000000415 Buy PAP Metrics Abstract Mirtazapine upsurges serotonergic activity by a mechanism different from reuptake inhibition. Our aim is to assess the efficacy of mirtazapine augmentation for patients with obsessive-compulsive disorder (OCD) who did not respond to sertraline monotherapy. Sixty-one patients suffering from OCD who were resistant to sertraline monotherapy were randomly allocated to receive mirtazapine (mean dosage = 39.56 mg/day) or placebo plus their current anti-OCD treatment (sertraline: average dose = 251.37 mg/day and 255.10 mg/day in the mirtazapine and placebo groups, respectively; P = 0.871). The primary outcome was OCD symptom severity as measured by Yale-Brown Obsessive-Compulsive Scale (YBOCS). Forty-five patients (22 in the mirtazapine group and 23 in the placebo group) completed the trial. Average YBOCS score decreased in the mirtazapine group from 27.14 ± 8.05 at baseline to 11.13 ± 4.27 at week 12. In the placebo group, average YBOCS score declined from 28.15 ± 3.27 at baseline to 18.94 ± 3.88 at week 12. Nine patients (40.90%) in the mirtazapine group and only one patient (4.34%) in the placebo group revealed at least a 35% decrease in YBOCS (P < 0.000). We found that mirtazapine adds to the effect of sertraline in improving obsessive and compulsive symptoms in OCD patients. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.