Supportive Care in Cancer

, Volume 16, Issue 11, pp 1291–1298 | Cite as

Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: superiority over imipramine

  • Eylem Sahin CankurtaranEmail author
  • Elvan Ozalp
  • Haldun Soygur
  • Derya Iren Akbiyik
  • Levent Turhan
  • Necati Alkis
Original Article


Goals of the work

This study aimed to compare the effectiveness of mirtazapine and imipramine on not only the distressing symptoms of cancer patients such as pain, nausea, vomiting, appetite loss, and sleep disturbances but also depressive and anxiety symptoms.

Materials and methods

Fifty-three patients with cancer who were diagnosed with major depressive disorder, anxiety disorder, or adjustment disorder were included. Twenty patients on mirtazapine, 13 patients on imipramine, and 20 patients in the control group without medication were interviewed during three visits (baseline, third week, and sixth week). Pain, nausea, vomiting, appetite loss, and sleep disturbances were evaluated with self-assessment single-symptom scales during each visit. The patients were also asked to complete the Hospital Anxiety Depression Scale (HADS) during each visit.

Main results

There were no significant differences among the three visits in the mirtazapine, imipramine, or control groups in terms of pain, nausea, vomiting, or appetite loss. For the initial, middle, and late insomnia, only the mirtazapine group showed improvements (p = 0.001, p = 0.001, p = 0.003). There were also significant differences in the mean total (p = 0.03), anxiety (p = 0.003), and depression (p = 0.025) scores of HADS among the three visits for patients taking mirtazapine. There were no significant differences for HADS scores from the baseline to the end point for patients taking imipramine or control group patients.


Our findings suggest that mirtazapine is effective for resolving insomnia as well as anxiety and depressive symptoms in cancer patients. However, more systematic research, such as placebo-controlled studies, is needed.


Cancer Distressing symptoms of cancer Imipramine Mirtazapine 


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Eylem Sahin Cankurtaran
    • 1
    • 2
    Email author
  • Elvan Ozalp
    • 1
  • Haldun Soygur
    • 1
  • Derya Iren Akbiyik
    • 1
  • Levent Turhan
    • 1
  • Necati Alkis
    • 1
  1. 1.Ankara Oncology Training and Research HospitalPsychiatry ClinicAnkaraTurkey
  2. 2.Ankara Oncology Research and Training Hospital (Division of Ahmet Andicen Hospital)Clinic of PsychiatryAnkaraTurkey

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