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Case Reports in Psychiatry
Volume 2013, Article ID 697872, 3 pages
Case Report

Mirtazapine Treatment of a Severe Depressive Episode and Resolution of Elevated Inflammatory Markers

1ST4 in General Adult Psychiatry, Bracton Centre, Oxleas NHS Foundation Trust, Dartford, Kent DA2 7AF, UK
2South West London and St. George's Mental Health NHS Trust, Springfield University Hospital, 61 Glenburnie Road Tooting, London SW17 7DJ, UK
3South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK

Received 26 August 2013; Accepted 17 September 2013

Academic Editors: J. S. Brar and F. Oyebode

Copyright © 2013 Shahzad M. Alikhan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Depression has been shown to be associated with systemic inflammatory activity and the mode of action of several antidepressants appears to involve immunomodulation. Effects on immune system activity have also recently been observed in correlation with therapeutic response to mirtazapine in cardiac patients with depression, but no study has yet examined these effects in otherwise physically healthy depressed patients treated with mirtazapine. This report describes an association between a clinical antidepressant response and a decrease in markers of systemic inflammation observed during pharmacotherapy with mirtazapine in a severely depressed but physically well patient. This observation adds to the evidence that changes in inflammatory responses may be implicated in the mode of action of antidepressants. Further studies of antidepressant responses to mirtazapine and levels of inflammatory markers in depressed patients without medical comorbidity can help elucidate the role of the immune system in the pathophysiology of depression, and hence contribute to the development of novel antidepressant therapies.