human psychopharmacology Hum Psychopharmacol Clin Exp 2002; 17: 341–344. Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hup.426 SHORT REPORT Effects of mirtazapine in patients with post-traumatic stress disorder in Korea: a pilot study Won-Myong Bahk 1 , Chi-Un Pae 2, *, Joshua Tsoh 3 , Jeong-Ho Chae 1 , Tae-Youn Jun 1 , Chul-Lee 2 and Kwang-Soo Kim 1 1 Department of Psychiatry, College of Medicine, The Catholic University of Korea, St Mary’ Hospital, 62 Youido-Dong, Youngdeungpo-Gu, Seoul 150-713, Korea 2 Department of Psychiatry, College of Medicine, The Catholic University of Korea, Kangnam St Mary’ Hospital, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea 3 Department of Psychiatry, Prince of Wales Hospital, Shatin, NT, Hong Kong, China This study was aimed at testing the efficacy and tolerability of mirtazapine in the treatment of Korean patients with chronic post-traumatic stress disorder (PTSD). Mirtazapine was administered for 8 weeks using a flexible-dose regime in 15 Korean patients with PTSD based on the DSM-IV criteria. We evaluated the patients at baseline and at weeks 4 and 8 after treatment with the interviewer-administered structured interview for PTSD (SIP), short PTSD rating interview (SPRINT), impact of event scale-revised (IES-R) and the Montgomery A ˚ sberg depression rating scale (MADRS). Scores on the SIP, SPRINT, IES-R and MADRS had significantly reduced after 8 weeks treatment. In this pilot study, mirtazapine was found to be effec- tive and well tolerated in the treatment of patients with PTSD. This calls for further evaluation of the effect of this drug on subjects with PTSD with randomized placebo-controlled studies. Copyright # 2002 John Wiley & Sons, Ltd. key words — mirtazapine; PTSD; Korea INTRODUCTION Post-traumatic stress disorder (PTSD) is characterized by distressing recollections of events associated with traumatic stressors such as road traffic accidents, rapes, war combats and natural disasters (Cyr and Farrar, 2001). The lifetime prevalence of PTSD was estimated to be 8% in the United States (Kessler et al., 1995), although this figure varies according to the diagnostic criteria applied (Breslau, 2001). A high proportion of these patients suffer from psychiatric co-morbidities such as major depressive disorder (MDD) (Marshall et al., 2001b). Furthermore, chroni- city is common: about 40% of patients with PTSD were found to be symptomatic 10 years after the event (Falkai, 1999). Therefore, early recognition of PTSD and timely intervention are key elements in preventing the illness from evolving into its chronic form (Davidson and Connor, 1999). The first drug approved by the Food and Drug Administration (FDA) in the United States for the treatment of PTSD was sertraline. The efficacy and tolerability (Brady et al., 2000) of the drug as well the prophylactic value (Davidson et al., 2001) has been investigated in a number of randomized con- trolled trials. Evidence on the efficacy and safety of other selective serotonin-reuptake inhibitors (SSRIs) has also accumulated rapidly (Marshall et al., 1998; Marshall et al., 2001a; Hertzberg et al., 2000; Hidalgo et al., 1999; Tucker et al., 2001). The novel antidepressant mirtazapine possesses unique pharmacological properties in that blockades are attained for both post-synaptic 5-HT2 and 5-HT3 receptors as well as the pre-synaptic -2 receptors. A Received 30 April 2002 Copyright # 2002 John Wiley & Sons, Ltd. Accepted 8 July 2002 * Correspondence to: Dr C.-U. Pae, Department of Psychiatry, College of Medicine, The Catholic University of Korea, Kangnam St Mary’s Hospital, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea. Tel: þ 82-2-590-1532, 1533. Fax: þ 82-2-594-3870. E-mail: pae@cmc.cuk.ac.kr