Age Ageing

Mirtazapine boosts sleep quality in older adults

May 6, 2025

This study provides the first robust evidence of mirtazapine's efficacy in reducing chronic insomnia symptoms in older adults. Despite mild adverse events, mirtazapine may be a valuable option for this population, warranting consideration in clinical practice.

Study details: The double-blind, randomized, placebo-controlled MIRAGE trial (NCT05247697) was conducted in a geriatric outpatient clinic. Sixty adults aged 65 and older with chronic insomnia were assigned to receive either mirtazapine 7.5 mg or placebo for 28 days. The primary efficacy endpoint was the change in Insomnia Severity Index (ISI) score from baseline to 28 days post-treatment. Safety endpoints included adverse events reported during the trial and those leading to premature discontinuation.

Results: Mirtazapine significantly outperformed placebo in reducing insomnia severity, with a mean ISI score change of -6.5 compared with -2.9 in the placebo group. Improvements were noted in wake after sleep onset, total sleep time, and sleep efficiency. No severe adverse events were reported, though six participants in the mirtazapine group and one in the placebo group discontinued due to adverse events.

Source:

Nguyen PV, et al. (2025, March 3). Age Ageing. Mirtazapine for chronic insomnia in older adults: a randomised double-blind placebo-controlled trial-the MIRAGE study. https://pubmed.ncbi.nlm.nih.gov/40135470/