Mirtazapine for chronic insomnia in older adults: a randomised double-blind placebo-controlled trial—the MIRAGE study.

This article reports on the MIRAGE study, a double-blind, randomized, placebo-controlled clinical trial evaluating the efficacy and safety of mirtazapine, a tetracyclic antidepressant, in treating chronic insomnia in adults aged 65 and older. Over 28 days, mirtazapine 7.5 mg significantly reduced insomnia severity, as measured by the Insomnia Severity Index (ISI), and improved subjective sleep parameters such as wake after sleep onset, total sleep time, and sleep efficiency compared to placebo. While no severe adverse events occurred, the mirtazapine group experienced more mild adverse events and higher treatment discontinuation rates, primarily due to daytime drowsiness and flu-like symptoms. The study concludes that mirtazapine may be a therapeutic option for chronic insomnia in older adults but highlights the need for further research to confirm its long-term efficacy and safety.