Mirtazapine and olanzapine reduce anxiety and depression scores in oral cavity cancer patients.

OBJECTIVES: Psychological distress is a common yet under-recognised complication in cancer patients, significantly affecting quality of life, treatment adherence and clinical outcomes. Patients with oral cavity cancer are particularly susceptible due to the visible disfigurement caused by the disease, speech and swallowing impairments and associated social stigma, which contribute to heightened levels of anxiety, depression and social withdrawal. This study aimed to evaluate and compare the efficacy and safety of olanzapine and mirtazapine in managing psychological distress in patients with oral cavity cancer. METHODS: A total of 144 patients fulfilling the inclusion criteria were randomly allocated into two groups of 77 patients each. Group M received the tablet mirtazapine 15 mg/day orally; Group O received the tablet olanzapine 5 mg/day orally at bed time. All patients were assessed by using the Hospital Anxiety and Depression Score at the time of the first visit, then the follow-up visit at second and fourth weeks. Data were collected and analysed. RESULTS: Both mirtazapine and olanzapine led to significant reductions in anxiety and depression scores over time, with p<0.001. Mirtazapine reduced anxiety scores from 14.10 at admission to 10.28 in the fourth week, while olanzapine reduced them from 14.08 to 10.97. For depression, mirtazapine showed a decrease from 14.07 to 10.24, compared with a reduction from 14.01 to 10.98 with olanzapine. The overall drug effect was statistically significant, though no significant interaction between drug and time was observed. CONCLUSION: Both mirtazapine and olanzapine effectively reduced anxiety and depression, with mirtazapine showing greater efficacy. Mirtazapine may be preferred, though olanzapine remains a viable alternative.