Abstract: Objective To compare the curative effects and safety of mirtazapine and fluoxetine in treatment of elderly depressive patients with insomnia.Methods 92 cases of elderly depressive patients with insomnia were randomly divided into two groups: the mirtazapine treatment group and the fluoxetine treatment group. The period of treatment was six weeks. The antidepressant effect was assessed with the drop rate of Hamilton Depression Scale (HAMD),the effect of improving sleep was assessed with HAMD sleep disturbance factor and the Pittsburgh Sleep Index (PSQI), and the administration of security was assessed with vice Treatment Emergent Symptom Scale (TESS).Results After treatment, the effective rate of the mirtazapine group was 90.9% (40/44), that of the fluoxetine group was 84.1% (37/44). In the end of 1st, 2nd, and 4th weeks after treatment, the difference between the two groups were significant (P<0.001). At the end of 6th week, the difference was not significant (P>0.05) in HAMD; the difference was significant in HAMD sleep disturbance factor and PSQI score (P<0.05).Conclusion The clinical effects of mirtazapine in treatment of depression are similar to that of fluoxetine, but mirtazapine takes effects fast, can improve the symptoms of insomnia, has higher safety and better compliance, and is more appropriate for the depressive elderly patients with insomnia than fluoxetine.

Key words: depression, insomnia, mirtazapine, fluoxetine