Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment

Psychosomatics. Sep-Oct 2006;47(5):440-2. doi: 10.1176/appi.psy.47.5.440.

Abstract

Gastroparesis is a condition of abnormal gastric motility characterized by delayed gastric emptying without evidence of mechanical outlet obstruction. The authors describe complete remission of recurrent postprandial discomfort, nausea, and vomiting within 1 week of starting mirtazapine in a gastroparetic patient who had failed to respond, in 7 months, to conventional prokinetics (erythromycin, metoclopramide, domperidone, perphenazine, itopride, bethanechol, and/or tegaserod) and pyloric injection of botulinum toxin. This is the first report to show that mirtazapine may be an effective alternative when gastroparesis is refractory to conventional measures.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Antiemetics / administration & dosage
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology
  • Diabetes Mellitus, Type 1 / complications
  • Drug Resistance / drug effects*
  • Erythromycin / administration & dosage
  • Female
  • Follow-Up Studies
  • Gastrointestinal Agents / administration & dosage
  • Gastroparesis / complications
  • Gastroparesis / drug therapy*
  • Gastroparesis / psychology
  • Humans
  • Lorazepam / administration & dosage
  • Metoclopramide / administration & dosage
  • Mianserin / analogs & derivatives*
  • Mianserin / therapeutic use
  • Mirtazapine
  • Nausea / complications
  • Nausea / drug therapy
  • Nausea / psychology
  • Severity of Illness Index
  • Treatment Outcome
  • Vomiting / complications
  • Vomiting / drug therapy
  • Vomiting / psychology

Substances

  • Antidepressive Agents, Tricyclic
  • Antiemetics
  • Gastrointestinal Agents
  • Mianserin
  • Erythromycin
  • Mirtazapine
  • Metoclopramide
  • Lorazepam