[Low-dose mirtazapine improved nausea and appetite loss during S-1 therapy]

Gan To Kagaku Ryoho. 2012 Jan;39(1):143-5.
[Article in Japanese]


This paper presents a man in his 80's with pancreatic cancer(cStage IV). He suffered from nausea duringS -1 therapy, and therefore, prochlorperazine maleate at a daily dose of 15 mgwas administered. However, refractory nausea was diagnosed because it did not improve, and mirtazapine at a daily dose of 7. 5 mgbefore bedtime was started. Nausea was improved in the next morning, and the patient ate almost all of his breakfast. After that, no nausea appeared, and his food intake was robust. Mirtazapine is a new antidepressant called noradrenergic and specific serotonergic antidepressant(NaSSA)and blocks 5-HT3 receptors to improve nausea. Mirtazapine is usually started at a daily dose of 15 mg, but this dose induces somnolence. Therefore, mirtazapine was administered at a low daily dose of 7. 5 mgin the present case. No somnolence or disturbance of daily life was seen, and administration was safely continued. We conclude that low-dose mirtazapine is one effective option for refractory nausea duringS -1 therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anorexia / prevention & control*
  • Antimetabolites, Antineoplastic / adverse effects*
  • Antimetabolites, Antineoplastic / therapeutic use
  • Drug Combinations
  • Histamine H1 Antagonists / administration & dosage
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Male
  • Mianserin / administration & dosage
  • Mianserin / analogs & derivatives*
  • Mianserin / therapeutic use
  • Mirtazapine
  • Nausea / prevention & control*
  • Neoplasm Staging
  • Oxonic Acid / adverse effects*
  • Oxonic Acid / therapeutic use
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Tegafur / adverse effects*
  • Tegafur / therapeutic use


  • Antimetabolites, Antineoplastic
  • Drug Combinations
  • Histamine H1 Antagonists
  • S 1 (combination)
  • Tegafur
  • Mianserin
  • Oxonic Acid
  • Mirtazapine