Pisa syndrome associated with mirtazapine: a case report

BMC Pharmacol Toxicol. 2018 Dec 6;19(1):82. doi: 10.1186/s40360-018-0272-8.


Background: Mirtazapine is a noradrenergic and specific serotonergic antidepressant; its pharmacological profile indicates a low risk for dopaminergic adverse effects. To date, there has been only a single case report of Pisa syndrome associated with mirtazapine.

Case presentation: The authors report a case involving a 79-year-old woman with bipolar disorder, in whom Pisa syndrome occurred after introduction of mirtazapine, and completely disappeared 3 days after suspension of the drug.

Conclusions: Aspects of this particular case suggest that Pisa syndrome is a possible side effect of Mirtazapine.

Keywords: Bipolar disorder; Dystonia; Mirtazapine; Pisa syndrome; Side-effects.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antidepressive Agents / adverse effects*
  • Bipolar Disorder / drug therapy
  • Dystonia / chemically induced*
  • Female
  • Humans
  • Mirtazapine / adverse effects*
  • Syndrome


  • Antidepressive Agents
  • Mirtazapine