title: Mirtazapine use in resistant hyperemesis gravidarum: report of three cases and review of the literature.
abstract: BACKGROUND
  Hyperemesis gravidarum is a serious health problem for the fetus and the mother. Effective treatment regimens are obscure in patients with severe symptoms. Our aim was to use mirtazapine in hyperemesis gravidarum patients who failed to respond to conventional anti-emetic drugs.
  
  
  METHODS
  Three pregnant women who had severe hyperemesis gravidarum. All patients had dehydration, ketonuria, hypokalemia, and weight loss. All failed to respond to conventional anti-emesis treatment regimens, such as metoclopramide and promethazine. Al patients had mirtazapine 30 mg/day within the intravenous fluid support approximately for 1 week. All responded to mirtazapine within 24 h and were able to resume diet within a few days after the initiation of treatment. None of these pregnant women had any disturbing symptoms of emesis throughout the pregnancy and had healthy newborns.
  
  
  CONCLUSIONS
  Mirtazapine seems to be an effective treatment modality in patients with severe hyperemesis gravidarum who do not respond to conventional anti-emesis treatment regimens. Larger-scaled studies should be performed to show the effectiveness of mirtazapine in pregnant women with severe hyperemesis gravidarum who may request pregnancy termination.
authors: Faculty of Medicine, Department of Obstetrics & Gynecology, Dokuz Eylul University, Izmir, Turkey. serkan.guclu@deu.edu.tr
authors: Serkan
authors: S
authors: Guclu
authors: Mert
authors: M
authors: Gol
authors: Erbil
authors: E
authors: Dogan
authors: Ugur
authors: U
authors: Saygili
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000188:drug therapy*; D007231:Infant, Newborn; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000078785:Mirtazapine; D011247:Pregnancy
chemical_list: D000932:Antiemetics; D008803:Mianserin; D000078785:Mirtazapine