Mirtazapine for severe gastroparesis unresponsive to conventional prokinetic treatment.
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.
Kim
Sung-wan
SW
Department of Psychiatry, Chonnam National Univ. Hospital, 8 Hak-dong, Dong-ku, Kwangju 501-757, Republic of Korea.
Shin
Il-seon
IS
Kim
Jae-min
JM
Kang
Ho-cheol
HC
Mun
Ji-ung
JU
Yang
Su-jin
SJ
Yoon
Jin-sang
JS
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D000932:Antiemetics / Q000008:administration & dosage; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004351:Drug Resistance / Q000187:drug effects*; D004917:Erythromycin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D018589:Gastroparesis / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage; D008787:Metoclopramide / Q000008:administration & dosage; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000078785:Mirtazapine; D009325:Nausea / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014839:Vomiting / Q000150:complications / Q000188:drug therapy / Q000523:psychology
D000929:Antidepressive Agents, Tricyclic; D000932:Antiemetics; D005765:Gastrointestinal Agents; D008803:Mianserin; D004917:Erythromycin; D000078785:Mirtazapine; D008787:Metoclopramide; D008140:Lorazepam