title: Mirtazapine: only for depression?
abstract: BACKGROUND
  Mirtazapine is an antidepressant first approved in the Netherlands in 1994 for the treatment of major depressive disorder. However, evidence suggests its effectiveness in a variety of other psychiatric disorders and non-psychiatric medical conditions.
  
  
  OBJECTIVE
  The present paper reviews the published literature on the off-label indications of Mirtazapine.
  
  
  METHODS
  A search of the relevant literature from MEDLINE, PsycLIT and EMBASE databases, included in the Science Citation Index and available up to March 2006, was conducted using the terms mirtazapine, case-reports, open-label trials and randomized controlled trials. Only articles referring to conditions other than major depression were included in this present review.
  
  
  RESULTS
  Off-label use of mirtazapine has been reported in panic disorder, post-traumatic stress disorder, generalized anxiety disorder, social phobia, obsessive-compulsive disorder, dysthymia, menopausal depression, poststroke depression, depression as a result of infection with human immunodeficiency virus, elderly depression, Methylenedioxymethamphetamine (MDMA)-induced depression, hot flashes, alcohol and other substance use disorders, sleep disorders, sexual disorders, tension-type headaches, cancer pain, fibromyalgia, schizophrenia and other less frequent conditions.
  
  
  CONCLUSIONS
  So far, data on the off-label usefulness of mirtazapine are limited and mainly based on observations from case reports or open-label studies. However, positive cues suggest that confirmation of these preliminary data with randomized controlled trials may give sufficient evidence to warrant the use of mirtazapine in a broad range of disorders.
authors.affiliation: 1Department of Psychiatry, Hospital de San Rafael, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: San
authors.affiliation: 1Department of Psychiatry, Hospital de San Rafael, Barcelona, Spain.
authors.forename: Belen
authors.initials: B
authors.lastname: Arranz