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2017 ; 11
(ä): 1035-1041
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Mirtazapine for symptom control in refractory gastroparesis
#MMPMID28408802
Malamood M
; Roberts A
; Kataria R
; Parkman HP
; Schey R
Drug Des Devel Ther
2017[]; 11
(ä): 1035-1041
PMID28408802
show ga
INTRODUCTION: Gastroparesis symptoms can be severe and debilitating. Many
patients do not respond to currently available treatments. Mirtazapine has been
shown in case reports to reduce symptoms in gastroparesis. AIM: To assess the
efficacy and safety of mirtazapine in gastroparetic patients. METHODS: Adults
with gastroparesis and poorly controlled symptoms were eligible. Participants
were prescribed mirtazapine 15 mg PO qhs. Questionnaires containing the
gastrointestinal cardinal symptom index (GCSI) and the clinical patient grading
assessment scale (CPGAS) were completed by patients' pretreatment, at 2 weeks,
and at 4 weeks. Primary end point was nausea and vomiting response to mirtazapine
using the GCSI. Secondary end point was nausea and vomiting severity assessment
using the CPGAS. P-values were calculated using the paired two-tailed Student's
t-test. Intention to treat analysis was used. RESULTS: A total of 30 patients
aged 19-86 years were enrolled. Of those, 24 patients (80%) completed 4 weeks of
therapy. There were statistically significant improvements in nausea, vomiting,
retching, and perceived loss of appetite at 2 and 4 weeks (all P-values <0.05)
compared with pretreatment. There was a statistically significant improvement in
the CPGAS score at week 2 (P=0.003) and week 4 (P<0.001). Of the total patients,
14 (46.7%) experienced adverse effects from mirtazapine and due to this, 6
patients stopped therapy. CONCLUSION: Mirtazapine significantly improved both
nausea and vomiting in gastroparetics after 2 and 4 weeks of treatment. Side
effects led to treatment self-cessation in a fifth of patients. From these data,
we conclude that mirtazapine improves nausea and vomiting, among other symptoms,
in patients with gastroparesis and might be useful in select patients.
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Female
[MESH]
|Gastroparesis/*drug therapy/surgery
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Mianserin/administration & dosage/*analogs & derivatives/therapeutic use
[MESH]