Rapid improvement in post-infectious gastroparesis symptoms with mirtazapine

作     者：Shinjini Kundu Shari Rogal Abdulkader Alam David J Levinthal 

作者机构：Medical Scientist Training ProgramUniversity of Pittsburgh School of MedicinePittsburghPA 15261United States Division of GastroenterologyHepatologyand NutritionDepartment of MedicineUniversity of Pittsburgh Medical CenterPittsburghPA 15213United States Department of PsychiatryStony Brook University HospitalStony BrookNY 11794United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第21期

页      面：6671-6674页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Supported by University of Pittsburgh Medical Center Pittsburgh PA United States 

主　　题：Nausea Vomiting Gastroparesis Symptoms Mirtazapine 

摘      要：We report the case of a 34-year-old woman with severe post-infectious gastroparesis who was transferred from an outside medical facility for a second opinion regarding management.This patient had no prior history of gastrointestinal symptoms.However,in the aftermath of a viral illness,she developed two months of intractable nausea,vomiting,and oral intake intolerance that resulted in numerous hospitalizations for dehydration and electrolyte disturbances.A solid-phase gastric emptying scan had confirmed delayed emptying,confirming gastroparesis.Unfortunately,conventional pro-kinetic agents and numerous anti-emetic drugs provided little or no relief of the patient’s symptoms.At our institution,the patient experienced a cessation of vomiting,reported a significant reduction in nausea,and toler-ated oral intake shortly after taking mirtazapine.Based on mirtazapine’s primary action as a serotonin(5-HT)1a receptor agonist,we infer that this receptor system mediated the clinical improvement through a combination of peripheral and central neural mechanisms.This report highlights the potential utility of 5-HT1a agonists in the management of nausea and vomiting.We conclude that mirtazapine may be effective in treating symptoms associated with non-diabetic gastroparesis that are refractory to conventional therapies.