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Rapid improvement in post-infectious gastroparesis symptoms with mirtazapine

World Journal of Gastroenterology 2014年第21期20卷 6671-6674页

作者： Shinjini Kundu Shari Rogal abdulkader alam David J Levinthal Medical Scientist Training Program University of Pittsburgh School of MedicinePittsburghPA 15261United States Division of Gastroenterology Hepatologyand NutritionDepartment of MedicineUniversity of Pittsburgh Medical CenterPittsburghPA 15213United States Department of Psychiatry Stony Brook University HospitalStony BrookNY 11794United States

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.

关键词： Nausea Vomiting Gastroparesis Symptoms Mirtazapine

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