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Mirtazapine: only for depression?

Published online by Cambridge University Press:  24 June 2014

Luis San  and
Belen Arranz
Luis San*
Affiliation:
Department of Psychiatry, Hospital de San Rafael, Barcelona, Spain
Belen Arranz
Affiliation:
Department of Psychiatry, Hospital de San Rafael, Barcelona, Spain
*
Luis San, Department of Psychiatry, Hospital de San Rafael, Passeig Vall d’Hebrón, 107-117, 08035 Barcelona, Spain. Tel: 34 629 736 820; Fax: 34 932 541 117; E-mail: 12636LSM@COMB.ES
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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.

Keywords

case reportscontrolled trialsmirtazapineopen-label trialsrandomized
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 18 , Issue 3-4 , June 2006 , pp. 130 - 143
Copyright
Copyright © 2006 Blackwell Munksgaard

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