-
International Journal of Health Sciences 2022Although there are numerous drugs available for the treatment of gastric ulcers (GU), these drugs are not always effective. Antidepressant medications have been used for...
OBJECTIVES
Although there are numerous drugs available for the treatment of gastric ulcers (GU), these drugs are not always effective. Antidepressant medications have been used for a variety of non-psychiatric indications, including antiulcer activity in various ulcer models. The purpose of this study was to compare the antiulcer effects of fluvoxamine and mirtazapine in two rat GU experimental models and to determine their relationship to antioxidant and antisecretory mechanisms.
MATERIALS AND METHODS
The antiulcer activities of various doses of fluvoxamine and mirtazapine on water immersion restraint stress (WIRS) and pyloric ligation-induced GU in rats have been studied against the positive control antiulcer drug famotidine. Various oxidative stress markers were evaluated.
RESULTS
Fluvoxamine and mirtazapine significantly protected against WIRS and pyloric ligation-induced gastric lesions, as evidenced by a dose-dependent decrease in ulcer index, myeloperoxidase (MPO) activity, lipid peroxidation, and an increase in prostaglandin E2, nitric oxide (NO), and reduced glutathione levels, as well as increased antioxidant enzyme activity. In the pyloric ligation model, fluvoxamine and mirtazapine improved GU more than famotidine. Furthermore, a 30 mg/kg dose of mirtazapine significantly improves both NO levels and MPO activity compared to famotidine.
CONCLUSIONS
The results highlighted the relationship in correlating the antiulcer effect of drugs from different antidepressant classes across two animal GU models, implying that antidepressants that affected both norepinephrine and serotonin levels (mirtazapine) had a more potent antiulcer effect in WIRS-induced gastric model than drugs that only affected serotonin levels (fluvoxamine).
PubMed: 35599943
DOI: No ID Found -
Drug Design, Development and Therapy 2017Gastroparesis symptoms can be severe and debilitating. Many patients do not respond to currently available treatments. Mirtazapine has been shown in case reports to...
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. -values were calculated using the paired two-tailed Student's -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 -values <0.05) compared with pretreatment. There was a statistically significant improvement in the CPGAS score at week 2 (=0.003) and week 4 (<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.
Topics: Adult; Aged; Aged, 80 and over; Female; Gastroparesis; Humans; Male; Mianserin; Middle Aged; Mirtazapine; Young Adult
PubMed: 28408802
DOI: 10.2147/DDDT.S125743 -
Journal of Chromatography. A Aug 2022A simple, rapid, and sensitive technique for measuring mirtazapine and its metabolites enantiomers in human fluids, such as urine and serum, was developed by applying...
Ultrasensitive analysis of mirtazapine and its metabolites enantiomers in body fluids using ultrasound-enhanced and surfactant-assisted dispersive liquid-liquid microextraction followed by polymer-mediated stacking in capillary electrophoresis.
A simple, rapid, and sensitive technique for measuring mirtazapine and its metabolites enantiomers in human fluids, such as urine and serum, was developed by applying ultrasound-enhanced and surfactant-assisted dispersive liquid-liquid microextraction (USA-DLLME) integrated with poly(diallyldimethylammonium chloride) (PDDAC)-mediated stacking in capillary electrophoresis (CE). The parameters that affect extraction and stacking performance, such as the extraction volume, surfactant types, surfactant concentrations, salt additives, extraction time, solution pH, and background electrolytes, were comprehensively studied and optimized to achieve optimal detection performance. Under optimal extraction conditions (injection of 120 µL of CHCl into 1 mL of a sample solution containing 0.05 mM Brij-35 at pH 10.0) and separation conditions (0.9% PDDAC, 10 mM phosphate, pH 3.0, and 20 mM dimethyl-β-cyclodextrin), on-line CE stacking of mirtazapine-related chiral drugs was achieved by the two strategies: (i) neutral DM-β-CD sweep low concentrations of DL-NaSSA and (ii) DL-NASSA is stacked by the difference in the viscosity between the PDDAC and sample zone. An approximately 2,800-4000-fold improvement in detection sensitivity was revealed for mirtazapine, N-demethylmirtazapine, and 8-hydroxymirtazapine enantiomers. The linear ranges for the quantification of all analyte enantiomers were 1.2-150 nM, with a coefficient of determination higher than 0.99; the relative standard deviations in the migration time and peak areas for six analytes were less than 1.8% and 5.8%, respectively. The proposed system provided the limits of detection (signal-to-noise ratio of 3) of the six analytes as 0.3-0.5 nM. The recovery of the six separated analytes spiked in urine and serum samples was revealed to be 82.7%-109.5% and 91%-112.8%, respectively. This advanced technique with high sensitivity enhancement factors was successfully employed to analyze mirtazapine and its metabolites enantiomers in urine and serum samples with reliability.
Topics: Body Fluids; Electrophoresis, Capillary; Humans; Liquid Phase Microextraction; Mirtazapine; Polymers; Reproducibility of Results; Surface-Active Agents
PubMed: 35914407
DOI: 10.1016/j.chroma.2022.463328 -
The Journal of Dermatological Treatment Mar 2021Mirtazapine has traditionally been used for the treatment of major depressive disorder, with an added benefit in patients who have comorbid insomnia or anxiety. Recent... (Review)
Review
BACKGROUND/OBJECTIVE
Mirtazapine has traditionally been used for the treatment of major depressive disorder, with an added benefit in patients who have comorbid insomnia or anxiety. Recent studies describe its usefulness in treating refractory pruritus of various causes as well. Our goal is to better define the use of mirtazapine in the treatment of refractory pruritus.
METHOD
Through a thorough literature review of PubMed, we identified all reports of the use of mirtazapine for pruritus.
RESULTS
Upon examination of 8 supporting articles, we found mirtazapine has quality evidence for the treatment of intra-thecal morphine-induced pruritus. Mirtazapine may also be effective in treating pruritus related to various other conditions, including psoriasis, atopic dermatitis, cutaneous malignancies (primary or metastatic), hematologic malignancies (lymphomas and leukemias), liver failure, renal failure, cholestasis, as well as pruritus of unknown origin.
CONCLUSIONS
Mirtazapine plays a role in treatment for intra-thecel morphine-induced pruritis yet high-quality trials are needed to confirm its efficacy in other dermatologic conditions.
Topics: Analgesics, Opioid; Antidepressive Agents; Clinical Trials as Topic; Humans; Mirtazapine; Pruritus; Receptors, Histamine H1; Receptors, Serotonin
PubMed: 31180795
DOI: 10.1080/09546634.2019.1630702 -
The Consultant Pharmacist : the Journal... Nov 2015The patient is a 75-year-old male who was admitted to the long-term care unit because of advancing dementia and was being treated with mirtazapine to improve his mood...
The patient is a 75-year-old male who was admitted to the long-term care unit because of advancing dementia and was being treated with mirtazapine to improve his mood and stimulate his appetite. This case report outlines an interesting occurrence of hypertriglyceridemia followed by hyperglycemia, which resembled diabetes mellitus and required insulin therapy. The patient continued to have elevated triglyceride levels that persisted despite discontinuation of mirtazapine therapy.
Topics: Aged; Antidepressive Agents, Tricyclic; Depression; Humans; Hyperglycemia; Hypertriglyceridemia; Male; Mianserin; Mirtazapine
PubMed: 26629801
DOI: 10.4140/TCP.n.2015.657 -
Journal of Addictions Nursing 2019The ongoing drug crisis in the United States continues to be headlined with numbers of deaths related to opioid overdose. Less known to the public and health care... (Review)
Review
BACKGROUND
The ongoing drug crisis in the United States continues to be headlined with numbers of deaths related to opioid overdose. Less known to the public and health care providers is the rise in methamphetamine use, often in conjunction with opioids or adulterated with fentanyl. An old practice with a new twist is the use of methamphetamine in conjunction with an opioid such as heroin.
PURPOSE
Although there are no Food and Drug Administration-approved medications to treat individuals with stimulant use disorders, a review of available studies suggests a few promising medications that may be helpful for patients in early recovery from methamphetamine.
OUTCOME
Some individuals are more likely to respond to medications such as long-acting naltrexone, bupropion, and mirtazapine, who have light-to-moderate use of methamphetamine. Naloxone kits should be considered for all patients who are actively using stimulants because of a high potential of adulterated methamphetamine.
Topics: Amphetamine-Related Disorders; Bupropion; Central Nervous System Stimulants; Dextroamphetamine; Drug Approval; Humans; Illicit Drugs; Methamphetamine; Methylphenidate; Mirtazapine; Naltrexone; Narcotic Antagonists; Opioid Epidemic; Opioid-Related Disorders; Treatment Outcome; United States
PubMed: 31478970
DOI: 10.1097/JAN.0000000000000298 -
Journal of the American Academy of... Apr 2018Avoidant and restrictive food intake disorder (ARFID) is a newly classified disorder in the DSM-5 that describes a pattern of restrictive eating across the lifespan that...
Avoidant and restrictive food intake disorder (ARFID) is a newly classified disorder in the DSM-5 that describes a pattern of restrictive eating across the lifespan that results in significant weight loss, nutritional deficiency, dependence on enteral feeding or nutritional supplements, or marked interference in psychosocial functioning. Currently, there are no evidence-based treatment approaches or medications for this disorder. We have administered a range of psychoactive medications to those with ARFID in our treatment program in an attempt to find an effective medication. One medication of interest has been mirtazapine because it promotes appetite and weight gain, decreases nausea and vomiting, and improves gastric emptying. Although mirtazapine is an off-label approach in a pediatric population and carries a black box warning for an increased risk of suicide, it is an effective treatment for depression and anxiety symptoms in adults and is generally well tolerated. There are no studies to date reporting on the use of mirtazapine in patients with ARFID.
Topics: Adolescent; Adult; Antidepressive Agents; Anxiety Disorders; Child; Feeding and Eating Disorders; Female; Humans; Male; Mirtazapine; Mood Disorders; Off-Label Use; Retrospective Studies; Weight Gain; Young Adult
PubMed: 29588055
DOI: 10.1016/j.jaac.2018.01.011 -
Journal of the American Association For... Sep 2022Inappetence is a welfare concern in rabbits (, as it can lead to potentially fatal gastrointestinal stasis. In other species, inappetence is commonly treated with...
Inappetence is a welfare concern in rabbits (, as it can lead to potentially fatal gastrointestinal stasis. In other species, inappetence is commonly treated with appetite stimulants; however, few published studies have evaluated the efficacy of appetite stimulants in rabbits. We performed 2 studies to evaluate the effects of capromorelin and mirtazapine on appetite in New Zealand White (NZW) rabbits. In the first study, healthy rabbits ( = 9) were evaluated using a randomized crossover design and 9 treatments: capromorelin 4 mg/kg oral (PO) once a day (SID), capromorelin 8 mg/kg PO SID, saline control PO SID, capromorelin 4 mg/kg PO twice a day (BID), capromorelin 8 mg/kg PO BID, saline control PO BID, mirtazapine 0.5 mg/kg transdermal (TD) SID, mirtazapine 1 mg/kg TD SID, and saline control TD SID for 3 d with a 1-wk washout period between treatments. Treatment efficacy was assessed by measuring daily feed intake and fecal output and by weighing rabbits twice a week. Overall, feed intake and fecal output were higher for all treatments as compared with controls, except for fecal output in the capromorelin 4 mg/kg and 8 mg/kg PO SID groups. Feed intake and fecal output were significantly higher with mirtazapine as compared with capromorelin. Body weight and erythema/petechia of the pinnae were greater in the mirtazapine 1 mg/kg TD SID group than in the control group. A second study evaluated rabbits that had undergone surgery (castration, = 7) and then received one of 3 treatments: capromorelin 8 mg/kg PO BID, mirtazapine 1 mg/kg TD SID, or saline PO BID for 3 d postoperatively. Feed intake and fecal output in the postoperative mirtazapine group were not significantly different from those of the capromorelin and control groups. Due to its superior efficacy as compared with capromorelin in healthy NZW rabbits, we recommend considering mirtazapine as a treatment for inappetence in NZW rabbits.
Topics: Animals; Rabbits; Appetite; Appetite Stimulants; Mirtazapine; Piperidines; Pyrazoles
PubMed: 35981857
DOI: 10.30802/AALAS-JAALAS-22-000003 -
PloS One 2022Hormonal fluctuations, such as the perinatal period, may increase susceptibility of women to depression, which in turn exert a negative impact on child's...
Hormonal fluctuations, such as the perinatal period, may increase susceptibility of women to depression, which in turn exert a negative impact on child's neurodevelopment, becoming a risk factor in development of neuropsychiatric disorders. Moreover, the use of antidepressants during this critical period presents a serious health concern for both the mother and the child, due to the consequences of treatment in terms of the reliability and safety for the proper neurodevelopment of the organism being not well known. Atypical antidepressants, such as mirtazapine, that targets both serotonergic and noradrenergic systems in the central nervous system (CNS), represent a novel focus of research due to its unique pharmacological profile. The aim of this work was to study the effects of maternal depression and/or perinatal antidepressant mirtazapine treatment on the neurobehavioral development of the offspring. Pre-gestationally chronically stressed or non-stressed Wistar rat dams were treated with either mirtazapine (10 mg/kg/day) or vehicle during pregnancy and lactation followed by analysis of offspring's behavior at juvenile and adolescent age. We found mirtazapine induced significant alterations of nursing behavior. In offspring, pregestational stress (PS) had an anxiogenic effect on adolescent males (p≤0.05) and increased their active behavior in forced swim test (p≤0.01). Interaction between pregestational stress and mirtazapine treatment variously induced anxiolytic changes of juvenile (p≤0.05) and adolescent (p≤0.05) females and impairment of spatial memory (p≤0.01) in adolescent females as well. Hippocampal density of synaptophysin, pre-synaptic protein marker, was decreased mainly by mirtazapine treatment. In conclusion, our results show mirtazapine induced significant alterations in maternal behavior and several sex- and age-dependent changes in neurobehavioral development of offspring caused by both prenatal mirtazapine treatment and/or chronic pregestational stress.
Topics: Mirtazapine
PubMed: 35113878
DOI: 10.1371/journal.pone.0255546 -
Behavioural Pharmacology Sep 2023Epidemiological studies have mentioned that cocaine use disorder (CUD) has increased in the last decade among women; these show endocrine and reproductive disorders and...
Epidemiological studies have mentioned that cocaine use disorder (CUD) has increased in the last decade among women; these show endocrine and reproductive disorders and a high propensity to stress and depression disorders. Mirtazapine-a tetracyclic antidepressant-decreases cocaine-induced locomotor activity and locomotor sensitization in male rats. The objective of this study was to evaluate if estradiol alters the efficacy of mirtazapine to decrease cocaine-induced locomotor activity in sham and ovariectomized female rats. Three hundred and twenty adult female Wistar rats were assigned to three experimental protocols. For experiments, 1-3, female rats were daily dosed with 10 mg/kg of cocaine during the 10 days of induction and expression of locomotor sensitization. During drug withdrawal (30 days), cocaine was withdrawn and the groups received daily mirtazapine, estradiol, or saline. In addition, the females underwent sham or ovariectomy surgery. Tamoxifen was administered during the antagonism phase. After each administration, locomotor activity for each animal was recorded for 30 min in activity chambers. The dosage of mirtazapine reduces estradiol-induced enhancement in cocaine-dependent locomotor activity during the expression of locomotor sensitization in sham and ovariectomized female rats. As well as they showed that estradiol co-dosed with mirtazapine enhances the efficacy of mirtazapine to decrease cocaine-induced locomotor activity. Finally, tamoxifen enhanced the estradiol and mirtazapine-induced decrease in the cocaine motor effect in female rats. Mirtazapine may be considered an effective therapeutic option for the treatment of CUD in women, even in those who are on hormonal treatment or antidepressant therapy with estradiol.
Topics: Rats; Female; Male; Animals; Cocaine; Mirtazapine; Estradiol; Rats, Wistar; Antidepressive Agents
PubMed: 37530137
DOI: 10.1097/FBP.0000000000000743